Do I have PCOS? What are the symptoms of PCOS?

I sat across from Lily, a young woman whose eyes were filled with worry and uncertainty.

“ I think  have PCOS.” She said softly.

“How old are you?” I asked. “What symptoms do you have?”

“I am 25 years old. My periods are very irregular.  Sometimes I have delayed periods by 2-3 months. I have also put on a lot of weight in the last 1 year.” She said.

“OK,” I said. “Let me examine you first.”

On examination, I found that she was indeed overweight and her BMI  (Basal Mass index) was over 30. Her other basic parameters like pulse rate and blood pressure were normal. She  had mild hair growth under the chin and along the cheeks. I could see some chest hair too.

Her signs and symptoms did suggest PCOS.

“Lily,” I said gently,  Your signs and symptoms do suggest PCOS but  they are not conclusive. You ill need to get an ultrasound done to check your ovaries. You will also need blood tests for the fasting insulin level, testosterone level and DHEA level.  These blood levels will be higher than normal if PCOS is present.”

Tears welled up in Lily’s eyes as she asked the question that weighed heavily on her mind. “Does this mean I won’t be able to have children someday? Am I suffering from infertility?”

I reached out and placed a reassuring hand on her shoulder.

“No,” I said. “Having PCOS doesn’t mean you cannot get pregnant. Many women with PCOS successfully conceive and have healthy pregnancies. There are  various options and treatments toimprove your fertility when the time is right for you and you want to get pregnant.”

Lily nodded, looking a bit relieved. “What about my irregular periods and the acne? It’s affecting my confidence.”

I smiled and nodded.

“ Yes, PCOS can cause  acne to increase – that is because of high  male hormones like testosterone. Women with PCOS can also suffer from   hormonal imbalances, leading to irregular periods and skin issues like acne. You can be prescribed medicines like metformin to help improve your insulin level.  I can also prescribe birth control pills to stabilize your hormones. These can regulate your menstrual cycle. Your skin will  also improve after the PCOS is controlled to some extent.

You will also have to make lifestyle changes to help manage your symptoms:

• Lose weight
• Healthy diet, cutting down on sugar and carbohydrates
• Regular exercise

Lily looked at me, a bit uncertainly,. “It’s so hard to lose weight with these cravings I get. I have tried so many times earlier”

I nodded understandingly. “I know it can be challenging, but small, sustainable changes can help. Focus on a balanced diet with whole foods, and find physical activities you enjoy. It could be dancing, walking, or even yoga. Join a support group or a community – they can offer guidance and encouragement.”

“OK doctor, I will try,” she said. “ I will come back later with the blood reports and ultrasound reports.

“Yes, do that,”  I said, “Losing weight  and improving your lifestye is the best way to control PCOS. Better than with medicines.

Lily left my office with confidence and hope that she will be able to manage her PCOS.