Polycystic ovary syndrome (PCOS) pose different signs and symptoms that could easily be mistaken for something else. Its signs are complex and vary from one person to another, making it hard to identify.

There are many symptoms of PCOS, but you don’t have to possess all of them to be diagnosed with it. In fact, most of the time most women don’t think about PCOS because they think one or two symptoms don’t apply to them, so they move on to research about something else, like thyroid issues or autoimmune diseases.

One of the most common conceptions about PCOS is that all women who have it also have cysts on their ovaries, but this is not always the case. These signs and symptoms of PCOS present themselves in different conditions, so no single PCOS experience is the same.

Most symptoms have underlying causes found in the excess of androgens, or the male sex hormones in the body. But here’s the catch: there are many reasons why different people suffer from an excess of androgen.

Women between the ages of 15 to 45 can be suffering from PCOS and not know it. In fact, some people can suffer from the symptoms of PCOS for years without ever getting properly diagnosed. In order to make sure your health complications isn’t PCOS or a sign of something potentially worse, here are five signs to help you decide.

Irregular periods

This is probably one of the most common signs that something isn’t right with your body’s hormones. It’s also a very telling symptom of PCOS. If you’re having difficulty remembering the last time you had your period, or if you really haven’t had a period in a while, more often than not, it’s a sure sign of PCOS.

When you’re suffering from polycystic ovary syndrome, you have high levels of androgen, and your ovaries can’t produce enough progesterone (the female reproductive hormone). When you’re low on progesterone, you won’t have a normal menstrual cycle because your ovaries can fail to release the egg during ovulation.

For women with PCOS, you might have irregular periods or not have them at all for months on end. If your periods are more than 35 days apart (a normal menstrual cycle is between 21 to 35 days), or if you have less than 10 periods a year, and having trouble getting pregnant, it might be time for you to get checked for polycystic ovary syndrome.

You still get acne

You can add oily skin to this symptom, too. Polycystic ovary syndrome causes fluctuations in your hormones, making you more prone to cystic acne and oily skin. Not everyone with PCOS suffers from adult acne, but if you can’t seem to shake those zits no matter what products you use, it might be time to see a dermatologist and a gynecologist so check if you either have a skin condition or problems with your hormones.

Acne caused by PCOS often feel like bumps and knots under the skin instead of surface whiteheads or blackheads. You will also find them constantly popping up on the areas of the skin that are sensitive to hormones, like your jawline, your cheeks, your chin, and your upper neck. Sometimes you can get them on your chest and on your back and can feel very painful.

Difficulty losing weight

The treatment for PCOS can vary, but most people are prescribed with birth control pills. However, as a side effect, these cause weight gain that can be difficult to shake off.

When you gain weight you might also notice more stretch marks appearing because of the sudden increase in fat storage in your cells. You will most likely see these stretch marks on your thighs, arms, and abdomen.

If you don’t know yet if you have PCOS, ask yourself, despite all your efforts to lose weight – a regular exercise program, clean eating, and even aided with weight loss supplements – and the scale hasn’t moved, it might be a sign of polycystic ovary syndrome.

The typical diet of low fat and low-calorie plans don’t work well with the medication for PCOS, but rather it’s more important to load up on the right type of fats that help your body produce more hormones.

Fatigue, depression, anger

When you have imbalanced hormones, you might often experience afternoon slumps or all around sluggishness throughout the day. PCOS also causes you to have intense desires to sleep after meals and feel more tired in your muscles.

You might also start to experience more frequent panic attacks, mood swings, depression,  and anxiety. The hormonal imbalance not only manifests itself physically but mentally as well.

You’re prediabetic or have type 2 diabetes

There’s still no concrete reason as to why, but insulin resistance has always been linked to PCOS. When we talk about insulin resistance, this means that your body is incapable of using insulin in the body and can lead to giving you just high blood sugar that makes you crave for more foods with carbohydrates. If you fail to keep track of your diet and your cravings, you can end up being prediabetic and develop type 2 diabetes.

If you’ve been noticing and experiencing these signs and symptoms, particularly the missed periods and the unyielding cystic acne, it’s best to go to your doctor. You can see your dermatology, gynecologist, or endocrinologist, all of whom will recommend you take different tests to figure out exactly what your body is trying to tell you.

You may need to get a transvaginal ultrasound to check for cysts, though you should keep in mind that not all women with polycystic ovary syndrome have cysts. There’s no one-size-fits-all treatment for PCOS, since some women possess a symptom that others don’t.

Ultimately, it comes down to what your body is experiencing, and what combination of medication and habit changes you can implement. It’s important to figure out the right diet that works for you, the right exercise regimen, and if you can try natural and herbal solutions like supplements.