Polycystic Ovary Syndrome (PCOS) is often talked about in terms of irregular periods and fertility struggles, but it’s so much more than that. As a hormone and metabolic condition, PCOS impacts nearly every system in the body, sometimes showing up in ways you’d never expect.

If you have PCOS or suspect you might, you might already know some common signs, but what about the lesser-known symptoms that are often dismissed or go unmentioned? Let’s talk about some of these subtle signals — they can be the missing pieces to understanding and managing your health better.

1. Fatigue That Won’t Go Away

Are you constantly exhausted, no matter how much sleep you get?

Fatigue can be overwhelming with PCOS, yet it’s often ignored. This isn’t just “I stayed up late” tired; it’s an ongoing exhaustion that can make the simplest tasks feel like running a marathon. One reason for this could be insulin resistance, which is common in PCOS. When your cells don’t effectively use glucose for energy, you’re left feeling drained and sluggish.

Tip: To combat fatigue, focus on stable blood sugar by eating balanced meals with protein, healthy fats, and fiber. Avoiding sugary foods and choosing low-glycemic carbs can help keep your energy levels more even.

2. Mood Swings and Anxiety

Do you find your mood fluctuates without warning, or feel anxious more than usual?

PCOS doesn’t just affect your body; it can have a huge impact on your mental health. Hormones that are out of balance — such as higher-than-normal levels of androgens (male hormones) — can mess with mood stability. Many women with PCOS experience sudden mood swings, irritability, or heightened anxiety and depression. The stress of dealing with chronic symptoms can amplify these feelings.

Tip: While it may seem unrelated, regular exercise (even gentle forms like walking or yoga) can help stabilize mood by lowering stress hormones and boosting “feel-good” endorphins. And if your anxiety or depression feels overwhelming, don’t hesitate to reach out for professional support; mental health is just as important as physical health.

Tip: Consider using gentle hair-care routines and seek support from a dermatologist if necessary. Supplements like biotin and zinc might also help support hair health, but always consult with a healthcare provider first.

3. Skin Issues: Acne, Dark Patches, and More

Do you feel like your skin is breaking out as though you’re back in high school?

Skin symptoms are an often-overlooked hallmark of PCOS. While acne is commonly associated with PCOS due to elevated androgen levels, other skin issues are also prevalent. For example, many women develop acanthosis nigricans, which are patches of dark, velvety skin that often appear on the neck, armpits, or inner thighs. These can be a sign of insulin resistance and are often mistaken for dirt or bruises.

Tip: Support your skin by opting for skincare products that are gentle and non-comedogenic (meaning they won’t clog your pores). Avoiding high-glycemic foods, which can spike insulin, may also help reduce acne breakouts over time.

4. Unexplained Weight Gain or Difficulty Losing Weight

Is your body weight fluctuating, or does it feel impossible to lose a few pounds?

Many women with PCOS find that they gain weight quickly, especially around their abdomen, and struggle to lose it. This isn’t because they’re not trying hard enough; it’s because of insulin resistance and hormone imbalances, which make it easier to gain weight and much harder to lose it. For those with PCOS, the body stores fat differently, often increasing the risk of developing metabolic issues.

Tip: Instead of focusing solely on weight loss, shift to a balanced lifestyle approach. Small, sustainable changes like reducing sugar intake, incorporating more whole foods, and finding enjoyable forms of movement can support your body in the long run.

5. Hair Loss or Unwanted Hair Growth

Are you noticing more hair where you don’t want it — and less where you do?

PCOS can lead to hair loss on the scalp (known as androgenic alopecia) and unwanted hair growth on areas like the face, chest, or back. This can feel particularly frustrating and isolating, but it’s a common experience for many with PCOS. The culprit here? Androgens, which are typically higher in people with PCOS, affecting hair follicles and triggering hair growth in unexpected places.

6. Digestive Issues

Do you experience bloating, gas, or irregular digestion?

Digestive issues, like bloating or discomfort, aren’t usually listed as classic PCOS symptoms, but they are common. PCOS is linked to inflammation, which can also affect the gut, leading to symptoms like constipation, gas, or bloating. Since our gut health is tightly connected to hormone health, it’s no surprise that PCOS can create digestive challenges.

Tip: Eating a high-fiber diet and incorporating fermented foods (like yogurt, kimchi, or kombucha) can support gut health. Managing stress, which is often a silent factor in digestion, can also make a huge difference.

Embracing a Holistic View of PCOS

PCOS isn’t just one or two symptoms — it’s an interconnected set of challenges that each affect the other. Many women feel misunderstood when their symptoms don’t match the “classic” picture of PCOS. The truth is, every PCOS journey is unique, and there’s no one-size-fits-all experience. Understanding the less-discussed symptoms can help you feel validated in your experience and empower you to make choices that support your health.

Learning to listen to your body, prioritizing balanced nutrition, moving in ways that feel good, and seeking a community or coach can help immensely. PCOS is complex, but remember, with small steps and a holistic approach, managing your symptoms and living well with PCOS is absolutely possible.