Despite being a super common condition, it can take years to get a PCOS diagnosis. Here, learn all about the hormone disorder, including PCOS symptoms and treatment.

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Affecting 1 in 10 — about 10 percent of — women of childbearing age, polycystic ovary syndrome (aka polycystic ovarian syndrome or PCOS), is a medical condition characterized by an imbalance of reproductive hormones. Despite being super common and serious, however, it can take an average of two years — and three different doctors — to diagnose PCOS, according to a 2017 study in the Journal of Clinical Endocrinology & Metabolism. One potential reason for this delayed diagnosis? The fact that PCOS symptoms manifest differently in different women, says Anuja Dokras, M.D., Ph.D., study author and director of the Penn PCOS Center at the University of Pennsylvania.

But, as with so many other health conditions, the more you know about the disease, the more likely you'll be able to advocate for yourself and score a successful diagnosis. And that's where this article comes in. Ahead, experts break down everything you need to know about the disorder, including PCOS symptoms as well as treatment.

What Is PCOS, Exactly?

PCOS is a type of endocrine disorder, wherein patients — typically those born with a uterus and ovaries — have a hormonal imbalance that can negatively impact the ovaries and development or release of eggs during the menstrual cycle, according to the Office on Women's Health (OASH). The condition may also involve metabolism problems that can impact the entire body.

What Causes PCOS?

While the exact cause of PCOS is unknown, many experts believe several factors contribute to the development of the disease, including genetics. In fact, according to the PCOS Awareness Association, you're more likely to have the condition if your mother or sister also has PCOS. But the jury's still out on how much DNA factors in, says Dr. Dokras. (Related: The Connection Between PCOS and IBS)

Also potentially at play? High levels of androgens, which are sometimes called "male hormones," although people born with a uterus and ovaries make small amounts of the hormones as well. Patients with PCOS, however, often produce more androgens than normal, potentially resulting in extra hair growth and acne — two telltale signs of PCOS — and preventing ovulation (when an ovary releases an egg), according to the OASH.

Similarly, those with the disorder often have high levels of insulin and insulin resistance. ICYDK, insulin resistance occurs when your body doesn't use insulin — the hormone that controls how the food you eat is changed into energy — effectively, causing your pancreas to produce more of it. This then increases your blood sugar levels (thus the high levels of insulin) and, in turn, your risk for developing diabetes. And it doesn't stop there: High levels of insulin can also, "promote weight gain" and lead to worsened PCOS symptoms, as Minisha Sood, M.D., a New York City-based endocrinologist previously told Shape. And on that note...

What Are the Symptoms of PCOS?

As just mentioned above, excess hair growth (on the face and body), acne, and weight gain are all common PCOS symptoms. PCOS can also cause missed or irregular menstrual periods and can cause cysts — fluid-filled sacs — to develop on the ovaries.

Why? Quick refresher: Ovulation occurs when a mature egg is released from an ovary so it can be fertilized by a sperm. If this doesn't occur, it's expelled from your body (along with your uterine lining) during your period. In some cases, however, a person might not make enough hormones needed to ovulate, thereby inhibiting the eggs from being released. Meanwhile, the follicle (which releases the egg) just keeps growing, and, over time, it can swell and become a cyst, according to the PCOS Awareness Association. Although benign and typically asymptomatic, these ovarian cysts can make androgen hormones (as if patients with PCOS needed more of 'em), leading to PCOS symptoms and problems with the menstrual cycle. But what comes first: the chicken or the egg the cysts or the period problems? TBD.

Now, yes, the potential for these growths might seem obvious given the condition's name. But simply having them isn't enough for diagnosis, according to the Centers for Disease Control and Prevention. What's more, many women do not have ovarian cysts but still suffer from PCOS. (Remember what Dr. Dokras mentioned earlier? PCOS symptoms often vary across patients.)

Other telltale signs of PCOS include thinning hair as well as fertility problems. So much so, in fact, that PCOS is considered one of the most common causes of infertility in people with uteruses, according to the CDC. And, as the OASH notes, most women only find out that they have PCOS when they're already having troubles with conception.

PCOS Diagnosis

Diagnosis, which can happen as young as 11 but is most common in the early 20s, is based on having at least two of the following criteria, explains Dr. Dokras: irregular periods, high androgen hormone levels, or abnormal hair growth (usually on the upper lip or chin, or near the belly button and inner thigh), and an increased number of follicles and cysts, which can be revealed via an ultrasound.

