PCOS Symptoms Often Overlooked: When Should You Get Checked?

PCOS doesn’t only affect reproductive health. It can also have a significant impact on overall wellbeing. Many women with PCOS experience anxiety, low mood, disordered eating patterns, and negative body image.

While PCOS is a long-term condition that cannot be cured, its symptoms can be managed effectively through the right approach, including lifestyle changes, medical treatment, and personalised fertility planning.

Interestingly, many women with PCOS also experience insulin resistance, even if they don’t have diabetes. This plays a key role in worsening hormonal imbalance. When insulin levels are elevated:

• androgen production increases,
• ovulation becomes irregular,
• fat accumulation (especially around the abdomen) tends to rise.

Common symptoms of PCOS

PCOS symptoms can vary from person to person, but the most commonly reported include:

• irregular or missed periods,
• weight gain,
• acne,
• hair thinning or hair loss,
• excessive hair growth on the face, chest, or back,
• mood changes,
• sleep disturbances,
• difficulty getting pregnant,
• signs of insulin resistance.

How is PCOS diagnosed?

PCOS is often linked to ovulation issues that affect fertility. It occurs when the ovaries produce higher levels of androgens, which disrupt normal reproductive function.

Doctors typically consider a PCOS diagnosis if at least two out of three of the following criteria are present:

1. Irregular menstrual cycles

Periods may become infrequent or unpredictable, often fewer than 8–9 cycles per year.

2. Elevated androgen levels

This may present as excess facial or body hair, acne, or other hormonal skin changes.

3. Polycystic ovaries

The ovaries may appear enlarged and contain multiple small follicles when examined via ultrasound.

Causes and risk factors

The exact cause of PCOS is still not fully understood, but several factors may increase the risk:

1. Sedentary lifestyle

Lack of physical activity can worsen insulin resistance.

2. High sugar and processed diet

Frequent consumption of sugary and refined foods may trigger blood sugar spikes and hormonal imbalance.

3. Chronic stress

Long-term stress increases cortisol levels, which can interfere with ovulation and metabolism.

4. Poor sleep quality

Irregular sleep patterns and excessive screen time can disrupt hormonal rhythms.

Tests for PCOS

There isn’t a single test to diagnose PCOS. Instead, doctors carry out a comprehensive evaluation to rule out other conditions with similar symptoms.

This may include:

• physical examination (checking acne, hair growth, weight changes),
• pelvic examination,
• blood tests to assess hormone levels,
• pelvic ultrasound to examine the ovaries and uterine lining.

Managing PCOS

Although PCOS cannot be cured, it can be managed with the right strategies to control symptoms and reduce long-term health risks.

1. Lifestyle changes

This is the foundation of PCOS management, especially for addressing insulin resistance:

• reducing sugar and refined carbohydrates,
• eating a balanced diet rich in fibre and protein,
• exercising regularly (at least 150 minutes per week),
• maintaining a healthy weight.

2. Medical treatment

Depending on your condition, your doctor may recommend:

• hormonal therapy to regulate menstrual cycles,
• insulin-lowering medication,
• anti-androgen treatment for acne and excess hair growth.

3. Fertility support

For those planning a pregnancy:

• ovulation induction,
• cycle monitoring,
• personalised fertility programmes.

Why early detection matters

Many women don’t realise that what they’re experiencing could be signs of PCOS. Without proper management, PCOS may increase the risk of:

• type 2 diabetes,
• metabolic disorders,
• infertility,
• mental health challenges.

PCOS screening at GWS Medika

To achieve an accurate diagnosis, PCOS screening should be carried out comprehensively, through both clinical evaluation and laboratory testing.

For a well-rounded assessment, PCOS screening ideally includes the following key parameters:

• Estradiol (E2), FSH, and LH: to assess reproductive hormone balance.
• Progesterone and Prolactin: to evaluate ovulation function and other hormonal imbalances.
• Testosterone, SHBG, and Free Androgen Index: to detect excess androgen levels.
• TSH and FT4: to assess thyroid function, which also affects the menstrual cycle.
• HbA1c & Insulin: to evaluate the risk of insulin resistance and metabolic concerns.

Before undergoing a PCOS examination, there are several important things to consider to ensure more accurate results:

• Sample collection should be performed between day 2 to day 5 of the menstrual cycle.
• Fasting for 8–10 hours is recommended prior to the test (drinking water is allowed), as the examination includes insulin level assessment.
• The test is ideally conducted in the morning to obtain more optimal hormone results.

PCOS screening results are typically available within approximately 14 working days after sample collection.

This is because some parameters require further analysis at a laboratory in Singapore.

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Listening to your body is the first step. With the right support and guidance, you can manage PCOS and feel more in control of your health and wellbeing.