According to the US office of Women’s Health, one out of every 10 women in childbearing age is suffering from Polycystic Ovary Syndrome (PCOS) on a global scale.  Compared to data from 2007, when PCOS occurred in about 1 out of 15 women, the number of PCOS patients is progressing with time. 
What is even more concerning is that, on average, 75% of these women remain undiagnosed after their gynecologist appointment (one reason can be lack of any symptoms).  This makes PCOS one of the most common, yet neglected health condition that can affect women’s overall health and quality of life.
But why PCOS affects more and more women every year? What causes it? How can you recognize the first (and not only the first) symptoms?
This article will guide you through these topics to raise awareness about this health condition! Because awareness is important when it comes to health!
Let’s get started!
What is polycystic ovary syndrome?
Polycystic ovary syndrome, polycystic ovarian syndrome, or simply PCOS, is a health condition that affects the proper function of the ovaries, delaying or preventing ovulation, increasing the chance or irregular periods and infertility, and eventually leading to hormonal-imbalance-related symptoms like weight gain, hair growth, and acne. 
According to the NHS, there are 3 features of PCOS :
- Irregular periods
- Excess androgen (increased male hormones)
- Polycystic ovaries (your ovaries are enlarged or surrounded by number of follicles that are basically sacs filled with fluid)
The source suggests that if you experience at least 2 of these features, you may get diagnosed with PCOS.
Keep in mind that even though the name of this health condition suggests cyst development around the ovaries, that doesn’t actually happen. That being said, the numerous fluid-filled follicles around the ovaries appear only in some women, while other can have PCOS without ovary enlargement or follicle development.
Normally, every month, one of the ovaries releases an egg that can be later fertilised by a spermatozoid (process also called ovulation). However, this health condition often prevents the egg from being released, which can leads to irregular periods, infertility, and hormonal issues.
Why do you get polycystic ovary syndrome?
The exact cause for PCOS is unknown for now. However, medical researchers and scientists suggest that there are various factors that can increase the predisposition to and risk of PCOS development. Some of these factors include:
Studies have found that women whose female relatives (mother, sister, aunt) suffer from polycystic ovary syndrome, are more prone to developing this syndrome, compared to women who don’t have such blood relatives.  Therefore, if your mother, grandmother, sister, or aunt has PCOS, it is recommendable to do regular annual gynecologist checks.
High androgen levels
Androgens are hormones that are usually produced in big amounts in man’s, and in minimal amounts in women’s body. They are also called “male” hormones, as they are responsible for physical characteristics like facial and body hair, as well as voice change.
That being said, (abnormally) high androgen levels in women were found to be associated with PCOS, as they can result in hormonal imbalance, suppress the regular function of the ovaries, restrict ovulation, and increase the risk of infertility. 
Evidence suggests that hyperproduction of insulin can be closely associated with hyperproduction of androgens. Or in other words, increased insulin can trigger increased androgen levels in the body. 
That being said, hyperproduction of insulin often occurs in people with insulin resistance (IR). For that reason, IR is considered to be a common cause of PCOS. This health condition occurs when the body cells become resistant to insulin, and the pancreas starts producing bigger amounts of the hormone in response. It often leads to weight gain, hyperinsulinemia, and metabolic syndrome, and PCOS.
In fact, the numbers show that insulin resistance and hyperinsulinemia affect between 65 and 70% of PCOS patients. 
More about the treatment of insulin resistance, you can find in the dedicated blog post.
Even though the relationship between obesity and PCOS is not well understood, the US Center of Disease Control and Prevention demonstrates that significant number of PCOS patients also suffer from excess weight, and suggests that obesity can be considered as indirect cause for ovarian disfunction, hormonal imbalance, and infertility. 
What are the symptoms of polycystic ovary syndrome?
According to a 2007 article in The Lancet, common symptoms of PCOS include  :
- Irregular period (delays over 10 days or skipping a month)
- Increased body (and facial) hair
- Weight gain
- Metabolic syndrome
- Increased risk of type 2 diabetes development
Evidence suggests that PCOS symptoms could be improved with a prescribed tailored treatment with hormonal (birth control, anti-androgen drugs) or antidiabetes medications (e.g., metfomin), weight loss, and exercising. 
What is more, a 2019 study published in The Journal of Endocrine Society found that PCOS symptoms could be improved with the use of probiotics or prebiotics, which to support/alter the balance in the gut microbiota. 
How to get diagnosed with polycystic ovary syndrome?
According to a 2016 article published in the American Family Physician Journal, the recommended guidelines for PCOS diagnosis (provided by the Endocrine Society) include :
- Diagnosis of hyperandrogenism (increased androgen levels)
- Lack of ovulation (and/or period)
- Polycystic ovaries
These three criteria should be covered before the final diagnosis is made by a health professional. To get diagnosed you should visit your gynecologist, endocrinologist, or healthcare provider.