What are common signs and symptoms of PCOS?

First of all, the words sign and symptom have different meanings in medicine. A sign is something that a physician can directly observe, verify, or measure, like acne or hirsutism which is visible to the naked eye. A symptom is something that a patient reports, but which a physician cannot directly observe, like mood swings or pain. Also, not all women with PCOS will have the same collection of signs and symptoms or the same severity for each. Every woman is different and every instance of PCOS is different.



Common SIGNS of PCOS include:


  • Hyperandrogenism/hyperandrogenemia
    These are two related terms. Hyperandrogenemia can be broken down into words parts which makes its meaning clear and easy to remember. Hyper is a prefix meaning “excessive”. Androgen is a root referring to male hormones — which comes from two other word parts: andro, which means “man” or “male”; and gen, which means “to make” or “cause”. Thus, an androgen is something that makes you masculine or causes male features. -Emia is a suffix that means “a condition of the blood”. So, we can see that hyperandrogenemia is a blood condition with an excess of hormones that cause male features. Hyperandrogenism is the collection of symptoms that result from hyperandrogenemia, and it comes from all the same word parts, except it uses the suffix -ism, which refers to a state of being. All of which can cause the following:
    • Hirsutism
      This comes from the word hirsute, meaning “hairy”, and the suffix -ism, which means “state of being”. So hirsutism is the state of being hairy, and it refers to the unwanted facial and body hair that comes from having excessive male hormones — androgens: testosterone or DHEA, for example.
    • Androgenic alopecia
      Here we have the familiar word part androgen with the suffix -ic that means “of something” or “relating to something”. Alopecia comes from a Greek word that means “fox-mange” (some of our word parts don’t make a lot of sense to modern people, but we’re stuck with them for historical reasons), and it means “bald”. So androgenic alopecia is baldness related to androgens, and any woman with PCOS who has thin head hair probably knows how unpleasant it can be.
    • Acne
      This one doesn’t need much explanation, anyone who’s ever had a pimple knows what acne is. But the word does have an interesting origin. It comes from the Greek word akmas (meaning “point”). But, sometime around the 6th century, a scribe copied down aknas instead of akmas, and from that we get the word acne today. There are many different types of acne, but most adult women with severe acne have PCOS.
  • Amenorrhea/Ologimenorrhea
    Again, the word parts are a great way to define these terms. Menorrhea comes from two roots: meno meaning month and rrhea meaning flow. So this part refers to your monthly flow, or menses (which actually just means “monthly”). The prefixes a- and ologo- mean “none/no/absent” and “few/insufficient”, respectively. Many women with PCOS go months at a time without a cycle or any menstrual flow, and some have never had a natural period in their entire lives. You’ll also sometimes hear the terms primary amenorrhea and secondary amenorrhea. This just refers to whether the condition began at puberty or later in life. Not all clinicians think that it is useful to distinguish between primary and secondary amenorrhea, but others do. It can be part of differential diagnosis in some cases.
  • Anovulation
    Anyone who is trying to conceive knows what ovulation is: it is the point in a woman’s cycle when the egg fully matures and is released from the ovary and is ready to be fertilized by a sperm. This comes right after the follicular phase of egg maturation and requires a special hormonal signal that women with PCOS don’t produce. Thus, many women with PCOS do not ovulate (the prefix “an-” just means “none/no/absent”). Anovulation actually leads to another sign of PCOS, which is:
  • Polycystic Ovaries
    This sign actually puts the PCO in PCOS, but unfortunately it is a little misleading as a term. A cyst is pretty much any fluid-filled cavity in the body (it comes from the Greek word kystis which means “bladder” or “pouch”). However, the “cysts” on the ovaries of women with PCOS are actually eggs stuck in the follicular phase. This phase of egg maturation comes just before ovulation, and since many women with PCOS never ovulate, they wind up with lots of eggs trapped in this phase. Sometimes, these follicles can go on to form a true cyst, but much of the time the “cysts” observed during ultrasound of women with PCOS aren’t true cysts at all. They are follicles that never finished ripening and were never released.
  • Hyperinsulinemia
    This is too much (hyper) insulin in the blood (-emia). Insulin is a very powerful hormone that tells the body when to dispose of sugar in the blood. Many women with PCOS are insulin resistant, meaning their body’s cells don’t respond to insulin the way they should. Since the sugar doesn’t get disposed of, it builds up in the blood, which stimulates production of more insulin. This is a vicious cycle that can be very dangerous if it goes uncontrolled and can lead to type II diabetes in the long term and a life-threatening conditon called ketoacidosis if it goes untreated for long enough.
  • Hyperglycemia
    This is too much sugar (the root glyco means “sugar”) in the blood. It is caused by insulin resistance and it in turn can cause:
    • Polydypsia
      This comes from the roots poly, meaning “many/excessive” and dypsos, meaning “thirst”. The suffix -ia is a very common suffix in medicine that means “condition”. So, this is a condition of excessive thirst.
    • Polyuria
      The root uro just means, you guessed it: “urine”. This is a condition of excessive urination. Not entirely unexpected if one is already experiencing polydypsia.
  • Obesity/Overweight
    Many women with PCOS are obese or overweight, and a woman with PCOS is significantly more likely than a woman without PCOS to be obese or overweight. This is probably a result of insulin resistance, although other factors can play important roles. Moreover, women with PCOS, because they have hyperandrogenism, will frequently have a masculinized adipose distribution. This means that their excess weight will go to the midriff, typical of men, as opposed to the breasts, buttocks, and thighs, which is typical of women.


