What Are the First Signs of PCOS?

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The matter of regulating and balancing hormones is a complex (and oftentimes overwhelming) undertaking many women face throughout their lives. This challenge is made no easier by the presence of PCOS. 

A common cause of infertility and cysts in the ovaries, polycystic ovarian syndrome (known commonly as PCOS)  is a type of hormone imbalance in women. People who suffer from PCOS also report, alongside a changing body in puberty, unexpected physical changes that they can’t explain. 

While a PCOS diagnosis can be overwhelming, there are answers and treatment options out there. In this article, we aim to tackle the issue of PCOS together; we’ll go into what signs and symptoms you should look out for, as well as how you can feel more confident (and in control of!) your health

What Is Polycystic Ovarian Syndrome (PCOS)?

Polycystic Ovarian Syndrome (PCOS) is a common hormonal disorder among women of all ages, manifesting as early as pre-pubescence, and affecting women even after menopause.

PCOS affects the ovaries and the adrenal glands in women, which can cause several complications and daily discomfort. Some of the most common symptoms include cysts on ovaries (causing painful periods, infertility issues, and distress), irregular or absent menstrual cycles, increased androgen (male hormone) levels, acne, abnormal hair growth (hirsutism), hair loss, and more. 

What Are the First Signs and Symptoms of PCOS?

Let’s dive down into the signs and symptoms that can occur from having Polycystic Ovarian Syndrome (PCOS):


Acne can be a very challenging symptom for young women who first develop PCOS, especially as severe acne may not respond to common treatments. 

However, there are plenty of acne treatment options backed by research and promising case studies, including salicylic acid, tretinoin, spironolactone, facial treatments, and more. A visit with your dermatologist might be necessary to find the right treatment option for you.


Did you know that 80% of women with PCOS experience obesity? Weight gain, especially around the midsection (abdomen) is a common symptom. Weight gain is associated with a hormone imbalance due to interactions between your hormones and insulin in your body. 

Unexpected physical changes should always be followed up with a visit to your doctor, so they can work with you to understand whether you may have PCOS, or if some other health problem may be at play. 

Excessive Hair Loss or Growth

Hair loss can include thinning and  more drastic loss of hair on your head. Hair will usually thin and fall out slowly or in clumps. 

On the other hand, some may experience excessive hair growth due to PCOS. Unwanted hair growth is commonly found on the face, upper lip, chin, neck, chest, and back. The medical term for this is hirsutism, which usually pertains to dark, thick hair found on areas of the body where men typically have visible hair. Hirsutism affects up to 70% of women with PCOS.Both excess hair growth and hair loss is thought to be the result of high levels of androgens (male hormones) present in the body.

Dark Patches 

Dark skin patches are not a symptom of Polycystic Ovarian Syndrome per se. However, women who develop insulin resistance can develop certain health conditions, which may darken the skin, especially the neck, armpits, and face. This is called acanthosis nigricans.

Skin Tags

This is one of the less common symptoms of Polycystic Ovarian Syndrome, but it still may occur if insulin resistance develops. Skin tags are typically small, flexible bumps or flaps of skin. Skin tags appear in the same area where dark spots are present.

These areas include the armpits, neck, under the breasts, and groin.

Irregular Periods 

Missed periods and or irregular menstrual periods are common signs of Polycystic Ovarian Syndrome (PCOS) and usually don’t get recognized until two to three years into your menstrual cycle. 

This is because, during puberty, irregular periods are somewhat common and a precursor to your cycle stabilizing. However, irregular or completely missed periods out of your teenage years is unusual and may be a cause for concern. 

A ‘late’ period is when your cycle is longer than 35 days, and secondary amenorrhea is defined as 3 or more missed periods in a row. If you are not on birth control and have irregular or missed periods, then it can be a sign of an underlying hormone imbalance (or some other health issue) that should be addressed.


Ovaries containing cysts are another potential sign of Polycystic Ovarian Syndrome (PCOS). “Cysts” are really eggs that don’t complete the monthly maturation process to then be released during ovulation. Instead, they sit in the ovary and accumulate fluid, leading to a cyst-like appearance. The ovaries can grow larger and can even cause painful periods. 


Infertility is one of the most complex struggles of Polycystic Ovarian Syndrome (PCOS). In order to conceive, a woman needs to ovulate; however, if you have irregular or missed periods, then there is the chance that your body is not ovulating.  This can make getting pregnant a challenge for those who wish to do so. 

This may seem like distressing news at first, but we urge you not to panic: fortunately there are many holistic and medical treatment options available to help regulate your hormones and get your ovaries to release an egg. 

Most people with PCOS can get pregnant. Options often focus on lowering your androgen levels and controlling insulin resistance to trigger ovulation. First-line treatment at Allara includes nutrition and lifestyle changes (like improving sleep, stress management, physical activity, etc.), targeted supplementation, and medications as necessary. 

How Is PCOS Diagnosed?

Polycystic Ovarian Syndrome (PCOS) is diagnosed on the rotterdam criteria. To determine that one has the condition, 2 of the following 3 criteria must be present:

  • Pelvic ultrasound, also known as a sonogram, which looks for cysts
  • Blood tests, to determine a hormone profile
  • Oligo – or amenorrhea

Other blood tests and medical history are also taken to ensure any other similar-appearing condition is ruled out.

