Classically, the suspicion of a diagnosis of PCOS is based on the clinical features. The common presentation of PCOS are women in their late teens and early twenties, complaining of the consequences of high levels of androgens (acne, increased body hair (hirsutism)) or of an irregular menstrual cycle. The main three clinical features of PCOS are:
The cause of the hirsutism is a rise in the secretion of free androgens and a reduction in the sex hormone binding globulin (SHBG). The SHBG levels fall as a result of the increased testosterone production.
The main concerns of PCOS are body changes (hair excess, obesity) and infertility due to anovulation. The anovulation results in an increased risk of irregular and heavy menstrual bleeding, endometrial hyperplasia and even endometrial cancer. The associated metabolic abnormalities are thought to result in an increased risk of cardiovascular disease.