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Symptoms and causes

Polycystic ovary syndrome (PCOS) is the most common hormonal disorder in women of reproductive age. It affects about one in 10 women and is more common in women from high-risk groups, such as Aboriginal and Torres Strait Islander women. PCOS is associated with increased levels of insulin and androgens (male-type hormones) in your body.

Learn more about PCOS symptoms and causes.

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Symptoms

Women with PCOS may experience different symptoms, and they can range from mild to severe. Symptoms can also change at different stages of your life.

Irregular or no periods

With PCOS, high levels of androgens and insulin in your body can disrupt your menstrual cycle. You may have regular periods, heavy or light periods, irregular periods or no periods. Some girls may not start their periods at all due to PCOS.

Learn more about how to treat and manage irregular periods.

Excess hair (hirsutism)

PCOS can cause excess hair growth on your face and body due to high levels of the androgen hormone. This hair is thicker and darker than normal. It usually grows in areas where men grow hair. For example, on your sideburn area, chin, upper lip, lower abdomen, chest, thighs and around your nipples.

About 60% of women with PCOS have excess hair growth.

Hair loss (alopecia)

PCOS can cause scalp hair loss in a male-like pattern (i.e. hair that recedes at the front and thins on top).

Skin conditions

With PCOS, higher levels of androgens can enlarge oil-production glands on your skin, which can cause acne (pimples). Acne is common in teenage years, but young women with PCOS may continue to have severe acne.

PCOS can cause skin tags, which are thick lumps of skin that can grow in your armpits, on your neck or along your bra line.

You might also develop rough, dark, velvety patches of skin in your armpits or on your neck.

Learn more about how to treat and manage hair and skin conditions.

Stress, anxiety and depression

Stress, anxiety and depression are common symptoms of PCOS. This could be due to hormonal changes, but more research is needed to understand how certain hormones affect emotional wellbeing.

Many women with PCOS must cope with symptoms (e.g. excess body hair and weight) that affect their self-esteem and body image. This can be distressing, especially if they don’t know where to get support.

Women may also feel anxious or depressed if they are planning to have a child (or more children) and PCOS causes fertility issues.

Stress is when you feel threatened or that you can’t cope with a situation. A little stress can provide motivation to act, but too much stress can affect your health.

Anxiety is an unpleasant feeling of nervousness, fear or worry that something bad is happening or is about to happen. For some people, these feelings can become constant and extreme. Ongoing feelings of anxiety can interfere with daily life.

Depression is a serious illness that negatively affects the way you think and how you feel and act. People with depression have constant and extreme negative feelings and thoughts. Depression can stop you from doing everyday activities such as sleeping and eating, and it can make it hard for you to function physically and emotionally.

Learn more about how to manage stress, anxiety and depression.

Weight

Women with PCOS can gain weight and may be at increased risk of having an unhealthy weight.

It can be hard to manage your weight when you have PCOS. Research suggests that hormones involved in controlling appetite and hunger aren't regulated properly in some women with PCOS.

Learn more about how to achieve and maintain a healthy weight.

Causes

We don’t know the exact cause of PCOS, but genetics and family history play an important role. PCOS may be associated with the hormone levels in your body before birth and your lifestyle or environment.

The name ‘polycystic ovary syndrome’ suggests the problem is mainly with the ovaries, and that you might have multiple cysts on your ovaries. But the cause of PCOS is hormonal.

In some women diagnosed with PCOS, an ultrasound image of the ovaries shows multiple follicles in the ovaries. These are not cysts. They are eggs that haven’t developed properly.

Genetics and family history

No single gene has been found to cause PCOS, so the link is likely to involve multiple genes.

It’s estimated that up to a third of women with PCOS have a relative who has PCOS (e.g. mother, aunt, sister or daughter). This may be higher in some ethnic groups.

Hormones

Hormones are chemicals made in your body that carry messages through your bloodstream. They help control many functions in your body, such as growth, energy, sexual function, reproduction, digestion and temperature.

With PCOS, it’s thought that increased levels of insulin in the body causes the ovaries to work differently, which produces high levels of androgens (male-type hormones). These hormones cause various symptoms, such as irregular periods and hair and skin conditions. If the hormone levels are controlled, the ovaries often function normally and symptoms may improve.

Insulin

About 85% of women with PCOS have insulin resistance. If you are insulin resistant, your body blocks glucose from going into your cells. This causes your body to produce more insulin. Higher levels of insulin increases the production of androgens (male-type hormones) in your ovaries.

Insulin resistance may be caused by lifestyle factors (e.g. being overweight) or genetic factors.

Androgens

Androgens are normally present in men and women, but at much lower levels in women. Many women with PCOS have increased levels of androgens. This can cause symptoms such as excessive body hair growth, scalp hair loss, acne and irregular periods.

Increased levels of androgens in women may also lead to eggs being underdeveloped. This can make it hard to get pregnant.

Weight

PCOS can affect women of all weight ranges. But a heavier weight can increase the hormones responsible for PCOS symptoms. Weight loss can normalise hormone production and lead to improvements in PCOS symptoms.

Learn more about how physical activity and diet can help improve PCOS symptoms.

Can you prevent PCOS?

There’s no proven way to prevent PCOS, but there are many things you can do to improve your symptoms.

Learn more about treatment and management of PCOS symptoms.

This web page is designed to be informative and educational. It is not intended to provide specific medical advice or replace advice from your health practitioner. The information above is based on current medical knowledge, evidence and practice as at May 2023.

This con­tent has been reviewed by a group of med­ical sub­ject mat­ter experts, in accor­dance with Jean Hailes pol­i­cy.

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Last updated: 
25 January 2024
 | 
Last reviewed: 
29 May 2023

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