There is no simple test for Polycystic Ovarian Syndrome (PCOS). Your health care professional will do a thorough history and physical examination, perhaps with lab tests, to determine whether your symptoms stem from PCOS or another disorder. Diagnosis begins with an inventory of symptoms, the most common of which are:

  • Hirsutism (excess body and/or facial hair, particularly on the chin, upper lip, breasts, inner thighs and abdomen)
  • Irregular or infrequent periods
  • Obesity
  • Acne and/or oily skin (particularly severe acne in teenagers or acne that persists into adulthood)
  • Infertility
  • Ovarian cysts
  • Hair loss or balding
  • Acanthosis nigricans (darkening of the skin, usually on the neck; AN is a sign of insulin problems as well)
  • Skin tags, small pieces of excess skin in the armpit or neck area

Women with PCOS may have varying combinations of symptoms, but two essential features of the disorder are:

  • Hyperandrogenism, excess blood levels of androgens or symptoms indicating hyperandrogenism. Androgens are hormones such as testosterone that, in excess quantities, cause such symptoms as hirsutism and acne. In more severe cases, "virilization" may take place, including such symptoms as clitoromegaly (an enlarged clitoris), balding at the temples, voice deepening and muscle growth.
  • Lack of ovulation, or irregular ovulation along with irregular or absent menstruation. Women with PCOS may have oligomenorrhea (eight or fewer periods per year) or amenorrhea (absence of periods for extended periods). Some women with PCOS have polymenorrhea, or periods that are too frequent.