Recognizing PCOS: Common and Lesser-Known Symptoms
Polycystic Ovary Syndrome (PCOS) presents with a broad spectrum of signs — some obvious, others easily missed. The most common and visible PCOS symptom is menstrual irregularity: cycles that are infrequent (oligomenorrhea), very light, or absent (amenorrhea). Many women also notice excess androgen effects — hirsutism (coarse hair on the face, chest, abdomen), persistent acne, and male-pattern hair thinning (androgenic alopecia). Weight gain, especially central (around the waist), and difficulty losing weight are frequent because of underlying insulin resistance. Less-obvious clues include acanthosis nigricans (dark, velvety patches behind the neck or in the groin), persistent pelvic pain, heavy bleeding when periods occur, and sleep problems such as snoring or daytime tiredness. Mood changes — anxiety and depression — are common and often under-recognized. Fertility issues due to anovulation are another presenting problem for many women trying to conceive.
Imaging may show “polycystic” appearing ovaries, but this alone does not confirm PCOS — diagnosis relies on a constellation of features. In India, PCOS is common: a systematic review reported an overall prevalence around 11.34% using the Rotterdam criteria (see https://www.cureus.com/articles/126192-prevalence-of-polycystic-ovarian-syndrome-in-india-a-systematic-review-and-meta-analysis.pdf). Regional studies vary widely (3.7–36%), so awareness matters locally in Paschim Vihar and New Delhi. Early recognition reduces long-term risks like diabetes and heart disease, so noticing even mild or intermittent symptoms should prompt evaluation. If you’ve had persistent cycle changes, new facial hair, worsening acne, or unexplained weight gain, consider a medical review — early care makes a meaningful difference.
Why PCOS Symptoms Vary by Age: Adolescents, Reproductive Years and Beyond
PCOS doesn’t look the same at every stage of life. In adolescence, the condition overlaps with normal puberty: irregular periods and acne are common in teens, which makes early diagnosis challenging. Experts recommend longitudinal assessment rather than a single snapshot; treatment may still be started for symptom control even when a definitive diagnosis is uncertain (see PCOS India guidance: https://pcosindia.org/files/Mod_2_Inside_Pages_PCOS_New.pdf). During the reproductive years many women notice clearer signs — persistent oligomenorrhea, hirsutism, weight gain and difficulty conceiving because of anovulation. Fertility concerns often bring women for the first time to gynecologists.
As women age, metabolic consequences become more prominent. Insulin resistance and the risk of type 2 diabetes increase with time, especially if weight gain accompanies PCOS. Cardiovascular risk factors — dyslipidemia and hypertension — may appear in the 30s and beyond. Menopause and perimenopause can change symptom patterns: some hyperandrogenic signs may persist (hair growth, thinning), while menstrual irregularity naturally resolves but metabolic risks remain. There are also phenotypes of PCOS: “classic” hyperandrogenic PCOS tends to show stronger skin/hair symptoms, while “lean” PCOS presents with fewer weight issues but can still have ovulatory dysfunction and metabolic abnormalities.
Geographic and ethnic differences matter; prevalence studies in India show wide variation (3.7–36%), influenced by diagnostic criteria and population characteristics (https://reproductive-health-journal.biomedcentral.com/counter/pdf/10.1186/s12978-025-02019-9.pdf). For adolescents and adult women in Paschim Vihar and New Delhi, these age-dependent patterns mean tailored evaluation and follow-up: teens need careful monitoring over time, reproductive-age women may need fertility-focused care, and older women require metabolic screening and cardiovascular risk management.
How PCOS Is Diagnosed: Tests, Criteria and What to Expect at Your Visit
Diagnosis of PCOS is clinical and laboratory-based. The widely used Rotterdam criteria require two of three features: oligo/anovulation, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology on ultrasound (see summary at https://en.wikipedia.org/wiki/Polycystic_ovary_syndrome). At your first visit, your doctor will take a detailed menstrual history (cycle length, bleeding patterns), ask about hair growth, acne, weight changes, and fertility history. Expect a physical exam checking BMI, waist circumference, blood pressure, skin for acanthosis nigricans, and a Ferriman-Gallwey-style assessment of hair growth.