Common SYMPTOMS of PCOS include:


  • Depression
    Depression is more common and more severe in women with PCOS than in those without PCOS. This has been shown in numerous studies over several decades. Some of this may be caused by the abnormal hormonal profile, and there also appears to be a link between body satisfaction (which is affected by many signs of PCOS) and depression.
  • Anxiety
    Feelings of worry or uneasiness are slightly more common in women with PCOS than in those without PCOS. It is still unclear whether this is related primarily to the hormonal changes associated with PCOS or to coping with the social pressure of PCOS signs.
  • Mood Swings
    Women with PCOS often report mood swings, significant changes in mood without an obvious cause. This may be linked to dramatic changes in blood sugar and the many hormonal imbalances that often accompany PCOS.
Viera Bergen says:

Hi…while I’ve never been diagnosed and am now in my 50′s I have dealt with all of the signs/symptoms (PCOS related)to varying degrees – med-severe. Obviously I don’t want to conceive and my cycle is irregular due to menopausal symptoms (for the last year or so, at any rate), will DCI put me back into a regular cycle? I did try taking your DCI a couple of years ago (for a few months) and didn’t find that it helped for cravings and/or weightloss. I REALLY have simple carb cravings and I am definitely obese. Any suggestions?

Chiral Balance says:

Hi Viera,

If you’re menopausal, DCI will not make you resume ovulation. However, an important caveat is that PCOS women sometimes have what is called premature ovarian failure, and DCI can sometimes reverse that. Since, you’re in your 50′s, I doubt that is a concern. We tend not to make any strong recommendation for our product folks without a firm PCOS diagnosis. I’ve heard anecdotal evidence that it can help some other people with certain conditions, but there is no clinical evidence for that. So, consequently – and especially if you’ve tried DCI before – I wouldn’t highly recommend DCI to you. That being said, lots of other vitamins, minerals and botanicals can help support healthy sugar metabolism and insulin metabolism and that can help stave off cravings. A few that come to mind are chromium, manganese, magnesium, EGCG (found in green tea extract), cinnamon.

Bonnie says:

Is DCI best taken with food or on empty stomach? If I take 2 is it best to split up by a number of hours, one in the am and one in the pm, or can I take them both at the same time? Thank you

Chiral Balance says:


For better bioavailability, it is better to divide your dose of DCI. If it is more convenient and you might otherwise miss a dose, it is fine to take two in the morning. We recommend taking it on an empty stomach to start. If that is poorly tolerated (a small number of women experience low blood sugar) then you can try it with food.

