PCOS symptoms include irregular periods, excess facial and body hair, hormonal acne and unexplained weight gain. Your OBGYN diagnoses polycystic ovary syndrome through a combination of blood tests, pelvic ultrasound and a detailed review of your symptom history. PCOS is a hormonal and endocrine disorder that affects an estimated 6-13% of women during their reproductive years, according to the World Health Organization. Up to 70% of women living with this condition have not received a formal PCOS diagnosis. That statistic means many women experience symptoms for years without understanding their cause. This guide explains what PCOS looks like, how your OBGYN identifies it and what PCOS treatment options are available through gynecology services at your local practice.
What Is PCOS and What Causes It?
Polycystic ovary syndrome is a hormonal disorder in which the ovaries produce excess androgens, a group of hormones that includes testosterone. The elevated androgen levels disrupt the normal menstrual cycle and interfere with regular ovulation. The name “polycystic” refers to the small fluid-filled follicles that may appear on the ovaries during an ultrasound. Not every woman with PCOS develops these follicles, and the presence of ovarian follicles alone does not confirm a diagnosis.
Three primary factors contribute to the development of PCOS. Insulin resistance causes the body to produce more insulin, which signals the ovaries to release additional androgens. Hyperandrogenism, the overproduction of male hormones, disrupts ovulation and triggers physical symptoms like excess hair growth and acne. Genetic predisposition plays a significant role as well. Women who have a mother or sister with PCOS or type 2 diabetes carry a higher risk of developing the condition. Researchers believe a combination of inherited genes and environmental factors like weight and lifestyle habits influence whether PCOS develops.
What Are the Most Common PCOS Symptoms?
PCOS symptoms affect multiple systems in the body and vary widely from one woman to the next. Some women experience several symptoms at once, and others may notice only one or two changes. A number of women learn they have PCOS only after they have difficulty getting pregnant.
| Symptom | What It Looks Like | Why It Happens |
| Irregular or missed periods | Fewer than 8 cycles per year, cycles longer than 35 days, or absent periods | Excess androgens prevent the ovaries from releasing an egg on a regular schedule |
| Hirsutism (excess hair growth) | Coarse, dark hair on the face, chin, chest, abdomen or upper thighs | Elevated testosterone stimulates hair follicles in androgen-sensitive areas |
| Hormonal acne | Persistent or cystic acne along the jawline, chin and lower face that does not respond to standard skincare | Androgens increase oil production in the skin |
| Thinning scalp hair | Hair loss or thinning at the crown and part line, similar to male-pattern hair loss | Androgens shrink hair follicles on the scalp over time |
| Weight gain | Unexplained weight gain, particularly around the midsection, and difficulty losing weight | Insulin resistance promotes fat storage and makes weight loss harder |
| Acanthosis nigricans | Darkened, velvety patches of skin on the neck, armpits or groin | A visible sign of insulin resistance |
| Skin tags | Small, soft skin growths in areas where skin folds | Associated with insulin resistance and hormonal imbalance |
These symptoms can affect self-confidence and day-to-day quality of life. If you notice persistent changes in your menstrual cycle, skin or hair growth patterns, an OBGYN evaluation can help identify the cause. Abnormal bleeding is one of the earliest and most recognizable signs that your hormones may need professional assessment.
How Does an OBGYN Diagnose PCOS?
Your OBGYN uses a set of criteria called the Rotterdam criteria to evaluate whether your symptoms point to PCOS. A PCOS diagnosis requires at least 2 of the following 3 findings: irregular or absent ovulation, clinical or laboratory evidence of elevated androgens, and polycystic ovarian morphology visible on ultrasound. You do not need to meet all three criteria, and you do not need ovarian cysts to receive a PCOS diagnosis. The word “polycystic” in the name describes a pattern of small follicles on the ovaries, not true cysts, and up to 20% of women without PCOS show a similar follicle pattern on imaging.
The diagnostic process at your OBGYN appointment typically follows these steps:
- Symptom and family history review. Your provider asks about your menstrual patterns, hair and skin changes, weight fluctuations, fertility concerns and whether close family members have PCOS or type 2 diabetes.
- Physical examination. Your OBGYN checks for visible signs of elevated androgens, including excess hair growth, acne, skin discoloration, skin tags, blood pressure and weight.
- Blood tests. Your provider orders labs to measure testosterone, DHEA-sulfate, fasting glucose or hemoglobin A1C, thyroid-stimulating hormone (TSH), prolactin and a lipid panel. These tests confirm androgen levels and rule out other conditions with overlapping symptoms, including thyroid disorders, congenital adrenal hyperplasia and prolactinoma.
