PCOS Symptoms: Irregular Periods, Acne, Hair Growth and What to Do

Periods that come every two or three months. Stubborn acne. Dark hair on the chin or upper lip. Weight that won't shift. Many young women in Bangladesh live with these problems quietly, sometimes facing hurtful comments from relatives, without knowing they may share one cause: polycystic ovary syndrome (PCOS).

The WHO estimates PCOS affects 10–13% of women of reproductive age, and that up to 70% of women with PCOS don't know they have it. It is common, manageable, and nothing to be ashamed of.

What Is PCOS?

The WHO describes PCOS as a common hormonal disorder in which higher than normal androgen levels (hormones often called "male hormones", which women also have) lead to:

• Irregular periods
• Abnormal ovulation (eggs not released regularly)
• Infertility
• Excess facial or body hair
• Acne

The WHO also says PCOS is:

• The most common cause of anovulation (not ovulating) worldwide, and a leading cause of infertility
• Something that runs in families
• A chronic metabolic condition that continues beyond the reproductive years

A new name: PMOS

The NHS now uses the name polyendocrine metabolic ovarian syndrome (PMOS) and notes that PMOS used to be called PCOS. Most people, doctors and websites in Bangladesh still say PCOS. Both names describe the same condition.

PCOS Symptoms

The NHS says symptoms usually start at puberty, under the age of 18, and continue until menopause. They can be mild or severe — or there may be no symptoms at all.

Main symptoms (NHS)

• Irregular periods or long gaps between periods
• Excessive hair growth (hirsutism) — face, chest, back — or hair loss from the scalp
• Weight gain or difficulty losing weight
• Difficulty getting pregnant
• Mental health problems such as depression or anxiety
• Oily skin and acne
• Feeling very tired
• Thick, dark patches of skin on the neck or armpits (acanthosis nigricans)

Example

Afsana, 21, a university student in Chattogram, gets a period only 4–5 times a year. She has acne along her jaw, dark hair on her chin, and a dark velvety patch on the back of her neck that she thought was "dirt". She has gained weight over two years. A doctor suspects PCOS and arranges hormone blood tests and an ultrasound.

"But I don't have cysts"

Despite the name, you don't need to have cysts on your ovaries to have PCOS — and having some follicles on a scan doesn't automatically mean PCOS. Diagnosis is based on the overall picture.

Why PCOS Matters for Long-Term Health

The WHO says women with PCOS are at higher risk of long-term problems including:

• Insulin resistance
• Type 2 diabetes
• Obesity

It also affects emotional well-being. This is why PCOS needs ongoing attention — not just treatment for periods or skin.

The dark skin patches on the neck or armpits (acanthosis nigricans) can be a sign of insulin resistance — mention them to your doctor.

How Is PCOS Diagnosed?

The NHS says a doctor may arrange tests with a gynaecologist or endocrinologist:

• Blood tests to check hormone levels and insulin resistance
• An ultrasound scan of the ovaries — the NHS says this is only done if you are over 18

Your doctor may also check for other conditions that cause similar symptoms, such as thyroid problems.

Before seeing a doctor, track:

• Dates of your periods for several months
• Weight and waist size
• Skin and hair changes (photos can help)
• Family history of PCOS, diabetes or irregular periods

PCOS Treatment

The NHS says there is no cure, but treatments and lifestyle changes can help.

Medicines the NHS lists

• Combined pill, progestogen-only pill or an intrauterine system (IUS) — to help with irregular periods
• Clomifene — to help fertility
• Spironolactone or eflornithine — to reduce facial and body hair
• Weight loss medicines, if overweight
• Metformin — a type 2 diabetes medicine, to help with tiredness and weight problems
• Skin creams or tablets for acne

These are prescription treatments. The right choice depends on your symptoms and whether you want to get pregnant. Don't start hormone pills or other medicines without a doctor's advice.

Fertility

The NHS explains PCOS can make it harder to get pregnant, usually because the ovaries don't release an egg each month. Many women with PCOS do get pregnant, sometimes with treatment. Speak to a doctor if you're trying to conceive.

Lifestyle Changes That Help

Healthy habits support treatment, especially for weight and insulin resistance:

• Regular physical activity — brisk walking, cycling, home workouts
• Balanced meals — smaller rice portions, more vegetables, dal, fish, eggs
• Fewer sugary drinks, sweets and fried snacks
• Regular sleep
• Managing stress

Even modest weight loss may improve symptoms for some women who are overweight. But PCOS isn't caused by "laziness", and slim women can have it too.

Mental Health and Self-Esteem

The NHS lists depression and anxiety among PCOS symptoms. Comments about weight, skin or facial hair — and pressure about marriage or fertility — can be very hard. Talk to someone you trust and tell your doctor if you feel low.

When to See a Doctor

See a doctor if:

• Your periods are irregular or you've had no period for several months (and you're not pregnant)
• You have excess hair, acne or hair loss that worries you
• You're trying to get pregnant without success
• You notice dark velvety skin patches
• Symptoms affect your daily life, work or relationships (NHS)

Related reading: PCOS raises the risk of type 2 diabetes — see the early signs of diabetes and HbA1c normal range. Thyroid problems can also cause irregular periods: read about hypothyroidism symptoms.

Frequently Asked Questions

What are the first signs of PCOS?

Irregular or missed periods, acne, extra facial or body hair, and weight gain are common early signs.

How common is PCOS?

The WHO estimates 10–13% of women of reproductive age have PCOS, and up to 70% don't know it.

Can PCOS be cured?

The NHS says there's no cure, but treatments and lifestyle changes can help symptoms.

Can I get pregnant with PCOS?

Yes, many women do. Some need fertility treatment. Talk to a doctor if you're trying to conceive.

Does PCOS cause diabetes?

The WHO says women with PCOS have a higher risk of insulin resistance and type 2 diabetes.

What is PMOS?

The NHS now calls PCOS "polyendocrine metabolic ovarian syndrome (PMOS)". It's the same condition.

Talk to a Doctor About PCOS Symptoms on ShifaMate

If you have irregular periods, acne or unwanted hair growth, you can consult a verified doctor privately through ShifaMate. Share your period dates, symptoms, photos of skin changes and any hormone or ultrasound reports. The doctor can advise on tests, treatment and referral, and issue a digital prescription when clinically appropriate. You can also browse ShifaMate doctors.

References

• World Health Organization. Polycystic ovary syndrome (fact sheet)
• NHS. Polyendocrine metabolic ovarian syndrome (PMOS) — formerly PCOS

This article is for general information and does not replace advice from a qualified doctor.