Karen says:

Hi, I havent bought the products yet but have tried others that the doctor prescribed and nothing helps. They keep wanting to prescribe me birth control but I am trying to conceive and it defeats the purpose. My question is does DCI help with ALL the sysmptoms including weight loss and fertility??

Chiral Balance says:

Hi Karen,

In clinical trials, DCI was shown to improve biochemical markers of PCOS, such as high testosterone, high triglycerides and many others. It also lowered blood pressure and increased the likelihood of ovulation. As far as weight loss, this wasn’t evaluated in clinical trials, but based on customer feedback, some women with PCOS who take DCI do experience weight loss – in most cases these are women who are already eating right and exercising and for them DCI is the last piece of the puzzle. Hirsutism and acne were not directly evaluated, but again, blood work showed a statistically significant decrease in testosterone, which should improve both. And, indeed, many women with PCOS report marked improvement in skin and hair-related symptoms.

Martina says:

I have a 15 yrs. old daughter who has a collapsed ovarian cyst (ultra sound showed this). We used different natural remedies to treat her but the pain was coming back more often and lasting longer. A doctor recomended DCI. I bought a bottle of the 600 for her she has been taking it once a day, since the beginning of Jan. . Yesterday and today she was having mild pain. Not sure if she is at her time to ovulate. However due to the fact that she is so young and not overweight would it be save to increase the DCI? I only have the 600 mg, Should we open a capsul and just use 1/2 of it so it would be like 300mg? Thanks

Chiral Balance says:

Hi Martina,

I’m sorry to hear that your daughter has had to deal with this. To answer your question, yes, it is fine to open a capsule and take half. if you want to get more precise, you can dissolve the contents of the capsule in water and drink half the water then and half later.

Laura says:

I just purchased a bottle of DCI and I am waiting patiently for it to arrive in the mail. I am curious though why weren’t the clinical trials evaluating weight loss and hair growth, as that is much more important to me as someone with PCOS? Also, can we look at these clinical trials for ourselves? Thanks so much! I am hoping this is what I am looking for. I have tried another very popular supplement company and did well on it initially .

Chiral Balance says:

Hi Laura,

One of the clinical trials is available for free from the New England Journal of Medicine. Another of the studies is available for a fee from Endocrine Practice.
In regards to weight loss and hair growth, I can’t really say why the clinical trials didn’t look at these metrics. I’ve often wondered that myself. We hope it works for you too – please let us know if you have any further questions.

Jeannette says:

I would like to know how long do it take DCI to work within your system? I have been taking it for about a month and have not seen any improvment with my PCOS like many of the other women who has taken DCI.

Chiral Balance says:

Hi Jeannette,

We recommend an 8 week trial. Most women with PCOS who take DCI will begin to see some improvement in that time frame.

Karen says:

Will DCI help elevated DHEAS? If not, what would you recommend? I was taking flutamide for it but I have new doctors and they don’t like prescribing it. Maybe it’s time to stop taking it anyway.

Chiral Balance says:

Hi Karen,

In clinical trials of D-chiro-inositol for PCOS, DHEAS, which was elevated in women who participate in the study, decreased to normal levels.

Vanessa says:

I’ve been taking DCI for almost a month now and I take 2 pills first thing in the morning along with Topirmate for migraines and Zrytec. I’ve noticed that my stomach has really been bothering me lately and am wondering if I should either take the pills with food instead or should I take the pills at different times? I read that it’s best to take on an empty stomach and at my weight, I need 2 pills per day. Any suggestions?

Chiral Balance says:

Hi Vanessa,

I’ve definitely got a few suggestions. First, try dividing your doses. Take 1 capsule in the morning and 1 in the evening. If that doesn’t help, definitely try taking them with food rather than on an empty stomach. If neither of those suggestions helps (they very likely will), just contact us again for further advice.

