How to Tell if You Have PCOS: Signs, Symptoms, and Diagnosis Guide

Wondering if you might have PCOS or how to tell if you have PCOS?  Maybe you’ve noticed some unusual symptoms in yourself like irregular or heavy periods, increased facial hair growth, hair loss, or unusual weight gain. In this article, I’ll help you understand what PCOS is, why getting your diagnosis of PCOS is important, and what your next steps should be.

Seeking Answers for PCOS symptoms

Before I was diagnosed with PCOS, I spent a lot of time on the internet seeking articles like this one to help me understand what was going on with my body and my hormones.

Back then, there wasn’t much out there and today there’s a lot of fluff articles without real substance.  Both impact your ability to get what you’re seeking: real answers.

It was because of that struggle and the deep passion I cultivated for nutrition strategies for PCOS that I sought higher education to become a PCOS nutrition professional.  I’ve been working in the field of PCOS nutrition since 2015.   You can learn more about me here.

Let me assure you that I know the unique pain of what you are going through and it’s my mission in life to help you live a vibrant and beautiful life despite PCOS- so if you do get a diagnosis I hope you’ll come back and peruse the many articles, podcasts, and videos I have on topics related to PCOS nutrition.

So, what exactly is PCOS?

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects millions of women globally. It’s actually one of the most common gynecological conditions and affects about 15% of all women.

Understanding PCOS

PCOS is usually noticed because of hormonal issues that show up on the body.  Some of these are related to hormones like androgens and some are related to more metabolic issues like insulin resistance.  Some of the things most of us with PCOS have in common are:

High levels of Androgens

This can be high levels of testosterone or DHEA, both are androgens.  Testosterone is made in the ovary and DHEA in the adrenals.  In PCOS, one of these is usually elevated.  This leads to symptoms of high androgens.

Symptoms of High Androgens

Common Signs of high androgens include:

• Facial Hair
• Hair Loss
• Belly Fat Retention
• Difficult Losing Weight
• Weight Gain
• Irregular Menstrual Cycles
• Acne

Root Causes of PCOS Symptoms: How to Tell if You Have PCOS

While hormone imbalances may be the first thing that triggers a deeper look at potentially diagnosing PCOS, it’s actually metabolic dysfunction that causes most of the symptoms of PCOS.

Underlying our PCOS hormones are 3 major root causes of symptoms: insulin resistance, chronic inflammation, and adrenal dysfunction.

Most with PCOS will have elements of all three, but some have more of one than another.

PCOS Insulin Resistance: Signs and Symptoms

• Unexplained weight gain or difficulty losing weight
• Increased hunger or cravings
• Fatigue or low energy levels
• Difficulty concentrating or brain fog
• Skin tags or dark patches on the skin (acanthosis nigricans)
• Irregular menstrual cycles or absence of periods
• Difficulty getting pregnant (infertility)
• Excessive hair growth (hirsutism), especially on the face, chest, or back
• Thinning hair or hair loss on the scalp (male-pattern baldness)
• Acne or oily skin

Symptoms of PCOS inflammation

• Chronic fatigue or low energy levels
• Persistent pain or discomfort, especially in the abdomen or pelvis
• Digestive issues such as bloating, gas, or constipation
• Joint pain or stiffness
• Frequent headaches or migraines
• Digestive issues such as bloating, gas, or irregular bowel movements
• Skin problems, including redness, rashes, or eczema
• Allergies or sensitivities to certain foods or environmental factors
• Difficulty managing stress or mood swings
• Recurrent infections or slow wound healing
• Elevated markers of inflammation in blood tests, such as C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR)

PCOS Adrenal Dysfunction: Signs and Symptoms

• Chronic fatigue or low energy levels
• Difficulty falling asleep or staying asleep (insomnia)
• Mood swings or irritability, often resembling symptoms of depression or anxiety
• Difficulty coping with stress or feeling overwhelmed easily
• Low libido or changes in sexual function
• Weight gain, particularly around the abdomen (belly fat)
• Dizziness or lightheadedness, especially when standing up quickly

How to Tell if You Have PCOS

Do you identify with a lot of the symptoms above?  You may have PCOS.

In order to get diagnosed, though, you will need to prove that you meet something called the Rotterdam criteria for PCOS diagnosis.

I’ll explain that below but keep in mind that you can have many symptoms associated with PCOS and not actually have PCOS.  If that’s the case, you may want to look into other chronic health conditions that have a lot of overlap with PCOS- things like hypothyroidism, autoimmune disorders, POTs, insulin resistance, etc.

Whatever is going on, nutrition and lifestyle changes can be super helpful in getting some balance back in your hormones and improving your quality of life.

How to Tell if You Have PCOS: Getting Diagnosed

Seeking medical evaluation is essential if you suspect you have PCOS.

To get a diagnosis, you should make an appointment with your gynecologist or a family doctor who does pelvic exams.

Usually, the diagnosis will involve a medical history review, physical examination, blood tests to measure hormone levels, and pelvic ultrasound to visualize the ovaries.

What your doctor is looking for are signs that meet the PCOS diagnosis criteria.

The Rotterdam Criteria for PCOS Diagnosis

Most medical professionals use the Rotterdam Criteria for PCOS Diagnosis.

The Rotterdam criteria, established in 2003 during a conference sponsored by the European Society for Human Reproduction and Embryology (ESHRE) and the American Society for Reproductive Medicine (ASRM), are widely used for the diagnosis of Polycystic Ovary Syndrome (PCOS).

According to these criteria, PCOS can be diagnosed if at least two out of three following criteria are met:

1) oligo/anovulation

If you rarely or never have periods or if your periods fluctuate a lot and are over 35 days in length, you meet this qualification.

2) clinical and/or biochemical signs of hyperandrogenism

If you have any of the signs of high androgens above, especially the body hair symptoms, you likely meet this.  Sometimes there are no outward signs of high androgens.  In these cases, blood work can sometimes show them.

If you take great pains to remove PCOS facial or body hair or cover up hair loss, I recommend taking a photo of the evidence or coming to the appointment with the signs visible to help your doctor determine high androgen symptoms easier.

3) polycystic ovaries on ultrasound examination

Doctors will typically use a vaginal wand to perform a transvaginal ultrasound and check the ovaries for cysts.  This procedure usually is painless but it can look a little scary!

Using the criteria above acknowledges that not all individuals with PCOS exhibit the same symptoms. In fact, as you can see by the criteria above, you don’t even need cystic ovaries to qualify as having PCOS!

Treatment and Management of PCOS

While PCOS has no cure, various treatment options can help manage symptoms and improve your overall health.

While some medications like birth control, metformin, IUDs, and spironolactone may help with outward signs of PCOS, most research now acknowledges that because PCOS has metabolic roots, a nutrition and lifestyle approach is ideal for management.

Nutrition helps with the deeper root cause issues of PCOS like insulin resistance and inflammation.  In my personal experience as a practitioner, I’ve seen many women reverse PCOS symptoms by changing their diets.

How to tell if you have PCOS: Next Steps

Here’s some help with planning a PCOS friendly meal plan as you get started.

You can also check out my PCOS podcast or my PCOS videos for more help as you dive in.

Finally, if you need someone to hold your hand through the process of changing your lifestyle, I’ve created a “new to pcos” course called PCOS Foundations for that exact purpose.  Hopefully it helps you make the changes you need to make as simply and painlessly as possible.

I truly wish you the best in your health journey and hope you get the answers you seek!