Considering Pregnancy with PCOS

PCOS, or Polycystic Ovarian Syndrome. If you know, you KNOW. But if you don’t, we are here to share. PCOS is a hormone-related condition that isn’t uncommon for women of reproductive age. It affects between 8-13% of women worldwide, so chances are you or someone you know struggles with it. It can cause missed periods, stubborn acne, ovulation issues, hormone dysregulation, and more. PCOS is even the top cause of infertility in women. We’ve collected the must-know information below 👇 

Polycystic… - what?

Polycystic ovarian syndrome is named for the multiple cysts found on the ovaries. When ovulation (the release of the mature egg from the ovary) doesn’t happen, more fluid-filled sacs, or cysts, containing immature eggs continue to develop. Think, no ovulation = angry ovary. These extra cysts can then release higher levels of androgens, the male sex hormones, such as testosterone, DHEA, DHEAS, androstenedione, and androstenediol. Androgens perform important functions for both men and women, but women usually have lower levels. At higher levels, they can cause chaos in the body.

How do I know if I have PCOS?

PCOS develops during puberty with the changes in hormones. It can be diagnosed early for some women and much later for others, depending on the severity of symptoms. For some, facial and body hair growth, called hirsutism, highly irregular periods, and more severe weight gain can lead to a diagnosis in early adolescence. For others, acne and thinning hair may not display strongly enough for you or a provider to choose to seek testing and you may not be diagnosed until early adulthood. Your provider may suggest further scans and tests that can help support diagnosis. An ultrasound can identify multiple cysts on your ovaries, and hormone blood tests can look for higher-than-normal levels of androgens and other hormones. But to get diagnosed with PCOS, two of three following health concerns must be present: irregular menstrual cycles caused by irregular or a complete lack of ovulation, high androgen levels, and/or excess cysts on the ovaries.

Can I get PCOS after puberty?

Some research suggests that PCOS has a genetic or hereditary component, so it is considered a condition you are born with. However, the severity of symptoms may determine whether or not you know that you have it and if it causes complications. Worsening insulin resistance and weight gain may exacerbate the condition in adulthood, leading to diagnosis of the condition later on. But you may have had it all along.

Is having PCOS my fault?

The cause still remains somewhat of a mystery, so, no, you probably did not significantly contribute to getting PCOS. Since medicine hasn’t yet discovered the cause (shocker, another loss for women’s reproductive health), we’ll share a few of the working theories or contributing factors.

Having baseline higher levels of androgens seems to be a primary indicator for potentially developing PCOS.

• Insulin Resistance: This affects between 50-75% of those with PCOS. When the body is insulin resistant, the amount of insulin normally released to bring down blood sugar levels isn’t enough. The subsequent high blood sugar then stimulates even more insulin to be released, causing an abnormally high amount of insulin to be circulating in the bloodstream. If your body is resistant to insulin, this may lead to increased levels of androgens and ovulation issues, as well as diabetes.

• Living with “low-grade inflammation” may also contribute to higher androgen levels. Some research suggests that those living with PCOS have higher biomarkers for inflammation than those without.

If a family member has PCOS, it is worth discussing your period cycle and symptoms with your provider, as this could increase your risk!

What’s the impact on my fertility?

The high levels of androgens and irregular or absent ovulation cycles mean that PCOS will likely impact your fertility to some degree. With missed or abnormal periods, planning a pregnancy can be tricky! However, while getting pregnant naturally may be tricker, it is certainly not impossible. Using ovulation trackers and talking to your provider about looking for ways to stimulate ovulation are good places to start. Thanks to modern medicine and research, those with PCOS can still get pregnant! You just might need a little more support.

Could PCOS impact a pregnancy?

We can’t forget that once pregnancy starts, the impact of having PCOS can still be felt. During pregnancy, women with PCOS are at higher risk of gestational diabetes, preterm delivery, preeclampsia, fetal macrosomia (bigger than average babies), and cesarean sections. There may also be an increased risk of miscarriage. You may have more testing and clinic visits once pregnant, and it is important to discuss these risks with your provider.

So what can I do?

Sadly, no cure yet. Today, PCOS is mostly treated with lifestyle modifications and prescription medications to help increase ovulation, manage hormone balances, and treat symptoms. These medications could include hormonal birth control to manage hormone imbalances, diabetes medications to improve insulin processing, and antibiotics or anti-androgen medications to treat acne.

Diet and exercise can improve one’s odds not only of getting pregnant, but also staying healthy during the pregnancy. As mentioned, PCOS can affect many areas of your health and those complications can worsen when you add pregnancy into the mix. Make sure you’re eating a balanced diet, limiting alcohol intake, getting moderate exercise, and coping with stressors in a healthy way!

TL;DR: Polycystic Ovarian Syndrome is a common condition affecting women’s reproductive health and also is a leading cause of infertility. Understanding your risk and your options is important for planning the healthy future, and healthy pregnancies, you may want!

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*The information provided is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or any other qualified healthcare provider with questions you may have regarding a medical condition or treatment.