Actually, this is not an uncommon occurrence, as there are a number of reasons why you might not be diagnosed until you are older. This can be confusing and many women wonder why this disorder wasn’t found earlier in their life. In fact, many women aren’t even aware that they have the syndrome until they are trying to get pregnant in their twenties or thirties.
PCOS is a disorder of the endocrine, or hormonal system. Women tend to have higher than normal levels of androgens (male hormones like testosterone) circulating in their body, leading to a wide range in symptoms. The most common symptoms of PCOS include irregular or absent periods, acne, weight gain and irregular hair growth on the face, chest or body. In addition, many women with PCOS have many small cysts on their ovaries, causing a characteristic polycystic appearance on an ultrasound. This can look like a string of pearls surrounding the ovaries.
Diagnosing PCOS can be difficult since a specific test can't be performed nor is there a set list of symptoms that doctors can look for. Each woman’s experience of PCOS is unique because no two women have the exact same symptoms. Some women have the physical signs of PCOS like hair growth, acne and obesity, while they still get regular periods. Other women are extremely lean and thin, but still have irregular periods and ovaries that appear polycystic on an ultrasound. However, a diagnosis is usually made when a woman has irregular or absent periods, in addition to signs of high androgen levels without another medical cause.
The symptoms associated with PCOS are often mistaken for those experienced during adolescence. Most physicians would consider irregular periods, acne and weight gain to be normal signs of adolescence and wouldn’t diagnose PCOS until later in life.
Most women, in fact, wouldn’t think that anything was abnormal if they were having problems with acne or irregular periods late into their teens because a majority of teens have experienced these issues at some point during their adolescent years.
In addition, many young women start taking some form of hormonal birth control in their late teens and early twenties. Examples of these options include the pill, the ring, the patch and the depo provera injection. While they differ in the way that the hormones are deposited into the body, all of these options release small amounts of hormones like estrogen and progesterone.
By maintaining elevated blood levels of these hormones, the pill tricks the body in a few different ways. They primarily stop the release of a mature egg by preventing the change in hormone levels that is necessary for ovulation to occur. This also keeps the cervical mucus thick and tacky which stops any sperm from reaching the fallopian tubes. They also mask the symptoms of PCOS by regulating the menstrual cycle and even treating acne.
Women with PCOS tend to have irregular menstrual cycles, meaning that they are not ovulating regularly. This can lead to infertility or difficulty becoming pregnant. Since it’s not unusual to have irregular periods in the months following stopping your hormonal birth control, the symptoms of PCOS may still not be apparent. This is especially true because most doctors recommend waiting at least a few months before trying to get pregnant.
It’s not a coincidence that many women are diagnosed with PCOS once they come off their hormonal birth control as they are trying to get pregnant. The absence of these hormones tends to make the symptoms more apparent, as women become more aware of their irregular menstrual cycles. If you've been diagnosed with PCOS, make sure to check out the rest of the content on this site to learn more about the syndrome and how to manage it.