- Pelvic ultrasound. An ultrasound allows your OBGYN to examine the ovaries for a polycystic follicle pattern and check the thickness of the uterine lining, which can thicken when ovulation does not occur regularly.
No single test confirms PCOS on its own. Your OBGYN pieces together your symptom history, lab results and imaging findings to reach an accurate clinical diagnosis.
What PCOS Treatment Options Can Your OBGYN Recommend?
PCOS treatment is not one-size-fits-all. Your OBGYN builds an individualized plan based on your specific symptoms, metabolic health and whether you are trying to conceive.
| Treatment | Purpose | Best For |
| Combined hormonal birth control (pill, patch, ring) | Regulates menstrual cycles, lowers androgen levels, protects the uterine lining from thickening | Women not currently trying to conceive |
| Spironolactone | Blocks androgen activity to reduce excess hair growth and acne | Hirsutism and persistent hormonal acne |
| Metformin | Improves the body’s response to insulin, may help regulate menstrual cycles | Women with insulin resistance or prediabetes |
| Letrozole or clomiphene | Stimulates the ovaries to release an egg | Women actively trying to conceive |
| Lifestyle modification (nutrition and exercise) | Supports healthy weight, improves insulin sensitivity, lowers androgen levels | All women with PCOS |
Lifestyle changes play a meaningful role in PCOS management at every stage. Clinical evidence shows that losing approximately 10% of body weight can improve menstrual regularity, reduce androgen levels and increase insulin sensitivity. That said, weight loss alone does not resolve PCOS for most women. Combining healthy eating habits and regular physical activity with medical treatment produces the strongest results.
Your OBGYN may refer you to a reproductive endocrinologist if you need advanced fertility support like in vitro fertilization (IVF). A referral to an endocrinologist may be appropriate if you have complex metabolic concerns that require specialized management.
How Does PCOS Affect Fertility and Pregnancy?
PCOS is one of the most common causes of female infertility, according to the American College of Obstetricians and Gynecologists (ACOG). Irregular or absent ovulation means fewer opportunities for an egg to be fertilized each cycle. Some women with PCOS ovulate occasionally and others rarely ovulate at all.
Your OBGYN can evaluate your fertility through bloodwork, ultrasound monitoring and a review of your ovulation patterns. First-line treatment for PCOS-related infertility typically involves ovulation induction medication like letrozole, which helps the ovaries release an egg on a more predictable schedule. If first-line options are not successful, your provider can refer you to a reproductive endocrinologist for treatments like intrauterine insemination (IUI) or IVF. You can learn more about evaluating fertility concerns in our guide to the signs of infertility.
Many women with PCOS conceive with the right treatment approach. PCOS does not mean you cannot become pregnant. It means your path to pregnancy may benefit from medical support and monitoring.
PCOS is a lifelong condition that does not fully resolve after menopause. Androgen levels may decrease as ovarian function declines, and menstrual irregularity becomes less of a concern. Metabolic risks tied to PCOS, including insulin resistance, type 2 diabetes and cardiovascular disease, persist beyond the reproductive years. Long-term follow-up with your provider remains an important part of managing your health.
When Should You See an OBGYN About PCOS Symptoms?
You should schedule an appointment with your OBGYN if you experience any of the following:
- Fewer than 8 menstrual cycles per year or cycles that consistently exceed 35 days
- New or worsening acne, excess facial or body hair, or thinning scalp hair
- Difficulty conceiving after 12 months of trying, or after 6 months if you are over age 35
- A family history of PCOS or type 2 diabetes
- Unexplained weight gain concentrated around the midsection
Your annual well-woman exam is an ideal opportunity to discuss any of these symptoms with your provider. Early identification of PCOS gives you and your OBGYN more time to address symptoms, protect your metabolic health and plan for your fertility goals.
Get PCOS Support from Gwinnett OB/GYN in Snellville, GA
PCOS is a manageable condition when you have an accurate diagnosis and a treatment plan built around your individual needs. The board-certified OBGYN team at Gwinnett OB/GYN brings over 45 years of experience in women’s healthcare, including the evaluation and long-term management of polycystic ovary syndrome.
Gwinnett OB/GYN offers on-site ultrasonography and on-site phlebotomy services Monday through Friday. That means your bloodwork and pelvic ultrasound can happen during the same visit, reducing the time between your first appointment and a confirmed PCOS diagnosis. The practice maintains an established referral network with reproductive endocrinologists and endocrinologists for patients who need advanced fertility or metabolic care.
Gwinnett OB/GYN serves patients in Snellville and surrounding communities, including Lawrenceville, Duluth, Loganville, Stone Mountain, Norcross and Lilburn. Schedule an appointment with Gwinnett OB/GYN to discuss your PCOS symptoms and take the first step toward a personalized care plan.