Polycystic Ovary Syndrome (PCOS) - When To Call a Doctor

When To Call a Doctor

Polycystic ovary syndrome (PCOS) is a long-term (chronic) condition; symptoms tend to start gradually. It is common for PCOS symptoms to be mistaken for some other medical problem.

PCOS causes a wide range of symptoms, so it may be difficult to know when to see your doctor. But early diagnosis and treatment of PCOS will help prevent serious health problems, such as diabetes and heart disease. See your doctor if you have symptoms that suggest PCOS.

If you are a teenage girl, see your doctor if you have:

• Not started menstruating by age 15 or within 2 years of breast and genital hair development.
• Fewer than eight menstrual cycles a year, and this has lasted for 2 years after you started menstruation.
• Severe acne.
• Hair loss from your scalp.
• Excessive hair growth or hair growing in places such as the chest, back, or face (hirsutism).
• Menstrual cycles that are consistently less than 21 days apart or more than 35 days apart.
• Any symptoms of diabetes, such as increased thirst and frequent urination (especially at night), unexplained increase in appetite, unexplained weight loss, fatigue, blurred vision, or tingling or numbness in your hands or feet.
• Ongoing skin problems, such as acne, oily skin, dandruff, skin tags (acrochordons) in the armpits or neck area, or dark skin patches (acanthosis nigricans) on the neck, groin, or underarms or in skin folds.
• Excess weight gain or upper body obesity (more abdominal fat than hip fat). This is linked to high androgen levels.

If you are between 20 and 40 years old, see your doctor if you have:

• Menstrual cycles that are consistently less than 21 days apart or more than 35 days apart.
• Regular menstrual cycles but you have been trying unsuccessfully to become pregnant for more than 12 months.
• Vaginal bleeding that lasts more than 8 days; large clots; or excessive spotting.
• Pelvic pain for more than 6 months.
• Excessive hair growth or hair growing on the chest, back, or face (hirsutism).
• Any symptoms of diabetes, such as increased thirst and frequent urination (especially at night), unexplained increase in appetite, unexplained weight loss, fatigue, blurred vision, or tingling or numbness in your hands or feet.
• Ongoing skin problems, such as acne, oily skin, dandruff, skin tags (acrochordons) in the armpits or neck area, or dark skin patches (acanthosis nigricans) on the neck, groin, or underarms or in skin folds.
• Depression or mood swings. Many women may have emotional problems related to the many physical symptoms of PCOS, such as excess hair, obesity, or infertility.
• Excess weight gain or upper body obesity (more abdominal fat than hip fat). This is also known as android obesity and is related to increased male hormone (testosterone) levels.

If you are older than 40, call your doctor if you have:

• Vaginal bleeding that lasts more than 8 days; large clots; or excessive spotting.
• Pelvic pain for more than 6 months.
• Any symptoms of diabetes, such as increased thirst and frequent urination (especially at night), unexplained increase in appetite, unexplained weight loss, fatigue, blurred vision, or tingling or numbness in your hands or feet.
• Any signs of heart disease, such as high blood pressure (hypertension).
• Depression or mood swings. Hormonal changes are a known cause of emotional symptoms. But depression and mood swings can also be linked to living with physical PCOS symptoms, such as skin and hair problems, obesity, or infertility.

Watchful Waiting

Taking a wait-and-see approach (called watchful waiting) is not appropriate when PCOS is suspected. Early diagnosis and treatment may help prevent future complications such as reproductive, metabolic, or heart problems.

Who To See

Health professionals who can diagnose and treat PCOS include:

• Gynecologists.
• Obstetricians.
• Family medicine doctors.
• Nurse practitioners.
• Physician assistants.
• Internists.
• Endocrinologists (pediatric or medical).
• Reproductive endocrinologists.
• Registered dietitians.

To prepare for your appointment, see the topic Making the Most of Your Appointment