PCOS 101: Breaking Down The Causes And Symptoms

Uterus and ovary made out of card and flowers, in pink, red and white

This week’s blog post takes a deep dive into the causes of PCOS symptoms.

As part of the PCOS Awareness Month Series, we’re spending the whole of September deep-diving into all things PCOS. If you missed last week’s blog, check out why we need PCOS Awareness here. This week, we’re getting down to the nitty-gritty – symptoms. More specifically, we’re diving into what might be causing common symptoms like hirsutism, irregular periods, and more known to impact quality of life.

Whether it’s worrying about missing periods or feeling uncomfortable in yourself, PCOS symptoms can feel overwhelming to navigate (1). This is particularly heightened if the support you have received so far is limited – an everyday experience amongst PCOS patients (1). It can be an anxiety-inducing condition, but thankfully, if we start to understand the causes of these symptoms, we can try to support them from the root. In doing so, we may improve the longevity and outcomes of PCOS, helping people take back their lives – one cycle at a time.

The prevalence and development of PCOS is suggested to be triggered by varying causes (2). Though research is still limited, the current understanding of PCOS identifies the following as attributing factors (2): 

– Hyperandrogenism (excess androgen levels, namely testosterone)
– Insulin resistance (issues regulating blood sugar)
– Genetics
– Inflammation (causing dysregulation throughout the hormonal pathways)
– Low vitamin D
And more.

Let’s look into the symptoms and causes of PCOS:

Symptom #1 – Excess Hair Growth (Hirsutism)

Excess hair growth is a common and impactful symptom of PCOS, affecting 65-75% of those diagnosed (3). Hirsutism generally presents on the face, varying in its density and amount. It can be frustrating to navigate and is suggested to induce anxiety in those experiencing it.

Causes: Hyperandrogenism & Insulin Resistance – excess testosterone causing increased hair follicle quantity and size (3).

Symptom #2 – Irregular Periods

Irregular cycles are one of the most prevalent symptoms of PCOS, identified by the absence of regular periods (4). The menstrual cycle can last longer than usual, causing changes in period length (4). As ovulation is also irregular in this case, this may impact fertility (4).

Causes: Hyperandrogenism & Lifestyle Factors – longer cycles are associated with heightened testosterone; however, cycle length can also be impacted by stress, sleep, and more. This may relate to inflammatory changes disrupting hormonal pathways (4).

Symptom #3 – Skin Changes

Oily, acne-prone skin is common in PCOS, prevailing through adulthood. This may cause cystic acne as well as surface-level changes, often coinciding with hirsutism (5).

Causes: Hyperandrogenism, inflammation, and insulin resistance – as with hirsutism, excess testosterone may cause excess oil production. When coupled with inflammation, inflammatory by-products may build up and present as skin changes (5).

Symptom #4 – Alopecia 

Though it may sound conflicting, it is common in PCOS to experience alopecia (hair loss) alongside hirsutism (6).

Causes: Hyperandrogenism – however, the mechanisms of this symptom are currently unclear (6).

Symptom #5 – Low Moods

When compared to non-PCOS cohorts, those with PCOS are considered to have a lower quality of life (1). Depression and anxiety are more prevalent and may be a side effect and symptom of the condition (1).

Causes: Insulin resistance, inflammation, the condition itself, and more – the cause is not exact; however, it may relate to varying parts of living with PCOS (1).

Exploring and understanding the causes of PCOS symptoms helps improve our approach to support PCOS. By identifying the underlying issues, we can ensure we implement long-term suggestions to manage and maintain them. If you want to learn how to manage the causes we have explored today, stay tuned for next week’s blog post! Plus, if you are struggling with any of the symptoms discussed above and want to learn how to take control of your cycle, check out my services and get in touch now.

If you’re interested in learning more and receiving personalised support to help optimise your PCOS to your lifestyle and needs, my PCOS POWER journey is here to help you feel your best. Plus, I’ll soon be launching my cycle syncing workshop! To receive updates about this and be the first to know once it’s live, sign up for my newsletter now. 

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If you’re looking for further support, please feel free to get in touch via my contact page, or email me at jgreen.nutrition@gmail.com.

1 – Kolhe, J.V., Chhipa, A.S., Butani, S. et al. PCOS and Depression: Common Links and Potential Targets. Reprod. Sci. 29, 3106–3123 (2022). https://doi.org/10.1007/s43032-021-00765-2
2 – Devi OJ, Pushpari C, Manaswini K, Anjum SN, Lakshmi VB. PCOS: a common but underdiagnosed condition in reproductive women. World J Pharm Res. 2021 May 4;10(7):598-612. https://wjpr.s3.ap-south-1.amazonaws.com/article_issue/1623923778.pdf
3 – Spritzer PM, Marchesan LB, Santos BR, Fighera TM. Hirsutism, normal androgens and diagnosis of PCOS. Diagnostics. 2022 Aug 9;12(8):1922. https://www.mdpi.com/2075-4418/12/8/1922
4 – Harris HR, Titus LJ, Cramer DW, Terry KL. Long and irregular menstrual cycles, polycystic ovary syndrome, and ovarian cancer risk in a population‐based case‐control study. International journal of cancer. 2017 Jan 15;140(2):285-91.https://onlinelibrary.wiley.com/doi/abs/10.1002/ijc.30441
5 – Carmina E, Dreno B, Lucky WA, Agak WG, Dokras A, Kim JJ, Lobo RA, Ramezani Tehrani F, Dumesic D. Female adult acne and androgen excess: A report from the multidisciplinary Androgen Excess and PCOS committee. Journal of the Endocrine Society. 2022 Mar 1;6(3):bvac003. https://academic.oup.com/jes/article-abstract/6/3/bvac003/6523224
6 – Carmina E, Azziz R, Bergfeld W, Escobar-Morreale HF, Futterweit W, Huddleston H, Lobo R, Olsen E. Female pattern hair loss and androgen excess: a report from the multidisciplinary androgen excess and PCOS committee. The Journal of Clinical Endocrinology & Metabolism. 2019 Jul;104(7):2875-91. https://academic.oup.com/jcem/article-abstract/104/7/2875/5342938

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