Recognising PCOS Symptoms – PCOS Awareness Month September 2023

As many as 1 in 5 women suffer from Polycystic Ovarian Syndrome or PCOS, making it the most common hormone disorder in the world. Yet, sadly, because the symptoms are often not recognised or misdiagnosed, PCOS continues to drastically reduce the quality of life for millions of women, while also increasing their risk of serious health complications and resulting in medical conditions such as infertility.

This year during PCOS Awareness Month, annually observed in September, our team at Cape Fertility add our voices to raise awareness of the symptoms of PCOS, which can be treated very effectively when recognised and diagnosed correctly.

Polycystic ovary syndrome, or PCOS as it is most often called, is a hormonal disorder that is common among women of reproductive age. PCOS symptoms may begin shortly after puberty, but can also develop during the later teen years and early adulthood. The exact cause is unknown, but it is considered a hormonal problem, and genetics and environmental factors are believed to be involved in the development of PCOS.

To raise awareness of this disease that is often not recognised or misdiagnosed, even by professionals, PCOS Awareness Month is observed worldwide in September each year, to reach the estimated 50% of the 10 million women who have PCOS and are unaware of it.

This is because there are so many different symptoms of PCOS, and these symptoms often go unnoticed or are incorrectly attributed to other causes. As a result, many women suffer for extended periods, even years, from the range of physical, mental and emotional symptoms of PCOS, that drastically reduce their quality of life, increase their risk of serious health complications, and is also a leading cause of infertility among women.

Recognising the symptoms of PCOS will ensure more women will be able to receive the very effective treatment for PCOS that is widely available. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

Our team at Cape Fertility contribute to the effort of raising PCOS awareness by sharing this information about the symptoms of PCOS, one of which is infertility.

Common symptoms of PCOS

According to PCOS Awareness Association (, the most common symptoms of PCOS are irregular menstruation, cysts, and hair and skin symptoms, such as acne and abnormal hair growth.

Usually, a diagnosis of PCOS can be made when two of the three symptoms detailed below are experienced.

1. Irregular periods

People with PCOS typically have irregular or missed periods as a result of not ovulating. Infrequent periods are a common sign of PCOS. For example, you might have fewer than nine periods a year with more than 35 days between periods. Other women with PCOS may suffer from abnormally heavy periods.

2. Polycystic ovaries

Although some women may develop cysts on their ovaries, many women do not. Your ovaries might be enlarged and contain follicles that surround the eggs. As a result, the ovaries might fail to function regularly.

3. Excess androgen

Elevated levels of male hormone may result in physical signs, such as excess facial and body hair, and occasionally severe acne and male-pattern baldness.

Unwanted hair growth – also known as hirsutism – related to PCOS is due to hormonal changes in androgens. The areas affected by excess hair growth may include the face, arms, back, chest, thumbs, toes, and abdomen.

Another symptom is thinning hair on the head, as hair loss related to PCOS may increase in middle age.

The hormonal changes related to androgens can also lead to acne problems, as male hormones can make the skin oilier than usual, causing breakouts on areas like the face, chest and upper back.

PCOS can also result in the darkening of skin, and thick, dark, velvety patches of skin may appear under a woman’s arms or breasts, or on the back of the neck.

Other PCOS symptoms

There are many other symptoms associated with PCOS. Below are brief explanations of some of these other symptoms.

* Weight gain – about half of people with PCOS will have weight gain and obesity that is difficult to manage.

* Fatigue – many people with PCOS report increased fatigue and low energy, and related issues such as poor sleep may contribute to the feeling of fatigue.

* Mood changes – having PCOS can increase the likelihood of mood swings, depression and anxiety.

* Pelvic pain – women with PCOS may experience pelvic pain with periods, along with heavy bleeding, or even when a woman isn’t bleeding.

* Headaches are often prompted by hormonal changes.

* Sleep problems such as insomnia or poor sleep are often reported by women with PCOS, and PCOS has also been linked to a sleep disorder called sleep apnea, which causes a person to stop breathing for short periods while sleeping, causing trouble falling asleep and tiredness even after sleeping.

* Depression and low self-esteem – emotions are often negatively affected by both hormonal changes and symptoms like unwanted hair growth, and many women with PCOS end up experiencing depression, anxiety and low self-esteem.

* PCOS is also often associated with life-threatening related conditions like diabetes, heart disease and stroke, high blood pressure and high cholesterol, depression.

PCOS and infertility

PCOS is also a leading cause of female infertility.

This is because PCOS often disrupts a woman’s menstrual cycles and makes it harder to get pregnant.

Lifestyle interventions are the first treatments doctors recommend for PCOS, and they often work well. Weight loss can also treat PCOS symptoms and improve the odds of getting pregnant. Birth control pills are also used to restore more normal menstrual cycles. Metformin, a medicine used to treat type 2 diabetes, may also help restart ovulation.

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

PCOS can be treated very effectively

The good news is that PCOS and its symptoms can be treated very effectively once diagnosed.

Because PCOS is a chronic medical condition caused by an imbalance of hormones, it can be well managed over the long term like other chronic medical problems.

The first treatments recommended for PCOS are usually lifestyle interventions because they often work well. Weight loss in particular is the corner stone of PCOS treatment.

Medicines are an option where lifestyle changes don’t work. Contraceptive or birth control pills, Provera, or a Mirena are among the first line medical treatment options for those who are not trying to fall pregnant. Metformin may help some women with PCOS symptoms, because metformin improves the insulin’s ability to lower your blood sugar and can lower both insulin and androgen levels.

If you suspect that you have PCOS and would like to know more, especially if you are trying to fall pregnant, we would like to invite you to come and meet one of our fertility specialists by clicking here

We offer all the most effective fertility treatments at Cape Fertility, including treatments for PCOS.

At Cape Fertility, we also 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.