5 Unusual Signs & Symptoms of PCOS You Should Look Out For
Published June 8, 2023.
PCOS, or polycystic ovarian syndrome, is the most common endocrine disorder affecting ~7% of the female population during reproductive years. While PCOS used to be viewed as a gynecologic issue only involving the ovaries, it is now seen as a complex endocrine + metabolic condition.
Despite the fact that the condition is called polycystic ovarian syndrome, you can have PCOS without cysts on your ovaries, and you can even have regular cycles but still have PCOS.
How Is PCOS Diagnosed?
So what are the key things we're looking for to diagnose PCOS?
There are 3 international guidelines commonly used to diagnose PCOS. The Rotterdam criteria is what is most commonly used to diagnose PCOS, and requires patients to have 2 out of 3 of the following:
- Hyperandrogenism (high testosterone) in bloodwork or symptoms of high testosterone such as acne, male patterned hair loss, facial hair
- Irregular ovulation/irregular cycles
- Polycystic ovaries (ovaries with numerous cysts) on ultrasound
Again, you need just two of the three to be diagnosed with PCOS based on the Rotterdam criteria, but there are many others, and many consider the diagnosis to be a spectrum rather than a specific set of criteria.
When we are looking for signs of PCOS in a child or adolescent, we want to be mindful that irregular cycles are common at the start of cycling years. Therefore, a diagnosis of PCOS should not be given to an adolescent until at least 2 years after starting menses.
While you need to meet a specific set of criteria there can also be clues or hidden PCOS symptoms that may be helpful to look for in addition to charting your cycles.
It is important to diagnose PCOS because then we can support hormones and the body in the specific way it needs in order to decrease long-term risks such as obesity, insulin resistance, high cholesterol, sleep apnea, infertility, pregnancy/birth complications, anxiety/depression, endometrial cancer, and more.
5 Surprising PCOS Symptoms
1. Mood Swings or Notable Mood Symptoms
2. Sweet Cravings
3. Gut Imbalances
4. Elevated cholesterol
5. Low vitamin D
These 5 surprising signs or symptoms commonly seen in women, combined with at least one of the above Rotterdam criteria, mean you should further look into the possibility of being diagnosed with PCOS.
1. Mood Swings
Irregular cycles or abnormally high testosterone are common manifestations of PCOS. Both of these findings can cause there to be more PCOS mood swings or mood symptoms. In fact, depression and emotional distress are commonly reported symptoms in those with PCOS.
2. Sweet Cravings
PCOS often involves insulin resistance where our body is not properly responding to insulin, a hormone that helps control our blood sugar levels.
While it is not fully understood why, many women with PCOS will have sweet cravings or binge eating behaviors that cause them to eat more carbs or sugars, which worsens the insulin and blood sugar picture. Insulin resistance is also known to cause more weight gain and difficulty losing weight.
When PCOS is untreated or out of control we can see a vicious cycle between cravings, eating things that worsen blood sugars, and difficulty losing weight.
3. Gut Imbalances
There is increasing research on how connected and important our gut is to our overall health. With PCOS, it is thought the gut could be tied to mood symptoms, eating patterns/cravings, obesity, inflammation, and maybe even insulin resistance. By looking at the health of the gut we may have great potential to improve the symptoms and risks associated with PCOS.
4. Elevated Cholesterol
Women with PCOS tend to have abnormal lipid panels (cholesterol) on bloodwork compared to the average population. This too is thought to be related in part to the insulin-resistance. In addition to mood symptoms or irregular cycles, this may be a helpful clue to do a further workup to look into PCOS.
5. Low Vitamin D Levels
Like the other more subtle or more surprising symptoms that may be linked to PCOS, it is worth considering vitamin D levels. Studies have shown supporting low vitamin D levels may improve insulin resistance, high cholesterol, and hormonal function in women with PCOS.
Understanding PCOS Is Key to Alleviating Symptoms
While PCOS is a complex disorder that involves numerous different signs and symptoms, the key is to seek support and speak to your doctor. This can help you improve your hormones and your symptoms to prevent long-term risks associated with PCOS. The above, unexpected, symptoms can be used in addition to criteria (like the Rotterdam criteria) to help you get a diagnosis and the treatment you deserve.
Remember that your entire body works together and PCOS symptoms can be improved with the correct approach.
