PCOS Symptoms: From Weight Gain to Infertility

Polycystic Ovary Syndrome (PCOS) is a complex hormonal medical condition that produces a range of challenging symptoms – from pelvic pain and weight gain to irregular periods and infertility – that severely impact the quality of life for millions of women worldwide.

It is crucial to recognise the symptoms of this condition, because effective treatment can be accessed widely and affordably, and even extreme symptoms such as infertility can be managed effectively.

Polycystic ovary syndrome (PCOS) is a medical condition that affects millions of women worldwide. It is common among women of reproductive age, and symptoms may present soon after puberty, during the later teen years, or in early adulthood.

As a hormonal disorder that affects the ovaries, PCOS can lead to various health challenges, including weight gain, irregular menstrual cycles, fertility issues and other symptoms.

Sadly, because the symptoms are not generally well known, they are often unrecognised, undiagnosed, or misdiagnosed. As a result, many women do not receive treatment, and the quality of their lives are often severely impacted by the disease and its symptoms.

Here is a helpful list of PCOS symptoms provided by the PCOS Awareness Association.

Irregular periods

Infrequent periods are a common sign of PCOS, as women with PCOS typically have irregular or missed periods because they are not ovulating. For example, a woman with PCOS might have fewer than nine periods a year, or more than 35 days between periods. Some women with PCOS suffer from abnormally heavy periods.

Polycystic ovaries

Although many do not, some women may develop cysts on their ovaries. The ovaries might be enlarged and as a result, might fail to function regularly.

Excess androgen

Elevated levels of the male hormone androgen may result in physical symptoms, such as excess hair, severe acne and male-pattern baldness.

Pelvic pain

Pelvic pain may occur with periods, along with heavy bleeding. Pelvic pain may also occur even between periods.


Many women with PCOS report increased fatigue and low energy. Related issues such as poor sleep may contribute to the feeling of fatigue.

Sleep problems

People with PCOS often report problems such as insomnia, trouble falling asleep, or poor sleep, and PCOS has also been linked to a sleep disorder called sleep apnea which causes people to stop breathing for short periods of time while they are sleeping.

Unwanted hair changes

Also known as hirsutism, excess hair growth related to hormonal changes in androgens may be experienced in areas such as the face, arms, back, chest, thumbs, toes, and abdomen. For some women, hair loss related to PCOS may increase in middle age.

Skin problems

Hormonal changes related to androgens can also lead to acne problems. Male hormones can make the skin oilier than usual and cause breakouts on areas like the face, chest, and upper back. In addition, PCOS may result in thick, dark, velvety patches of skin appearing under the arms or breasts, or on the back of the neck.

Mood changes and headaches

Having PCOS can increase the likelihood of mood swings and anxiety. Hormonal changes due to PCOS can also prompt headaches.


Hormonal changes and symptoms like unwanted hair growth can negatively affect emotions and many women with PCOS experience depression and anxiety.

Weight gain

One of the most frustrating symptoms that affect about half of people with PCOS is weight gain and obesity that is difficult to manage.

There are some key factors contributing to weight gain in PCOS, and these include insulin resistance, hormonal imbalance, increased appetite and cravings, reduced physical activity and certain medications.

PCOS often goes hand in hand with insulin resistance, making it tougher for the body to manage blood sugar levels. This can lead to storing extra calories as fat, especially around the midsection. Insulin resistance in PCOS primarily results from a combination of genetic factors, hormonal imbalances (including elevated androgens and insulin), obesity, chronic inflammation, and lifestyle choices such as poor diet and physical inactivity. These factors collectively disrupt the body’s ability to use insulin effectively, leading to higher insulin levels in the bloodstream and reduced glucose uptake by cells, ultimately contributing to insulin resistance in individuals with PCOS. Understanding these factors is crucial for effective management through balanced living and tailored healthcare.

PCOS also results in an imbalance in sex hormones, including excess male hormones or androgens. This hormonal turmoil can impact metabolism and make it more challenging to lose the weight.

PCOS can also cause increased appetite and sugar and carb cravings, that make it harder to control calorie intake. Similarly, PCOS can make it tough to keep up with regular exercise -essential to maintaining a healthy weight – due to symptoms like irregular periods, fatigue, and pelvic pain.

Furthermore, certain PCOS medications, such as hormonal treatments, might also cause weight gain as a side effect.


PCOS is a leading cause of female infertility, because PCOS can disrupt a woman’s menstrual cycles and make it harder to get pregnant.

Weight loss can treat PCOS symptoms and improve the odds of getting pregnant. Medicines are another option – both birth control pills and metformin are used to relieve PCOS symptoms in women trying to conceive.

However, not every woman with PCOS is the same. Although some are still able to conceive naturally, others may need the assistance of further fertility treatments.

Can PCOS be treated?

While PCOS can be a challenging and unwelcome part of life, the good news is that PCOS can be treated very effectively, and even extreme symptoms such as infertility can be managed effectively by adopting a proactive attitude towards health, making lifestyle changes, and seeking medical treatment.

Lifestyle interventions are the first treatments doctors recommend, because weight loss can treat PCOS symptoms and also improve the odds of getting pregnant. Medicines are another option. Both birth control pills and metformin are used by many to try to relieve PCOS symptoms.

Birth control pills can restore more normal menstrual cycles. Metformin is often used to treat type 2 diabetes and may help some women with PCOS
symptoms. Metformin improves insulin’s ability to lower blood sugar and can lower both insulin and androgen levels. After a few months of use, metformin may help restart ovulation, but it usually has little effect on acne and extra hair on the face or body.

What to do if you think you have PCOS

Women with PCOS face great difficulties and obstacles in managing their health and well-being, especially if they are trying to conceive. These challenges can be physical, emotional, and sometimes even social, as the condition can impact self-esteem and body image.

The exact cause of PCOS is unknown, and this makes early diagnosis and treatment along with weight loss crucial to reduce the risk of the long-term complications of PCOS such as type 2 diabetes and heart disease.

If you or someone you care about are suffering from the symptoms of PCOS, don’t delay in seeking medical assistance. Arranging an initial consultation with our team at Cape Fertility is as simple as contacting us here…

At Cape Fertility, we value each individual patient and we look forward to providing you with individualised and personalised care, affordable quality fertility treatment, and higher success rates at our purpose-built premises in the beautiful city of Cape Town.