Polycystic ovary syndrome — PCOS — is one of the most common hormone conditions in women of reproductive age, affecting roughly 1 in 10. It happens when the ovaries make higher-than-typical levels of androgens, often called "male-type" hormones. That hormone shift can disrupt ovulation and cause symptoms across the body, from your cycle to your skin to your weight. Despite the name, you do not need to have cysts on your ovaries to have PCOS.
What causes PCOS?
The exact cause is not fully known, but three factors work together. Genes play a role — PCOS often runs in families. Insulin resistance is present in most women with PCOS: the body's cells respond poorly to insulin, the pancreas makes extra, and that extra insulin signals the ovaries to make more androgens. And the ovaries themselves may simply be more sensitive to these signals. It is not caused by anything you did.
Common symptoms
- Irregular, infrequent, or missing periods
- Acne, especially along the jawline, chin, and back — often persisting into adulthood
- Unwanted facial or body hair growth
- Thinning hair on the scalp
- Weight gain, especially around the midsection, or weight that is unusually hard to lose
- Dark, velvety skin patches on the neck or underarms
- Trouble getting pregnant
- Fatigue and cycle-linked mood changes
You do not need every symptom. Most women have a mix, and two women with PCOS can look almost completely different.
How PCOS is diagnosed
There is no single test. Diagnosis usually requires two of three signs: irregular or absent ovulation, signs of high androgens (symptoms or blood work), and polycystic-appearing ovaries on ultrasound — after ruling out look-alike conditions such as thyroid disorders. A careful history matters as much as the labs.
How PCOS is managed
PCOS cannot be cured, but it can be managed well. Care is personal, but commonly addresses cycle regulation, insulin resistance and metabolic health, skin and hair concerns, and fertility when pregnancy is the goal. Lifestyle foundations — steady eating, movement you enjoy, and sleep — support every part of the plan.
If this sounds like you, an evaluation can bring real answers. Book through our secure booking portal to meet with Bertine JeanLaurent, MSN, APRN, FNP-BC, by video visit.
Frequently Asked Questions
Is PCOS serious?
It deserves care, not panic. PCOS raises the long-term risk of type 2 diabetes and heart disease, and it can affect fertility and daily quality of life. The reassuring part: it is very manageable, and managing it lowers those risks.
Can you have PCOS without ovarian cysts?
Yes. Despite the name, cysts are only one of three diagnostic criteria, and you need just two of the three. Many women with PCOS have normal-looking ovaries on ultrasound.
At what age does PCOS usually start?
Symptoms often begin in the teens, around the first periods — but PCOS is frequently not diagnosed until the twenties or thirties, sometimes when a woman has trouble conceiving. It can be identified at any reproductive age.