Adult acne, fatigue, weight gain: Why PCOS may be the culprit

Hormonal imbalances lead to a multitude of symptoms, including unexplained weight gain, adult acne and hair loss

Rachel McArthur

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Having lived with Polycystic Ovary Syndrome (PCOS) for years now, I have had my fair share of ups and downs, as I am sure most sufferers - or fellow ‘cysters’ - have. PCOS is a disorder in which a female’s hormones are out of balance, caused by small cysts growing on the ovaries.

These hormonal imbalances lead to a multitude of symptoms, including unexplained weight gain, adult acne, hair loss (female pattern baldness), irregular cycles and infertility issues. As most ladies would agree, it sometimes feels that these symptoms rob you of your femininity.

There are days when I do not want to leave the house because I have had such a bad skin flare-up that even the best foundation cannot cover. One year, my hair had thinned so much that I had to wear hair clip-ins.


Despite PCOS affecting approximately one in 10 women, the condition continues to be relatively misunderstood. It is the most common endocrine disorder among women between the ages of 18 and 44, and the leading cause of female infertility. “There is no definite answer to what causes PCOS,” says Dr Anna Burattin, consultant of endocrinology and metabolic diseases at Burjeel Hospital Abu Dhabi.

“It is likely the result of both genetic and environmental factors. Women with PCOS often have a mother or sister suffering with the condition. We have witnessed a very high number of these cases in the United Arab Emirates [UAE]. Hence we never exclude it from our diagnosis until we do the necessary tests.”

Dr Wafa Elias Nabhan agrees. “I have been working in the UAE for almost six months now as an endocrinologist at NMC Royal Hospital [in Abu Dhabi], and I feel there is significant awareness in women consulting for this condition for themselves or their affected daughters.

“You have to keep in mind that this condition is multifactorial polygenic and environmental, and has a significant psychosocial impact on womanhood. The most common symptoms include irregular menses, infertility, hyper-androgenism acne and with different degrees of symptomatology.”

Dr Burattin says: “The predominant symptoms are related to menstrual-cycle disturbances and elevated levels of male hormones, known as androgens. This can lead to infertility [because of not ovulating]; infrequent, absent and / or irregular menstrual periods; hirsutism [increased hair growth on the face or body]; acne, oily skin or dandruff; weight gain or obesity, usually with extra weight around the waist; thinning hair; patches of skin that are thick and dark; skin tags [excess flaps of skin in the armpits or neck area]; anxiety or depression; sleep apnea; high cholesterol levels and elevated blood pressure.”

Because symptoms vary from person to person, there cannot be a ‘one-size-fits-all’ treatment plan. “Typically an individual will have some of these symptoms, and it is not necessary that they will suffer from all the mentioned symptoms,” says Dr Burattin.


There is no known cure for PCOS, but it can be managed. Those with PCOS are usually advised by their doctor to incorporate certain lifestyle changes that can help reduce symptoms. According to Dr Burattin, they are:

1. Weight loss: “When you have PCOS, losing just 10 percent of your body weight can help relieve some of the symptoms. The doctor can advise on a workout routine and nutrition plan that should be followed to help lose weight.”

2. Making time for sleep: “Get seven or more hours of sleep a day, because a decent amount of sleep can help with weight loss.”

3. Medication: “Metformin, a prescription drug that helps your body’s sensitivity to insulin, may be able to help you conceive. Metformin can reduce the level of male hormones that are running through your body and interfering with your ability to become pregnant.”

4. Quitting smoking: “Smoking interferes with fertility.”

5. Hair care: “Lifestyle changes such as avoiding processed and canned food, getting enough sleep and drinking lots of water can help. Birth-control pills and anti-androgens lower the levels of androgens. They are usually the first choice for the treatment of hirsutism to reduce hair growth in unwanted areas.”

6. Turning to nature: “Natural supplements can play a role in the improvement of PCOS symptoms - some examples include nettle roots, green tea, spearmint tea, vitamin D and folic acid.”