There seems to be a lot of people who had trouble getting diagnosed...glad to know I wasn't the only one!
I had the same problems really. I started menstruating at about 14, and I was NEVER regular...three periods a year was my average and when they did come they would last for two weeks or more! I also had acne very badly (I was actually seeing a dermatologist and taking antibiotics for it for a number of years), and I also had what seemed like an excessive amount of hair on my face. While my facial hair is blonde (thank heavens!), it was still very long and thick and seemed to grow faster than it should...when I was 16 and started waxing my eyebrows I had to do it every 3 1/2 weeks like clockwork, rather than the 6-8 they tell you it should last. I never put the symptoms together.
At 16 I started seeing another doctor after my family moved, and this doctor was young and just out of med school. I went in to get worked up for my irregular periods, and they ran an initial hormone level and said everything was "fine"; but the doctor put me on birth control anyway because he was concerned that I was going to run a risk of uterine cancer if I didn't start flushing things out regularly.
The BC seemed to help, but sometimes I'd still skip periods or have extremely light ones...not to mention I started craving sugar like mad! I mean, I would go through an entire large bag of candy in one day! Needless to say this did absolutely nothing for my weight or my health.
Two years ago I moved again to another state and started seeing another gyn. He asked me about my medical history, and I told him. He asked me if I'd "always had acne", "had extra hair on my face", "had problems losing weight" and such. Of course all of these were the symptoms I had suffered with for years, but I didn't think they were related to anything. That's when the doctor said, "I see you tend to carry your weight around your middle. That's a sign of something called PCOS." He wanted to send me for ultrasounds and a blood test with an endocrinologist to verify, but my health insurance is absolute crap and won't pay for any of it. So he made the diagnosis based "purely on symptoms"...so while I've never been formally diagnosed with blood work we're treating it as though I have been.
The first thing he did was switch me from a tri-phasic birth control pill (which I had been on) to a mono-phasic. He said that was the recommended treatment for women with PCOS because their hormones are "all out of wack anyway" and adding three different ones to the mix "doesn't help anything". He explained the links between PCOS and Insulin Resistance and recommended trying a low-carb diet and seeing how things progressed. After I went home I started doing research and everything he'd said was verified in the numerous medical sources I looked at. I started the mono-phasic BC pills, which work much better and don't give me the sugar cravings I used to have with the tri-phasics. I started on South Beach and working out more regularly. I also started taking Cinnamon Supplements daily to help combat insulin resistance...it's a natural alternative to Metformin. My blood sugar has been much steadier since I've done all of this and things seem to be going better.
I've since learned that PCOS is actually a spectrum of disorders and there could be any variety of hormone imbalances that cause it, and that treatment can be better directed once you know which imbalance you have. I'd like to learn one day which imbalance I suffer from, but I'll have to wait for a better job with actual health insurance rather than "catastrophic coverage" only.
If you want more info, there is a great message board for people with PCOS.
http://www.pcosupport.org/ Good luck!