Consult with Your Healthcare Provider 

While PCOS symptoms will vary upon the person, it is highly recommended that, if you suspect you may have PCOS, you consult with your healthcare provider. As these are the first and most popular signs that begin to appear with Polycystic Ovarian Syndrome (PCOS), there could be some other ones as well. 

Now that we have dug deeper into the first signs and symptoms of Polycystic Ovarian Syndrome (PCOS), you may be wondering: Is this a severe diagnosis? Does PCOS worsen over time? Can PCOS be life-threatening?

These are all important questions to ask, and so we’ll take a moment to discuss each in turn. 

Can Polycystic Ovarian Syndrome (PCOS) Worsen Over Time?

Polycystic Ovarian Syndrome (PCOS) can present as mild for some people, while others can develop worsening symptoms. Without a proper diagnosis and treatment, there is certainly a higher likelihood that signs and symptoms can worsen over time.

With PCOS,there is a higher risk of developing insulin resistance, which in turn may progress to Type 2 diabetes. There is a very strong genetic component between the PCOS and insulin resistance that can even appear in male relatives. This is a serious health concern since your body can no longer appropriately move the glucose from the blood into the body’s cells to use for energy. 

High blood sugar levels from type 2 diabetes is associated with other chronic diseases and can cause nerve and blood vessel damage to the kidneys, eyes, extremities, and other areas of the body.

PCOS also comes with a greater risk of elevated cholesterol or triglycerides (AKA blood lipids), cardiovascular disease, heart attack, and stroke. All of these are intertwined, however, very treatable through diet, lifestyle, and pharmaceutical interventions.

Another comorbidity that can arise from not treating and maintaining your PCOS is infertility and pregnancy loss. The infertility is associated with less frequent ovulation of untreated PCOS. Women who have Polycystic Ovarian Syndrome (PCOS) with insulin resistance tend to have more pregnancy complications, such as gestational diabetes, which poses greater risk for both mother and baby. 

We would also like to point out that women who have PCOS are not guaranteed to have issues getting pregnant: it really is case by case, and so it is important to work with a healthcare provider to create a conception plan that you are comfortable with.

Fortunately, PCOS in and of itself is not life-threatening. 

Some complications that come with this diagnosis can worsen over time without a treatment plan. You’ll want to be vigilant with your treatment plan and maintain a healthy, low stress, and active life as much as possible! 

Allara Health Is Behind You All The Way

We have learned that Polycystic Ovarian Syndrome (PCOS) itself is not life-threatening, but its complications can cause a multitude of disruptions within the body. 

Since PCOS is often overlooked, it is important that you listen to your body and be vocal about any physical changes you see that are unusual or unexpected. If you reach out to a healthcare provider and you find they are unresponsive, or don’t listen to your concerns, then it’s critical that you pursue care where your worries are addressed. 

You deserve a doctor who listens and respects you and your body and will give you the attention you need. With so many symptoms, Polycystic Ovarian Syndrome (PCOS) is one of the most complex hormonal disorders a female can be diagnosed with. 

With Allara Health, our providers will not just respect and listen to you, but will serve as the subject matter expert that can help you navigate the complex syndrome. We are the one-stop shop for women battling Polycystic Ovarian Syndrome (PCOS). We encourage you to sign up online and get set up with Our Team of specialized health care professionals who will develop the proper treatment plan for you.

Book your test here. 


The Role of Polycystic Ovary Syndrome in Reproductive and Metabolic Health: Overview and Approaches for Treatment) | NIH 

Polycystic Ovary Syndrome (PCOS) | Johns Hopkins Medicine 

Acanthosis nigricans - Symptoms and causes | Mayo Clinic 

Obesity: Overweight, Diet, Exercise, Symptoms, Causes & Risk | eMedicine Health 

Allara Health provides personalized treatment for hormonal, metabolic & gynecological conditions that utilizes a holistic plan that merges nutrition, lifestyle, medication and supplementation, and ongoing, expert support to heal your body.

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“I was given an explanation of how my hormonal imbalance was affecting me as a whole- body & mind- & tools so that we could start to manage my condition. I am happy to announce after a year of trying, I found out that I was pregnant & I couldn’t be happier!”

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“This is genuinely the first time in my 7 years of being diagnosed, that I have felt seen and heard.”

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“The Allara Community gives me the courage and support to continue my PCOS journey - I am never afraid to ask the hard questions and love hearing from other women with the same challenges.”

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“I was given an explanation of how my hormonal imbalance was affecting me as a whole- body & mind- & tools so that we could start to manage my condition. I am happy to announce after a year of trying, I found out that I was pregnant & I couldn’t be happier!”

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"Dr. Henigsman went above and beyond making sure I had all the necessary tests, but also tremendously helped me in understanding my diagnosis, helping me change my lifestyle, and making sure I get the treatment I deserve."

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"Before Allara I had no real direction or understanding of what it meant to have PCOS. Now I have a team of people that take time to explain every single thing to me, ask me how I feel and let me be apart of my treatment plan and I’ve lost 55 pounds."

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