Symptoms:

Changes in the menstrual cycle:

• Absent periods, usually with a history of having one or more normal menstrual periods during puberty (secondary amenorrhea)
• Irregular menstrual periods, which may be more or less frequent, and may range from very light to very heavy

Development of male sex characteristics (virilization):

• Decreased breast size
• Deepening of the voice
• Enlargement of the clitoris
• Increased body hair on the chest, abdomen, and face, as well as around the nipples (called hirsutism)
• Thinning of the hair on the head, called male-pattern baldness

Other skin changes:

• Acne that gets worse
• Dark or thick skin markings and creases around the armpits, groin, neck, and breasts due to insulin sensitivity

Signs and tests:

During a pelvic examination, the health care provider may note an enlarged clitoris (very rare finding) and enlarged ovaries.

Diabetes, high blood pressure, and high cholesterol are common findings, as are weight gain and obesity.

Weight, body mass index (BMI), and abdominal circumference are helpful in determining risk factors.

Levels of different hormones that may be tested include:

• Estrogen levels
• FSH levels
• LH levels
• Male hormone (testosterone) levels
• 17-ketosteroids

Other blood tests that may be done include:

• Fasting glucose and other tests for glucose intolerance and insulin resistance
• Lipid levels
• Pregnancy test (serum HCG)
• Prolactin levels
• Thyroid function tests

Other tests may include:

• Vaginal ultrasound to look at the ovaries
• Pelvic laparoscopy to look more closely at, and possibly biopsy the ovaries