The Hidden PCOS Symptoms No One Talks About—Are You Missing These Signs?

I still remember the day I first realised something was off. Sitting in my room, I felt a mix of confusion and fear as I scrolled through my phone, trying to understand the strange symptoms I was experiencing. I had heard of PCOS—polycystic ovarian syndrome—but I thought it was just about irregular periods and weight gain. Little did I know there were so many hidden symptoms that no one talks about,” says Meera*, a 24-year-old marketing professional.

If you're juggling work and family, you may not pay attention to the subtle signs of PCOS. This common condition often goes unnoticed because its symptoms can be easily overlooked or dismissed. In this blog, we will turn the spotlight on these symptoms - helping you recognise PCOS as early as possible.

Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder common among women of reproductive age. It occurs when the ovaries produce an abnormal amount of androgens, which are male sex hormones usually present in women in small amounts.

PCOS can feel like a complex puzzle, but understanding why it happens can make it easier to manage. Let's break down the main reasons:

1. Insulin Resistance

Your body uses a hormone called insulin to turn the sugars and starches you eat into energy. Insulin resistance means your body's cells aren't responding well to this hormone. To compensate, your body produces more insulin to try to get the job done. High insulin levels can cause your ovaries to produce more androgens, which are male hormones like testosterone.

What You Might Notice: Symptoms like weight gain or difficulty losing weight. Women with PCOS have a 70% chance of having insulin resistance. Up to 80% of women with PCOS are overweight.

2. Hormonal Imbalance

When your body has higher levels of androgens (male hormones) than normal, they interfere with the signals that trigger ovulation (the release of an egg from the ovary). This can lead to:

a.Irregular Periods

These include menstrual cycles that are longer than 35 days, fewer than nine periods a year, prolonged periods that may be scanty or heavy, or cycles that are unpredictable.

What You Might Notice: Skipped periods, delayed periods, unusually heavy or light menstrual flow and trouble getting pregnant.

b.Physical changes:

• Hirsutism: Excessive hair growth on the face, chin, chest, abdomen, or back.
• Severe Acne: Persistent acne on the face, chest, and upper back.
• Male-Pattern Baldness: Thinning hair or hair loss from the scalp.

3. Inflammation

Your body experiences low-grade inflammation, meaning your immune system is active even when you're not sick. This constant inflammation can worsen hormone imbalance.

What You Might Notice: Fatigue, headaches, and joint pain.

4. Genetics

PCOS can run in families due to shared genes. If your mother, sister, or close female relative has PCOS, you might be more likely to develop it.

PCOS usually affects women aged 15 to 44 but can occur at any age after puberty. Urban lifestyles with high stress, poor diet, and sedentary habits are known factors

Did you know? Even though PCOS affects 1 in 5 women in India, 70% of them remain undiagnosed. Let’s understand why.

The symptoms of PCOS usually begin in your late teens, when acne, weight gain, and irregular periods are common, so they are often overlooked.

However, there may be deeper factors at play. As women many of us are taught to prioritize the needs of others over our own. This can lead us to overlook our health problems. Another reason we might ignore our symptoms is because of cultural beliefs.

Talking about certain health issues, like menstruation or mental health, can be considered taboo. This can make it difficult for us to seek help or even admit that something is wrong. When it comes to PCOS, ignoring symptoms can lead to more serious problems later on.

Now, let's explore the subtle signs that often go unnoticed but are equally important.

1. Mood Swings

Hormonal imbalances can affect neurotransmitters - chemicals in the brain like serotonin and dopamine- that usually regulate our mood. Women with PCOS are 3 times more likely to experience anxiety and depression.

Meera* continues, “I used to think my mood swings were just due to stress at work or home. It wasn't until I connected the dots that I realised PCOS was playing a role."

Lifestyle Tip: Incorporate stress-relief practices like yoga or meditation into your daily routine. Even a short 15-minute session can make a difference.

2. Fatigue and Low Energy

There were days I couldn't get through without multiple cups of chai. It felt like no matter how much I rested, I was always tired,” says Yashi*, a 34-year-old homemaker.

Lifestyle Tip: Opt for a balanced diet rich in whole grains, fruits, and vegetables to keep your energy levels stable. Include foods with a low glycemic index to manage blood sugar levels.

3. Sleep Disturbances

PCOS can disrupt sleep patterns by interfering with the release of melatonin, a hormone that helps regulate sleep. Women with PCOS are four times more likely to experience sleep problems. Additionally, 35% of women with PCOS may develop sleep apnea due to weight gain.

I would toss and turn at night, my mind racing with thoughts about the next day, but my kids always said I had an anxious personality - so I let it go,” explains Preeti, a 42-year-old mom of two.

What You Might Notice

• Loud snoring
• Gasping for air during sleep: You might wake up suddenly feeling short of breath.
• Feeling excessively tired during the day, even after a full night's sleep.
• Waking up with headaches can be a sign of disrupted sleep.
• Poor sleep can affect your focus and memory.

Lifestyle Tip: Establish a calming nighttime routine. Consider drinking warm turmeric milk or herbal teas before bed.

4. Skin Issues Beyond Acne

Hormone imbalances may lead to:

• Acanthosis nigricans - a condition characterised by dark, velvety patches of skin, often in the folds of the skin, such as the armpits, groin, and neck.
• Skin tags - small, fleshy growths that often appear on the skin, and do not cause any pain or discomfort.

If you notice any changes in your skin, it's a good idea to consult with a healthcare professional for a proper evaluation.

5. Digestive Problems

Hormonal fluctuations can affect the digestive system, altering gut motility and microbiota balance, leading to bloating and constipation.

Lifestyle Tip: Include probiotics like homemade curd or buttermilk in your diet to improve gut health. Increase fibre intake with foods like oats and lentils.

It all starts with listening to your body. Pay attention to how you feel, both physically and emotionally, and keep track of any changes. A simple journal can help you spot patterns in your symptoms, and the more you know about PCOS, the better prepared you’ll be to understand what’s happening.

Talking to others can also make a world of difference. Whether it’s confiding in friends, family, or joining a local women’s health group, you’ll find that shared experiences can offer comfort and valuable insights.

Of course, seeing a healthcare professional is a must. Don’t wait—early diagnosis is key. A gynaecologist or endocrinologist can guide you through necessary tests, like blood work or ultrasounds.

With PCOS, there are no quick fixes—we need to understand our bodies, make informed choices, and build a strong support system along the way. After all, true health is a journey, not a sprint

Recap: Managing PCOS

Diet

Focus on high-fiber foods and avoid refined carbs. Include healthy fats like ghee and coconut oil. Opt for balanced meals with Indian superfoods such as chia seeds and fenugreek.

Exercise

Engage in daily yoga or go for a brisk walk to stay active.

Stress

Practice Pranayama (breathing exercises) and meditation. Keep a journal to help manage stress and emotions.

Sleep

Prioritise 7-8 hours of quality sleep each night to support hormonal balance.

1. PCOS symptoms are more than just irregular periods and weight gain.
2. Many women overlook subtle signs like mood swings, fatigue, and skin changes that could indicate PCOS
3. Insulin resistance can lead to weight gain and hormone imbalances, which are common in women with PCOS.
4. Hormonal imbalances can disrupt sleep patterns and affect digestion, leading to issues like sleep apnea and bloating.
5. Women with PCOS are more likely to experience mood swings, anxiety, and depression due to hormone fluctuations.
6. Keeping track of physical and emotional changes, consulting healthcare professionals, and adopting lifestyle modifications are vital steps for early diagnosis and effective management.