5 Signs of Hormonal Imbalance in Women with PCOS

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting millions of women worldwide. It is characterized by hormonal imbalances that can lead to a variety of symptoms and health issues. Understanding the signs of hormonal imbalance is crucial for early diagnosis and effective management of PCOS. As the lead medical director at the Fertility Institute of San Diego, I, Dr. Minoos Hosseinzadeh, am committed to providing comprehensive care and support for women dealing with this condition.

1. Irregular Menstrual Cycles

One of the most common signs of hormonal imbalance in women with PCOS is irregular menstrual cycles. This can manifest as infrequent periods, prolonged menstrual bleeding, or complete absence of periods (amenorrhea). The irregularity is often due to anovulation, where the ovaries do not release an egg during the menstrual cycle.

Why It Happens

Hormonal imbalances, particularly elevated levels of androgens (male hormones) and insulin resistance, interfere with the normal regulation of the menstrual cycle. This disruption can lead to the formation of cysts in the ovaries, which further contributes to menstrual irregularities.

Impact on Fertility

Irregular menstrual cycles can make it challenging to predict ovulation, reducing the chances of conception. For women trying to conceive, this unpredictability can be particularly frustrating and emotionally taxing.

2. Excessive Hair Growth (Hirsutism)

Hirsutism, or excessive hair growth, is another hallmark of PCOS-related hormonal imbalance. Women may notice coarse, dark hair growing in areas where men typically grow hair, such as the face, chest, back, and abdomen.

Why It Happens

This symptom is primarily driven by elevated levels of androgens, such as testosterone. These male hormones, though present in all women, are significantly higher in those with PCOS, leading to hirsutism.

Managing Hirsutism

There are various treatments available to manage hirsutism, including lifestyle changes, medications, and cosmetic procedures. It’s essential to consult with a healthcare provider to determine the best approach based on individual needs and health status.

3. Acne and Oily Skin

Hormonal imbalances in PCOS can also affect the skin, leading to acne and increased oil production. This symptom is often most noticeable during puberty but can persist or worsen in adulthood for women with PCOS.

Why It Happens

Androgens stimulate the sebaceous (oil) glands in the skin, leading to increased oil production and clogged pores. This creates an environment conducive to acne development.

Treatment Options

Topical and oral medications, as well as lifestyle changes like a balanced diet and proper skincare, can help manage acne. It’s important to work with a dermatologist or healthcare provider to find an effective treatment plan.

4. Weight Gain and Difficulty Losing Weight

Weight gain, particularly around the abdomen, is a common issue for women with PCOS. This can be frustrating, as it often occurs despite efforts to maintain a healthy diet and exercise routine.

Why It Happens

Insulin resistance, a common feature of PCOS, can make it difficult for the body to use insulin effectively. This leads to higher insulin levels, which can promote fat storage and weight gain. Additionally, hormonal imbalances can affect metabolism and appetite regulation.

Addressing Weight Issues

A comprehensive approach, including dietary changes, regular physical activity, and possibly medication, can help manage weight. Working with a healthcare provider or nutritionist can provide personalized guidance and support.

5. Thinning Hair or Hair Loss

While some women with PCOS experience excessive hair growth, others may suffer from thinning hair or hair loss, particularly on the scalp. This condition, known as androgenic alopecia, can be distressing and impact self-esteem.

Why It Happens

Elevated androgen levels can shrink hair follicles, leading to hair thinning and loss. This process can be gradual and may be more noticeable in certain areas, such as the crown or parting of the hair.

Managing Hair Loss

Treatment options for hair loss include medications, lifestyle changes, and hair restoration therapies. Early intervention is key to preventing further hair loss and promoting regrowth.


Recognizing the signs of hormonal imbalance in women with PCOS is the first step toward effective management and improved quality of life. At the Fertility Institute of San Diego, we are dedicated to providing personalized care and support for women with PCOS. Whether you’re struggling with irregular periods, unwanted hair growth, acne, weight issues, or hair loss, we are here to help.

If you’re ready to start your fertility journey, please book a complimentary virtual consultation with Dr. Hosseinzadeh to go over fertility options or any other reproductive healthcare questions. Click here.

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