Oya says:

I am 48 and I was on Spironolactone and the pill for over 20 years and my hirsutism was under control but I stopped taking them 6 months ago because I was getting very ill and the doctors couldn’t figure out what was wrong with me. I haven’t had a period since then and my excess hair is starting to come back, which is very disturbing to me. I am still overweight but I lost about 40 pounds by switching to a low carb diet and was hoping it would help stop the return of my hirsutism as well but maybe that was wishful thinking. Now I am on gluten and casein free diet and feel better physically. I just ordered a bottle of DCI and am really hoping that will stop the progression of my hair growth and help me get my periods back. I read suggestions about it but is there any evidence that a low carb diet helps with PCOS?

Chiral Balance says:

Hi Oya,

There is a substantial body of evidence that low-carb diets are a well-tolerated method for controlling blood sugar in people with type II diabetes and metabolic syndrome. Since one of the common features of PCOS – insulin resistance – is common to all 3 conditions, it is a reasonable extension of the observations in diabetic and metabolic syndrome patients to patients with PCOS. Recent studies, one published just this February in the journal Clinical Endocrinology, have shown that this theory is sound and that PCOS women respond well to lower carbohydrate diets. So, yes, there is evidence that low carb diets help women with PCOS.

Sue says:

I am in my sixties – and have never been diagnosed with PCOS – but have all the symptoms – hirsuteness (since a teenager), now thinning hair, despite being rather promiscuous have never fallen pregnant (good thing for me personally), had bad PMT, have always had a lot of tummy fat – despite being quite slim, have a sugar addiction and skin tags.

Is it worth my while taking DCI at my age?

Chiral Balance says:

Hi Sue,

That sounds like textbook PCOS. Interestingly, we’ve heard from a number of women in your age group lately and I’ve been giving them all the same advice. If you think you had PCOS, but are now past the age where a doctor is willing to diagnose PCOS, then I say give DCI a try. In your case in particular, the sugar cravings, skin tags, hirsutism, and masculine adipose distribution are all consistent with insulin resistance and PCOS, which is something DCI has helped a lot of women with. And, we have a pretty generous refund policy, so there isn’t much risk in giving DCI a try.

Christy Short says:

Hello, I was diagnosed with Premature Ovarian Failure at 17, I am now 41. I have had a few periods since that time and have excessive unwanted hair growth. I would like to know if you have had any positive feedback from women with POF who have had success with DCI?
Thank you!

Chiral Balance says:

Hi Christy,

Women with PCOS are at an increased risk of POF (premature ovarian failure) and you have also described one of the other signs of PCOS (excessive and unwanted hair growth). In all of the years we have been in business, I have only ever had feedback from 1 woman who had POF (she also had PCOS), and she actually resumed a normal cycle after she started DCI. In one other case, I heard from a woman in her late 40′s who had been diagnosed with early menopause; after starting DCI, her hormones went right back to pre-menopausal levels and she resumed a cycle as well. So, those two accounts are encouraging, but I want to emphasize that DCI has never been studied in the context of premature ovarian failure and I don’t have any statistics or figures to suggest what fraction of women with POF might see improvements after starting DCI. So, the real question is did you have PCOS and it lead to both POF and unwanted hair, or did the POF occur for some other reason and then the POF lead to the unwanted hair growth? In the former case, I think DCI stands a chance of helping. In the latter case, I would be less optimistic. If you think you might also have PCOS, you could ask your doctor to be worked up for it; some simple blood tests, an ultrasound and a thorough history/family history should help your physician to make a decision.

Elle says:

I am wondering how long do I have to take DCI for? Once I start and it works, do I have to take it forever? Or can I stop once the symptoms are gone?

Chiral Balance says:

Hi Elle,

As long as you continue to take D-chiro-inositol, any benefits that you experience will also continue.

Ann says:

Will DCI work just as well if I take the capsule contents instead of swallowing them in pill form?

Chiral Balance says:

Hi Ann,

Yes, it will. It is fine to take the contents directly. You will find that DCI has a mild sweet flavor. If you’ve ever eaten carob, I think it will remind you of that flavor.