But there are differences based on age (acne and irregular periods are also features of puberty) as well as ethnic groups (some races have more body hair) so diagnosis isn't always simple. Plus, the symptoms are often relevant to multiple specialists, since you'll see a dermatologist for acne and a gynecologist for menstruation issues and not think to cross-share the information, points out Dr. Dokras. (Related: Why Is It So Hard for Black Women to Get Diagnosed with Endometriosis?)

While PCOS is hard to diagnose, it's incredibly important that it be diagnosed ASAP. Why? PCOS increases your risk of four of the 10 leading causes of death in America: heart disease, cancer, stroke, and diabetes.

In fact, more than half of women with PCOS will have diabetes or pre-diabetes before they turn 40, and are four to seven times more likely to have a heart attack than women of the same age without PCOS, according to the PCOS Awareness Association. Sufferers are two to five times more likely to develop metabolic syndrome — that's the increased blood pressure, blood sugar, and cholesterol that often lead to potentially deadly diseases — than women without the condition. Nearly half of PCOS sufferers are more depressed and one-third are more anxious than women without PCOS. The hormone imbalance also makes your bones weaker, increasing the prevalence of osteoporosis. And while many women with PCOS have a harder time getting pregnant, those who do are then at a higher risk for complications, including gestational diabetes, preeclampsia, and preterm delivery.

Phew — that's a lot of risks. Why does PCOS mess with your health so badly? Your first instinct is probably to blame the out-of-whack hormone levels, but it's not quite that easy. A study in Fertility and Sterility found that women with PCOS had a higher risk of metabolic syndrome whether or not they had excessive levels of male hormones. (Related: What Ob-Gyns Wish Women Knew About Their Fertility)

Weight is definitely a factor, considering anywhere from 35 to 60 percent of women with PCOS are overweight, carrying fat especially around their stomach, which is known to up your risk for heart disease. But even lean women with PCOS have a higher risk of diabetes and higher cholesterol compared to women without the issue, says Polish research.

The short of it: Docs don't know exactly why, but they do know PCOS significantly increases your risk for some serious diseases. And unfortunately, there isn't a cure. But you can mitigate other factors that simultaneously up your risk for the other diseases.

PCOS Treatment

Lifestyle intervention is the strongest line of defense, according to pretty much every study on the topic. Quitting smoking, cleaning up your diet, and losing weight can all help reduce the symptoms of PCOS. The key is really in weight loss — science says PCOS sufferers at a normal weight have a lower risk for type 2 diabetes than those who are overweight or obese. In fact, a study in the North American Journal of Medical Sciences found women with PCOS who lost weight not only reduced their risk of type 2 diabetes and heart disease, but 63 percent regained normalcy in their menstrual cycle and 12 percent became pregnant over just three months. Scoring at least six hours of sleep can also help reduce the risk of diabetes and infertility. (Related: What's the Best Diet for PCOS?)

Depending on your symptoms, your doctor might also prescribe medication as part of your PCOS treatment. For example, an Rx for hormonal birth control (think: the pill, IU, vaginal ring) might help make your menstrual cycle more regular, improve acne, and reduce extra hair on the face and body. Similarly, anti-androgens — medicines that block the effects of androgens in your body — might also address concerns such as scalp hair loss, face and body hair growth, as well as acne. Another drug known as Metformin, an oral diabetes medication, has been shown to improve insulin and androgen levels, which, in turn, can better other PCOS symptoms. However, it's worth noting that neither Matformin nor anti-androgens are approved by the Food and Drug Administration to treat PCOS, according to the OASH.

So how do you know if you're at risk? If you are overweight; if you have irregular periods; abnormal hair growth on your face, stomach, or inner thighs; a history of ovarian cysts; or family members with PCOS; it's definitely worth talking to your gynecologist. If your doc is concerned, they'll likely order a blood test (which can detect high androgen and insulin levels) and an ultrasound (which can spot extra follicles and cysts) and go from there.

For those diagnosed with PCOS, heads up: Dr. Dokras' research found that only 15 percent of women were happy with the info they received, while 90 percent wanted more educational material and 70 percent were interested in patient workshops and groups. So, if you do have the condition, check out the PCOS Awareness Association, which provides info on local support groups and medical resources.