I'm writing what I know on the subject from research, doctors and personal experience. Many other reviews and an internet search will give you the more specifics of the condition for more detail - I didn't want to end up with a 100,000 word review!

The basics of PCOS are a hormone imbalance, trouble conceiving, irregular or absent periods, weight gain, excess hair (hirsutism), acne - people seem unable to agree on cause. If you're overweight some doctors blame that, according to some sources the lack of ovulation causes the rest - ultimately the starting point/cause is unknown for most people. There is evidence that it may be at least somewhat hereditary.


***Polycycstic Ovarian Syndrome and Polycystic Ovaries*
To start with I will say you can have ovarian cysts and not have PCOS. Many women have polycystic ovaries without any of the symptoms of PCOS - the syndrome part being the important point. Even more women will have cysts with only 1 or 2 symptoms that are often written off as due to other causes or not even reported. It's not a set thing that you must have every symptom - many women only find out about the condition when they have trouble conceiving as they've had no other symptoms. A few women have PCOS with no cysts, just to make things more complicated. Ultimately symptoms are not always reliable.


***Doctors***
Doctors are not always entirely helpful with this condition - as a reasonable number of women with it are overweight or obese, this is often blamed for their symptoms, as obesity alone can cause some of these symptoms. It's also a condition that doctors will say you probably have and never follow up on properly - it took years for me to get a formal diagnosis and treatment, unfortunately this isn't uncommon.


***Pushing for diagnosis***
I shouldn't have to write this part, yet as stated it seems to be a major issue. Diagnosis can be done with either a full set of blood tests or with an ultrasound, procedure seems to vary as to which is used initially, in my area it's normal to do blood tests and if needed an ultrasound to confirm.
If you're not getting these done push and if needed, don't hesitate to change doctors. I know women sometimes feel unsure of going to male doctors with gynecological issues, but they're just as qualified and based on the experience of many people I know who suffer, less likely to push patients off as complaining about what are actually normal periods or amount of hair and such.



***My Story***
I was initially told I "may" have PCOS at around 14-15 years old - I was put on a standard pill to "treat" the symptoms which was at best ineffective and at worst, made me feel ill. Unfortunately I was grieving after a parental loss and didn't realise the pill I was on wasn't actually even the slightest bit effective at treating PCOS. I had periodic changes in medication and blood tests (I later found out they weren't al the tests needed to diagnose) - earlier this year I changed doctors and finally got an official diagnosis and am now recieving treatment.


The issue is, untreated PCOS gets worse. My weight has increased (partly PCOS, partly too-much-in,too-little-out due to other issues, but I would have been able to control it better with treatment), I've developed the acne associated with the condition, I look far more gorilla-like and am way behind in getting it sorted. This is why the earlier diagnosis the better - trying to correct hormones that are 10% out is easier than 50% out (random percentages).

My symptoms are the period issues (heavy when a young teenager, then largely absent), severe pains, hirsutism (excess hair, on my face, chest and abdomen, generally thickened and darkened hair and fast growing), acne, weight gain, thin hair (head hair - the androgens simultaneously cause excess hair growth on the body and can cause thinning on the head) and oily skin. I certainly have fertility problems but as I've not tried to conceive these do not effect me at present.

As a result of it being left untreated I'm also now at severe risk for type 2 diabetes - weight loss will hep this but ultimately it being left untreated builds up the likelihood - another reason it is especially important to get a correct diagnosis and treatment.



The good news is for me, treatment is proving effective - it takes months to start truly changing your hormones and the symptoms (especially hair) can take a lot longer to show any improvement as your hormones need to be normalised and your body given chance to catch up, however my blood tests do show an improvement, I've also had far less of the ovary pain associated with the condition. I've been on it about 4 months and it's likely to be 6-12 before the symptoms are truly easing due to how far out my hormones were, but it can improve and is worth treating.



***Related Conditions***
These are some things that have been linked to PCOS:
- Depression, Anxiety, Low self esteem, confidence problems - all may be related to the fact that many women feel bad about the excess hair and other external symptoms, although I have heard some people consider that depression may be hormone related. These things can be treated in their own right with appropriate self help, counseling or even medications if needed.
- Diabetes - related due to the effect that PCOS has on insulin resistance which can lead to diabetes - it's not a definite thing, many people never develop diabetes but sufferers are high risk.
- Obesity - while often classed as a symptom it's also a linked illness/disease/concern in it's own right. Insulin Resistance makes gaining weight easier and losing weight harder - how much is not agreed on, but it's definitely a factor. Obesity also makes PCOS symptoms worse (which can then cause weight gain - nice cycle, right?) - to break this you need to tackle one or preferably both to make the other less problematic.



***Managing Symptoms*

My final word is some help with those pesky symptoms.

Facial (and other) hair - facial hair can be removed by shaving, epilating, waxing, tweezing and a few other less common methods. I like epilating as it removes the hair for longer than shaving - although it is more painful. I, I think like most PCOS sufferers, use a mix. I epilate regularly, shave if needed to remove hair inbetween/if I'm in a rush/can't face the pain, and tweeze a fair bit for those annoying hairs or right on my chin (where epilating hurts worst and is least effective for me) - don't expect to be able to stick to 1 method if using root removal as the hairs can grow so fast sometimes you'll find you can't bear to leave it. Bear in mind though the fast growing hair symptom can make shaving awful - I'd often need to shave in the morning and then again a few hours later if I was relying on it alone, which isn't pleasant or good for your skin.
Bleaching also works - I use jolens bleach on my upper lip hair (the "m" word makes it feel worse!), arm hair and chest - the latter 2 I don't need to do as often and unlike on the face tend to not be noticable if just bleached. Upper lip tends to be a mix of removal and bleaching - I prefer removal but it can be harsh on that area.
Finally - it's less noticeable to those around you than it is you, so if you have a few chin hairs - don't panic!

Acne - normal acne advice works, one thing I will say is moisturising helps, not hinders - dry skin produces more oils which can make acne worse. Also bear in mind you may find some hair removal techniques irritate acne, so you may want to tailor your choices around it. Mineral foundation eases mine a fair bit and covers it well for most days.

Thin head hair - you're slightly limited to what you can do about this. It also killed the condition of my hair completely - a good cut can help, as can the right styling products. Anything volumising can be helpful, as can something for dryness. My hair is dyed (blonde) which doesn't help the condition of my hair - but the ends dry out stupidly anyway since the hair isn't as healthy and it makes me feel better, so it may still be worth doing if you're fed up of your natural colour!




***Summary***

Well I know this has ended up very long but I hope it helps somebody - even if to just feel less alone. My summary is it sucks, but get help even if you have to push for it - and don't let it rule your life!