Signs and symptoms of polycystic ovarian syndrome (PCOS) may first appear around the time of puberty. But for most women, signs do not become noticeable until their early teens. The most common symptoms are:

• Hirsutism. A growth of coarse body hair in a male pattern, which may appear on the chin, upper lip, neck, sideburn area, chest, nipple area and the lower abdomen along the midline.
  
  
• Irregular or infrequent periods.
  
  
• Prolonged premenstrual syndrome (PMS) symptoms, such as bloating, pelvic pain, headaches, mood swings and/or depression.
  
  
• Excessive weight gain.
  
  
• Acne and/or oily skin. Particularly severe acne, especially if it persists into adulthood.
  
  
• Polycystic ovaries. Enlarged ovaries containing more than 12 follicular cysts, tiny follicles in the range of a quarter to half an inch in diameter (0.6 to 1.3 centimeters).
  
  
• Hair loss or male-pattern hair thinning.
  
  
• Acanthosis nigricans (AN). Darkening of the skin around the areas of the neck, arms, breasts, or thighs. AN is usually indicative of insulin resistance as well.
  
  
• Skin tags. Small pieces of excess skin around the armpit or neck area.   

Symptoms of PCOS vary among women. Some women may have very little acne, whereas others have severe acne, facial hair growth or hair loss in the scalp. Also, many women do not show any visible signs of the disease.

It is important to note that there are a number of other conditions that may cause similar symptoms, such as thyroid problems (e.g., hypothyroidism, hyperthyroidism). Because of this, it is essential that patients exhibiting symptoms consult a physician to rule out other conditions and determine an appropriate treatment plan.