Sarah says:

I just ordered my first bottle of DCI and wanted to know if it I should take 1 or 2 capsules. I currently weigh 235. So I am not quite at the weight that would require 2, but wondered if I would benefit from 2 since I am closed to 260 than 130.

Chiral Balance says:

Hi Sarah,

Sorry if this was unclear. A person weighing 130-260 would need to take 2 capsules daily. Someone weighing less than 130 would take one, and someone weighing more than 260 would take 3.

marry says:

Hi Chiral

im 17 and i have this problem since i was 12, i have been diagnosed with PCOS and on metformen for past three years.

now the problem i need your help is after urination i have severe discomfort in urethral orifice that i cannot sit down and feel like standing for 5 to 10 min. this same problem is faced by my mother and my 10year old sister but occasionally. plz advise.

Chiral Balance says:

Hi Marry,

You need to see your doctor or Ob Gyn. Recurrent pain is serious and requires medical attention. Since it sounds like it runs in your family, you should be sure to mention that to your doctor and consider causes of urinary symptoms and pelvic area pain that have a genetic component such as interstitial cystitis of pelvic floor dysfunction. Again, you really should go see your doctor about this and clearly explain the pain and the family history.

Tanya says:

Unfortunately I have recently been told I have PCOS, now I have many symptoms: I have gained over fifty pounds, insulin resistant, high blood pressure, my body aches for no reason. This went untreated for almost twenty years as my HMO at the time opted to give me several surgeries for ovarian cyst removal and the finally removing my uterus. The one ovary I have left is yet causing me problems but the worst of it is the hair loss, it is devastating I ALWAYS had thick and long hair now the only thick hair is growing on my face!! What do product do you recommend for hair loss while I do not wish to increase the hair on my face. Living in Los Angeles and working in the entertainment business unfortunately my looks are what get’s me into various studios for catering jobs for in Los Angeles it is all about vanity. Can you help??? Signed Losing Lock in LA.

Chiral Balance says:

Hi Tanya,

I would recommend trying DCI and/or the Saw Palmetto/Milk Thistle blend. In PCOS, many of the symptoms you’re describing are the result of high testosterone, which is the result of insulin resistance. DCI can help to improve insulin sensitivity and thereby lower testosterone, which will get at the root of the problem. Saw Palmetto can decrease the effects of testosterone and that may be beneficial as well.

Andrea says:

I’ve been diagnosed with PCOS based on having most of the symptoms: amenorrhea, anovulation, excess/ unwanted hair, and acne. I’ve never been overweight, in fact, most of my life I’ve been a little underweight. My acne has greatly improved for unknown reasons with only pimples here and there from time to time. I’ve been on Metformin in the past, which I discontinued due to side effects, but it did help me have more periods and occasional positive ovulation tests. My doctor recommended I take either Myo-inositol or DCI. I read your article about MYI vs. DCI, which was very informative, but I’m still not sure which is right for me. I would love to have a decrease in unwanted hair, but seeing I don’t have problems with weight and possibly (or likely?) not insulin resistant, I don’t know if DCI is right for me. What would you recommend?

Chiral Balance says:

Hi Andrea,

That is an excellent question. You’ll be interested to know that DCI was also studied separately in a group of women who have what is sometimes called “lean PCOS”, which would be the category that you fall in. These women did not have any insulin resistance either, but they benefited from DCI with improved hormone profiles and increased rates of ovulation among other things. How do we reconcile these observations then? Well, it has been shown in other studies that the ovaries of women with PCOS respond differently to insulin than the ovaries of women without PCOS. That in and of itself could help to explain why even women without global insulin resistance still benefited from DCI. Or, put another way, in some women with PCOS, insulin metabolism is irregular throughout the body, and in others insulin metabolism is only irregular in a few specific tissues. And so keeping that in mind, your very intuitive question can be explained. In regards to a firm recommendation, keep in mind this website sells DCI, so I’d say give that a try. If you do decide to try myo-inositol, shop around. There are some very very expensive brands of myo-inositol out there. And there are some very inexpensive ones too.

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