PCOS Symptoms: From Missed Periods to Infertility

What Exactly is PCOS?

Polycystic Ovary Syndrome (PCOS) is a complex hormonal condition with multifactorial causes.

It is typically characterized by excess androgens (male hormones) and insulin resistance. These two factors lead to a variety of symptoms, most notably chronic anovulation (lack of ovulation).

The most common signs and symptoms of PCOS include: .

1. Irregular Menstrual Cycles

One of the hallmark symptoms of PCOS is irregular or missed periods. This happens because the majority of the patients with PCOS also have something called chronic anovulation. 

This is predominantly going to cause an impediment for the follicles to have enough maturity to grow and ultimately end up ovulating. This is predominantly going to occur because of the excessive androgen that is present in the microenvironment of the follicle and the ovarian cortex added to.

The insulin resistance causes a lot of these follicles to initially start their development and then end up with an Pothys political inside, and as a result of this, their entire follicular development gets arrested.

A lot of the girls who are especially young and have PCOS often come to the doctor predominantly with the same complaint that they have not been getting regular menstrual cycles, and in fact, they get a lot of worry because of this, due to the social pressure in the country.

A lot of effective treatment approaches are available for women who have regular periods and wish to have a symptomatic menstrual cycle.

However, PCS should always almost be treated in a holistic manner and not just based on symptomatology alone.

2. Weight Gain and Central Obesity

Due to insulin resistance, the way the body processes glucose is disrupted, leading to weight gain. This creates a vicious cycle involving excess androgens and chronic irregular menstrual cycles, which further worsens glucose metabolism and contributes to central obesity.

The patients also end up having a lot of weight gain along with that. It is also important to understand that this weight gain is going to be a very stringent weight gain for the patient, and a lot of them will experience a great amount of difficulty when it comes to losing this weight.

Another proportion of the obesity, which is characterized by PCOS, is predominantly going to be central obesity, where there is a lot of fat deposition. 

Most women with PCOS gain weight in the lower abdomen, buttocks, and inner thighs. This kind of weight gain is difficult to reverse and is often persistent.

As a result of insulin resistance, the body’s ability to process glucose becomes impaired. This creates a vicious cycle involving excess androgens and irregular menstrual cycles.

Many women with PCOS experience significant and stubborn weight gain. This weight is typically centralized—around the lower abdomen, buttocks, and inner thighs—and is difficult to lose. Even with lifestyle changes, weight loss tends to be slow and challenging.

3. Difficulty Losing Weight

As explained before, predominantly due to a lot of insulin resistance, the mechanism by which the glucose gets metabolized in the muscle and overall in the body gets severely compromised in a lady who is suffering from PCOS, and these are predominantly the women who are in the reproductive age group.

Though as doctors, we predominantly ask a lot of these women to undergo weight loss and clinical nutrition, as well as diet management therapy.

It is important for a patient to understand that this can be extremely difficult. Wait for them to lose in a lot of situations.

What happens to these women is that after having an initial weight loss, they become stagnant, and because they become stagnant, they lose the motivation to continue their efforts further, and this causes a relapse of the entire disease process.

4. Excessive Hair Growth (Hirsutism)

Excessive hair growth is basically a result of the excessive androgen that is produced in the microenvironment in the body of a lady who is suffering from PCOS because of the huge amount of androgen that is produced.

There is a lot of circulating free testosterone, which is available in the female body, and this causes a lot of Hirsutism. This needs a proper, thorough endocrinologist evaluation, and this is one of the hallmarks of a patient who is suffering from severe PCOS. 

The hair growth of PCOS is typically characterized by excessive or unwanted hair appearing in areas like under the chin, sideburns, upper and lower chest, upper and lower abdomen, upper and lower back, inner thighs, and above the buttocks.

A patient may resolve to a lot of therapy, especially dermatological and cosmetic therapy, in order to make sure that they undergo laser therapy over the hair in order to make sure that the hair growth does not occur for cosmetic benefit, but a patient must remember that the long-term outcome and treatment is going to be to cut the loop of PCOS, and this requires a good and sustained effort in the form of diet plus exercise plus other strategies.

5. Acne

Predominantly due to the androgen excess that occurs in the female body. As a result of PCOS, there is going to be a lot of secretion of oils, which is going to happen through the skin, and this causes a lot of oily skin on top of it, superseded infections from the local bacteria that are present over the skin due to the routine activity, causing ACNE.

This acne is predominantly present over the face, over the back, and over the upper aspect of the chest and the neck.

Treatment of acne can predominantly involve a long-term hormonal pill, which is to be used by the patient for at least the window of 12 to 16 months, and this needs to be combined in consultation with a dermatologist to make sure that the local lesions of the acne are well under control; otherwise, there can be a cosmetic disfigurement that can occur to these women.

6. Infertility

Infertility is a common complication of PCOS. 

It’s the hallmark of a patient who is suffering from PCOS because this is a disease that predominantly affects girls in the reproductive age group due to chronic anovulation and disturbances in ovarian development and an androgenic microenvironment.

A lot of women find there to be a great difficulty as far as ovulation is concerned, and as a result of this, because there is no ovulation, despite all other parameters for the female partner, like the age or the fallopian tubes, being absolutely favorable, the majority of them also end up being infertile.

The treatment options for infertility are extremely simple in a patient with PCOS, and they require a good amount of holistic care, which we have discussed in the infertility vertical.

It’s important to be cautious, as many women with PCOS may be unnecessarily advised to undergo in vitro fertilization (IVF), particularly due to the increasing commercialization of fertility treatments in India. IVF is not always required and should only be recommended when truly indicated.

The majority of the women who are advised to do IVF due to PCOS in India will end up taking our expert opinion, and believe me, only approximately 20% of them actually require in vitro fertilization (IVF).

The remaining 80% are easily managed by either medical or surgical options.

7. Endometrial Hyperplasia

Long-term PCOS can give rise to something called estrogen excess in the body of the female, and as a result of this, this can trigger endometrial hyperplasia, and as a result of this, it can lead to early development of endometrial cancer.

Women should clearly remember that if they are suffering from PCOS and if they are getting very, very infrequent periods, they must make sure that their obesity is kept under control as well as take some medication to artificially induce menstruation so that the exposure of estrogen to the uterus is cut down and there is shedding of the endometrium, which in turn prevents the development of endometrial cancer.

Ultrasound  Picture

Due to this chronic situation of PCOS, many women who are going for routine health checkups or getting an ultrasound done due to any other cause may have a radiologist report a PCOS-like picture represented in their ultrasound, and when they get this, they usually go into a state of shock and end up consulting doctors.

This should not be the first stage of consulting a doctor, because remember one thing: ultrasound is no longer even considered to be a diagnostic criterion for monitoring of the disease for women who are suffering from PCOS.

PCOS should not be treated symptomatically alone. A comprehensive, holistic approach is essential. This includes lifestyle changes, diet and exercise, medical therapy, and, in some cases, surgery. The aim is to break the vicious cycle of insulin resistance and androgen excess.

If you’re facing irregular periods, unwanted hair growth, weight gain, acne, or struggling with fertility—know that help is available. I’m Dr. Jay Mehta, and I specialize in treating PCOS with a holistic and personalized approach. You don’t have to navigate this alone.

Let’s find the right treatment plan for your unique body. Book a consultation at Shree IVF Clinic, Mumbai, and take the first step toward hormonal balance and better health.