What Is PCOS? Causes, Symptoms & Why It's Often Misdiagnosed

What Is PCOS? Causes, Symptoms & Why It's Often Misdiagnosed

Polycystic Ovary Syndrome (PCOS) is one of the most common yet misunderstood hormonal conditions affecting women. It’s estimated to impact 1 in 10 women of reproductive age but many go years without a diagnosis, dismissed by the healthcare system or told their symptoms are "just part of being a woman."

If you’ve been struggling with irregular periods, fatigue, acne, or stubborn weight gain, and you feel like no one has given you real answers, this blog is for you.

What Is PCOS?

PCOS is a complex endocrine disorder that affects how the ovaries function. Women with PCOS often produce higher-than-normal levels of androgens (male hormones), which can disrupt ovulation and cause a cascade of symptoms throughout the body.

Despite the name, not all women with PCOS have ovarian cysts. And not all cysts mean you have PCOS. It’s a syndrome, meaning it’s diagnosed based on a collection of symptoms, not just one.

What Causes PCOS?

The exact cause isn’t fully understood, but several factors may play a role:

  • Insulin resistance: Many women with PCOS have trouble using insulin effectively, which can lead to high insulin levels and stimulate excess androgen production.
  • Genetics: PCOS tends to run in families. If your mother or sister has it, your risk is higher.
  • Inflammation: Low-grade chronic inflammation is common in PCOS and may contribute to hormone imbalance.
  • Hormonal disruption: Elevated luteinising hormone (LH), low sex hormone-binding globulin (SHBG), or increased androgens like testosterone are often seen in bloodwork.

Common Symptoms of PCOS

The symptoms of PCOS can vary, but these are the most common:

  • Irregular or missing periods
  • Excess facial or body hair (hirsutism)
  • Acne or oily skin
  • Weight gain, especially around the belly
  • Difficulty losing weight
  • Hair thinning or scalp hair loss
  • Mood swings, anxiety, or depression
  • Fatigue or poor energy
  • Fertility struggles or difficulty ovulating

Why PCOS Is So Often Misdiagnosed (Or Missed Altogether)

Many women go years before receiving a diagnosis, and some never do. Here’s why:

  • Symptoms are normalised: Painful, irregular periods or acne are often dismissed as “just hormonal” or “part of being a woman.”
  • Lack of proper testing: Some doctors may not run the full hormone panel or check insulin resistance markers like fasting insulin or HOMA-IR.
  • BMI bias: Lean women with PCOS often go undiagnosed because they don’t “look” like the typical PCOS patient.
  • Symptom overlap: PCOS shares symptoms with thyroid issues, adrenal dysfunction, and perimenopause, which can complicate diagnosis.

How PCOS Is Diagnosed

There’s no single test for PCOS. Most diagnoses are based on the Rotterdam criteria, which requires two of the following three:

  • Irregular or absent periods
  • Signs of excess androgens (on blood tests or physically, like acne or hair growth)
  • Polycystic ovaries seen on ultrasound

That’s why functional and comprehensive blood testing is so important, below are the markers you have to look out for:

  • Total and Free Testosterone
  • DHEA-S
  • SHBG
  • LH & FSH
  • Insulin and HbA1c
  • And thyroid markers, because thyroid conditions can mimic or worsen PCOS

Why Getting a Diagnosis Matters

PCOS isn’t just about periods or fertility. Left unaddressed, it can raise your risk of:

  • Type 2 diabetes
  • Heart disease
  • Endometrial cancer
  • Anxiety and depression
  • Infertility

But knowledge is power. With the right information, you can take back control of your body, your hormones, and your long-term health.

Final Thoughts

PCOS is a whole-body condition. If your symptoms are being dismissed, trust your instincts and advocate for deeper testing. You deserve better than vague advice or the pill as a quick fix.

At Nudae, we believe in a proactive, root-cause approach to hormone health. Our at-home hormone panels are designed to give you clarity, so you can finally connect the dots and move forward with confidence.

Disclaimer: Nudae testing is not a diagnostic tool. Always consult with a healthcare professional for clinical diagnosis and treatment.x

 

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