gynecology and obstetrics
Polycystic Ovary Syndrome (PCOS)
Symptoms and Signs of PCOS
Symptoms of polycystic ovary syndrome typically begin during puberty and worsen with time. Ovulatory dysfunction is usually present at puberty, resulting in primary amenorrhea; thus, polycystic ovary syndrome is unlikely if regular menses occurred for a time after menarche. Premature adrenarche is common, caused by excess dehydroepiandrosterone sulfate (DHEAS) and often characterized by early growth of axillary hair, body odor, and microcomedonal acne. Typical symptoms include irregular menses, usually oligomenorrhea, Amenorrhea , mild obesity, and mild hirsutism. However, in up to half of women with PCOS, weight is normal, and some women are underweight. Body hair may grow in a male pattern (eg, on the upper lip, chin, back, thumbs, and toes; around the nipples; and along the linea alba of the lower abdomen). Some women have acne, and some have signs of virilization, such as temporal hair thinning. Other symptoms may include weight gain (sometimes seemingly hard to control), fatigue, low energy, sleep-related problems (including sleep apnea), mood swings, depression, anxiety, and headaches. In some women, fertility is impaired. Symptoms vary from woman to woman. Areas of thickened, darkened skin (acanthosis nigricans) may appear in the axillae, on the nape of the neck, in skinfolds, and on knuckles and/or elbows; the cause is highinsulinlevels due toinsulinresistance. If women with PCOS become pregnant and if obesity is present, risk of pregnancy complications is increased. These complications include Diabetes Mellitus in Pregnancy , 