Typical labs include serum total and free testosterone (or free androgen index), DHEA-S when adrenal causes are suspected, and baseline reproductive hormones (TSH, prolactin). Because insulin resistance is central to PCOS, fasting glucose, HbA1c, fasting insulin, and a lipid profile are often ordered. Pelvic ultrasound — preferably transvaginal in adults — can document polycystic ovarian morphology but is not strictly necessary if clinical and biochemical criteria are met. In adolescents, the diagnostic approach is cautious: puberty-related irregularity and acne can confound findings, so longitudinal follow-up is recommended and treatment may be started before a formal diagnosis (PCOS India guidance: https://pcosindia.org/files/Mod_2_Inside_Pages_PCOS_New.pdf).
Bring a period diary (three to six months if available), photos of hair/skin changes, and a list of medications and family history to your appointment. If initial tests are inconclusive, your doctor may monitor cycles over several months, repeat hormone levels, or refer to endocrinology or reproductive specialists for further evaluation.
Managing PCOS Symptoms: Lifestyle, Medication and Fertility Options
First-line management of PCOS is lifestyle-focused: modest weight loss (5–10% of body weight) improves menstrual regularity, insulin sensitivity and chances of pregnancy. A balanced, calorie-appropriate diet, regular aerobic and resistance exercise, improved sleep and stress management are cornerstone interventions (see lifestyle evidence: https://juniperpublishers.com/jgwh/pdf/JGWH.MS.ID.556069.pdf). For metabolic risk, regular monitoring of glucose and lipids is essential.
Medical treatments are individualized. Combined oral contraceptives are commonly used to regulate cycles and reduce androgenic symptoms such as acne and hirsutism. Metformin improves insulin sensitivity and can help restore ovulation, particularly when weight loss is limited. Anti-androgens (e.g., spironolactone) reduce excessive hair growth and acne but require contraception during use. Topical or procedural dermatologic treatments (laser, electrolysis) target persistent hirsutism. For fertility, letrozole is now a first-line ovulation induction agent; gonadotropins and assisted reproductive technologies are options when first-line approaches fail or when additional infertility factors exist.
Psychological support matters: anxiety, depression and body image concerns are common in PCOS and benefit from counseling or cognitive-behavioral therapy. Long-term care includes cardiovascular risk reduction and diabetes prevention. If lifestyle changes and first-line medications don’t control symptoms, referral to Sanchet Hospital’s multidisciplinary gynecology and endocrinology teams can provide individualized plans — combining medical therapy, nutritional counseling and fertility clinics available in New Delhi.
When to See Sanchet Hospital: Red Flags, Follow-Up and Multidisciplinary Care
Seek medical attention sooner rather than later if you notice persistent or worsening symptoms. Red flags include: absent periods for three months or longer (when not pregnant), very irregular cycles interfering with life or fertility, sudden or rapid-onset hirsutism or hair loss, severe acne, unexplained and rapid weight gain, symptoms of high blood sugar (excessive thirst, frequent urination), or difficulty conceiving after 6–12 months of unprotected intercourse. Mood symptoms — persistent low mood, anxiety, or disordered eating — also warrant evaluation. Early assessment reduces risks of type 2 diabetes, cardiovascular disease and endometrial hyperplasia/cancer.
Sanchet Hospital in New Delhi and Paschim Vihar offers multidisciplinary care that is ideal for PCOS: gynecologists for reproductive and menstrual concerns; endocrinologists for metabolic and hormonal management; dermatologists for acne and hirsutism; dietitians and physiotherapists for lifestyle programs; and mental health professionals for psychological support. Typical follow-up includes metabolic screening (glucose, lipids), cycle monitoring, and adjustments to medications every 3–6 months until stable. Bring a period diary, photos of skin/hair changes, current medications, and any family history of diabetes or heart disease to your visit.
PCOS is common in India (estimated pooled prevalence ~11.34% using Rotterdam criteria), and early, local care improves outcomes. To discuss symptoms, testing or fertility planning, visit Dr. Suneeta Agarwal, expert gynecologist at Sanchet Hospital — she can provide personalised evaluation, tests and a clear management plan tailored to your stage of life and goals.
