Irregular, infrequent, or absent periods
Very heavy periods
Trouble getting pregnant
Excess facial or body hair
Acne that persists or worsens
Thinning hair on the scalp
Weight gain or difficulty losing weight
Darkened skin patches, especially on the neck, armpits, or groin
Skin tags
Enlarged ovaries or multiple small follicles seen on ultrasound
Blood tests showing elevated androgens
Blood tests showing insulin resistance or related metabolic changes
Symptoms that started around puberty or early adulthood
A healthcare provider evaluation using symptoms, blood tests, and possibly ultrasound