PCOS symptom checklist: what to note before your appointment
Cycle, skin, hair, metabolic and fertility signs of PCOS, with the details a clinician needs to assess you properly.
is diagnosed on a combination of features, not a single test, which means the quality of your own record makes a real difference to how quickly you are assessed.
In short: PCOS symptoms cluster into cycle irregularity, androgen-related skin and hair changes, metabolic signs and fertility difficulty. Around one in ten women of reproductive age are affected. Diagnosis uses the Rotterdam criteria: two of three features, with other causes excluded.
Cycle
- Fewer than nine periods a year
- Cycles longer than 35 days or highly unpredictable
- Periods that stopped altogether outside pregnancy
- Very heavy bleeding after a long gap
Record actual dates for six months if you can. "Irregular" means less than a dated list.
Skin
- Persistent adult acne, typically along the jaw, chin and upper neck
- Oily skin
- Dark, velvety patches at the neck, underarms or groin, which can indicate
- Skin tags
Hair
- Coarse hair growth on the face, chest, abdomen or back
- Thinning at the crown or a widening parting
Metabolic
- Weight that is difficult to shift, particularly around the middle
- Strong sugar cravings and post-meal energy crashes
- Raised blood glucose, HbA1c or cholesterol on previous tests
- Family history of type 2 diabetes
Fertility
- Difficulty conceiving after twelve months, or six months if over 35
- Uncertainty about whether or when you ovulate
Mood
Anxiety, low mood and body image distress are more common in PCOS than in the general population, and they are consistently under-addressed in appointments. Write them down; they belong in the consultation.
What to bring
Six months of cycle dates, a note of when skin or hair changes began and how fast they progressed, your weight history, family history of diabetes and PCOS, and any previous blood results.
Get assessed sooner if
- Hair growth or voice change is progressing rapidly, which needs prompt review
- You have gone more than three months without a period
- You are planning a pregnancy
Common questions
Can I have PCOS at a normal weight? Yes. A significant proportion of women with PCOS are of normal weight, and insulin resistance can still be present.
Does PCOS always cause facial hair? No. Presentation varies widely and some women have mainly cycle symptoms.
Is acne alone enough for a diagnosis? No, but it counts as a clinical sign of raised androgens within the criteria.
Read the full PCOS guide or find a gynaecology specialist.