If you’ve never heard of PCOS, you’re not alone. It stands for Polycystic Ovarian Syndrome and although you may never have heard the term before there is a pretty good chance someone you know has it. PCOS affects nearly one in ten women of childbearing age, making it one of the most common causes of female infertility in America.
Although this condition makes conceiving naturally very challenging, with fertility treatments and lifestyle changes women with PCOS can have children of their own. Here is everything you need to know about PCOS and the steps you can take to improve your odds of conceiving.
10 What Is PCOS?
PCOS stands for Polycystic Ovarian Syndrome, it is a condition that occurs when a woman’s sex hormones (estrogen and progesterone) are out of balance. This imbalance often promotes the growth of ovarian cysts (benign masses on the ovaries). It is a serious condition that can lead to complications with menstruation, fertility, appearance and heart health. It affects up to five million American women.
Most women begin showing signs of PCOS after their first menstrual cycle. The most common symptom is irregular periods but symptoms can also include the following:
- Weight gain
- Pelvic pain
- Anxiety or depression
- Polycystic ovaries
PCOS is typically marked by a decrease in female sex hormones and increase in male hormones. This may cause some women to develop the following masculine characteristics:
- Decreased breast size
- Deeper voice
- Thinning hair on your head
- Excess hair on body and face
There is no definitive reason as to why some women develop PCOS, but the condition appears to be linked to the following characteristics:
- Genetics: Unfortunately if your mother or sister has PCOS, it is likely that you will have it as well.
- Excess production of the hormone androgen: Androgen is a male sex hormone that is present in all women, but those with PCOS produce too much of it. This can affect ovulation as the excess androgens alter the natural development and release of eggs.
- Excess Insulin: Insulin is a hormone that helps turn sugars and starches into energy. Too much insulin in the body has been linked to PCOS.
- Excess body weight: Women who are overweight are more likely to be diagnosed with PCOS.
There is no PCOS specific test, but your doctor will perform a physical and pelvic exam to determine whether or not you have it.
Your doctor will likely order blood tests to analyze the following:
- Hormone Levels in the Blood – this test will determine whether you have low levels of female hormones and higher than normal levels of male hormones.
- Thyroid Function Test – this test will check to ensure that your thyroid is functioning properly by measuring the amount of thyroid hormone your body is producing.
- Fasting Glucose Test – this test measures your blood sugar levels.
- Lipid Level Test – this test measures the amount of cholesterol in your blood.
- Vaginal Ultrasound – the doctor will perform an ultrasound to look for signs of PCOS such as swollen ovaries.
- Pelvic Laparoscopy – this is a surgical procedure that will require an incision in your abdomen so that a camera can be inserted to check for growths (or cysts) on your ovaries. If there are growths present your doctor will likely take a small sample to examine.
6 Effects on Fertility
Since PCOS affects the levels of sex hormones in a woman’s body it affects fertility significantly. Most women diagnosed with PCOS are unable to conceive naturally for the following reasons:
- They do not ovulate
- They have irregular periods
- Their endometrium (uterus lining) is not prepared to sustain a pregnancy
Women with PCOS who do become pregnant have a heightened risk of miscarriage since their sex hormones are not functioning properly. Fertility treatments have been shown to be effective in helping women who suffer from PCOS become pregnant.
Although it is disheartening to find out you may be unable to conceive naturally, there is a silver lining. Since your body does not ovulate and release an egg regularly in your teens and twenties, you may end up with more eggs than normal in your thirties. These extra eggs can be used for fertility treatments and actually increase your chance of conception down the line.
5 Fertility Treatments
If you have PCOS and want to become pregnant your doctor will likely recommend one of the following treatments:
- Clomid: This is generally the first fertility drug that doctors prescribe as it promotes ovulation.
- Gonadotropins: If Clomid doesn’t work for you, you will likely be prescribed gonadotropins. These are naturally occurring hormones that stimulate your ovaries to release one or more eggs. There is a chance that this treatment can result in a multiple pregnancy as gonadotropins may over stimulate your ovaries.
- Metformin: If you are resistant to Clomid or overweight, the diabetes drug metformin may help increase your sensitivity to insulin. This would cause male hormone levels to fall and promote regular ovulation.
- Ovarian Drilling: This is a surgical technique that can help women conceive if Clomid does not work for them. Ovarian drilling destroys the tissues that are producing male hormones on the ovaries. This can temporarily regulate your hormone levels to allow for conception.
4 Conceiving Naturally
Although fertility treatment is the most effective means to get pregnant with PCOS, there are some things you can do to help the process.
- Follow a Low-Glycemic Diet: Since insulin is a contributing factor to many women’s PCOS, limiting insulin resistance may help balance sex hormones and increase fertility. Following a diet with less refined carbohydrates can reduce insulin resistance, decrease the hormone androgen and result in more regular periods and ovulation.
- Maintain a Healthy Weight: Obesity is a significant problem for many women with PCOS. In fact, 35-60% of women with a high waist-to-hip ratio have high insulin and androgen, which are linked to PCOS. For this reason, it is important to stay active and exercise to increase your chances of conceiving.
- Take your Vitamins: Omega-3 has been shown to decrease inflammation that typically accompanies insulin resistance.
3 Pregnancy Complications
If you have PCOS and become pregnant your doctor will likely refer you to a doctor that specializes in high-risk pregnancies. Women with PCOS require extra monitoring during pregnancy due to the heightened risk of miscarriage, gestational diabetes, and premature delivery. Those who suffer from PCOS may also have higher risks of the following:
- High Blood Pressure
- High Cholesterol
- Anxiety and Depression
- Heart Attack
- Breast Cancer
- Sleep Apnea
- Endometrial Cancer
Although not all of these risks are associated with pregnancy, they are important to keep in mind if you have PCOS.
There is no cure for PCOS, but there are ways you can manage the symptoms and decrease your likelihood of complications. As mentioned above, a healthy diet and regular exercise are important for women with PCOS as it can lower blood glucose levels and promote regular periods.
If you are not planning on becoming pregnant birth control pills can be used to minimize symptoms. They can help eliminate acne, regulate periods and decrease male hormone levels. You may also be prescribed anti-androgens, a drug that decreases male hormone levels in your body. This can help with excess hair growth, and reduce acne as well. Additionally, diabetes medication may be prescribed to help control insulin levels.
It is possible that some women may require surgery. The procedure is called ovarian drilling and will destroy part of the ovary as a temporary solution to promote ovulation and reduce male hormone levels.
There is no way to prevent PCOS since it is largely based on genetics. However, diagnosing and treating PCOS as soon as possible is your best option in reducing complications. If you have irregular or nonexistent periods, it is important to visit your doctor to test for additional PCOS symptoms.
If you are overweight and have PCOS, losing weight and maintaining a healthy lifestyle can reverse some of your symptoms. It is also very important for women with PCOS to avoid tobacco products.
A Polycystic Ovarian Syndrome diagnosis sounds scary and complicated, but it is entirely manageable with professional help. Talk to your doctor about how PCOS will affect your overall health and what you can do to prevent serious complications.