If your high school sex-ed teacher is to be believed, one sexual encounter without protection is guaranteed to end in pregnancy. So why does this not ring true when you’re a grown-ass woman ready and willing to make babies?
Fertility struggles are sh*t. And there are lots of factors that can contribute. Polycystic ovary syndrome (PCOS) is one potential culprit. (But it should be noted, you can still get pregnant and have a healthy baby with PCOS.)
If this term has popped up during chats with your doctor or fertility specialist, you’re probably wondering, ‘Do I have PCOS?’. And, ‘What does it MEAN?!’
Here’s what you need to know about PCOS and how it can affect your journey towards getting pregnant.
What is PCOS (polycystic ovary syndrome)?
In our opinion, PCOS could stand for: Pretty. Crappy. Ovulation. Situation.
It’s a hormonal disorder that f*cks up your body’s natural ovulation cycle, and can also have side effects like excess facial hair, weight gain, and menstrual cycles that are all over the shop.
PCOS is wildly common among women of reproductive age. The Office on Women’s Health reports that 1 in 10 experience it!
Are there different types of PCOS?
Some nutritionists and wellness experts define different ‘types of PCOS’ depending on whether it’s brought on by coming off the oral contraceptive pill, inflammation in the body, or an abnormal stress response. In the medical sphere, though, PCOS is just PCOS. It may show up in different ways, but the symptoms are often the same.
What are the first signs of PCOS?
According to Mayo Clinic first signs of PCOS can appear as early as puberty, when you have your first ever period. But it can also surface later on in life during times of significant weight gain. When the physical signs of PCOS are mild, women often don’t find out they have it until they run into fertility issues.
PCOS symptoms can include:
- Irregular menstrual cycles.
- ‘Hirsutism’, which means excess hair on the face, chin, and/or pubic hair.
- Thinning hair.
- Weight gain or difficulty losing weight.
- Darkening of skin, particularly under the boobs, along neck creases or in the groin area.
- Skin tags, which are small flaps of skin. These are more common in the armpits or neck area.
An official PCOS diagnosis generally won’t be made until your doctor has confirmed at least two of the main PCOS symptoms: period irregularity, excess androgens (male hormones), and polycystic ovaries.
A note on polycystic ovaries: This is what it’s called when your ovaries develop an excess of follicles (collections of fluid). These may show up on an ultrasound like a ‘pearl necklace’ of smaller-than-usual follicles at the periphery of the ovary. But having polycystic ovaries doesn’t always mean you have PCOS. (Yeah, confusing.)
What causes PCOS?
Doctors still remain stumped about what actually causes PCOS (meaning there’s no one-size-fits-all approach to treating it). But there are a few theories out there.
Is PCOS genetic?
It seems to be, a bit. You’re more likely to get it if a family member has had it.
Is it related to being overweight?
There also seems to be something in this. Somewhere between 40% and 80% of women with PCOS are overweight or obese as well. But there are overweight women who don’t have it, and people of normal weight who do have it. The mystery continues.
Is it to do with diet?
Maybe! But in a complex way.
Insulin resistance seems to be a big factor in PCOS, and may be what triggers the production of excess male hormones (androgens) in the body. Your body could become resistant to insulin due to being overweight, unhealthy eating habits, or a family history of Type 2 Diabetes.
Sydney researchers have found that a controlled PCOS diet may help spark regular ovulation. While further studies are needed, they’re in the process of investigating whether a Mediterranean-style diet may be the best diet for PCOS and ovulation.
Is it totally random?
Could be that too. It’s likely brought on by a mixture of unexplained hormonal things, insulin resistance, and menstruation irregularities.
Long story short: we don’t know what causes PCOS.
How to diagnose PCOS
Diagnosing PCOS can be complicated. The Centers for Disease Control and Prevention notes that you may visit multiple medical practitioners for opinions on various symptoms, not realizing that it’s all caused by PCOS.
For example, you might see a dermatologist wanting advice on WTF your skin is doing. You might visit a gynecologist wondering what’s up with your whack periods. Or you might see your family doctor for their thoughts on why (for the love of god!) you can’t seem to lose weight.
You may not register any of this until you try to get pregnant.
Your doctor might check for PCOS if you’re showing some of the signs, or if you have fertility concerns.
How to test for PCOS
While there’s no one definitive ‘PCOS test’ for diagnosis, there are a series of tests a doctor can perform to check off your symptoms and likelihood of having it.
- An ultrasound – This can reveal polycystic appearance of follicles on your ovaries, however New Zealand-based nutritionist Emily Jensen is adamant that a PCOS ultrasound diagnosis is not enough to confirm you have it.
- Period tracking – Your doctor might ask about your menstruation history to assess if your cycle is regular.
- A blood test – This can be done to confirm high levels of male hormones.
If your doctor suspects you do have PCOS, they might refer you to see a PCOS specialist to make a formal diagnosis and discuss your treatment options.
PCOS treatment options
There’s no way to ‘cure’ PCOS, but it can be managed. There are a few ways to treat PCOS symptoms, including:
- Losing weight – Your doctor might recommend increasing your physical activity or adjusting your diet to lose some weight. This can often help kickstart your ovulation, and help you get pregnant. However it should be noted that weight gain is often a side effect of PCOS, so you may need support beyond diet and exercise to lose weight.
- Removing hair – If excess facial hair is one of your PCOS symptoms, you could look into hair removal creams or treatments if it bothers you. A trip to a dermatologist may be helpful!
- PCOS medication – Some medications can help rebalance your hormones and reduce the signs of PCOS. (Thank f*ck!) Hormonal birth control treatments are often prescribed if you’re not trying to get pregnant. Anti-androgen medications or metformin (used to treat Type 2 Diabetes) may be recommended, but these options aren’t FDA-approved for PCOS treatment at present. If you are trying to conceive, your doctor might recommend other forms of medication to help with hormone balance.
Getting pregnant with PCOS
Because PCOS often prevents you from ovulating regularly (or at all!), it can be difficult to conceive. So can you get pregnant with PCOS?
Some women with PCOS will fall pregnant easily and never really realize they’ve got it. Others may experience PCOS infertility for a while and seek medical help. But know this: there ARE ways to help get your ovulation on track and become a mama.
Been diagnosed with PCOS? Pregnancy is still possible.
1. Talk to your doctor or fertility specialist
If you have a PCOS diagnosis and want to get pregnant, they’ll be able to advise you on steps to take to get your ovulation in order.
2. Decide on a treatment plan
This might include:
- Losing some weight.
- Starting supplements such as inositol.
- Trying medication to induce ovulation.
- Treating insulin resistance or pre-diabetes, if present.
- Surgery (although not especially common practice in women with PCOS, ovarian drilling may help you ovulate naturally for up to eight months).
- Trying IVF (in vitro fertilization).
Some alternative therapies such as massage and acupuncture claim to assist with fertility, but there isn’t really enough substantial data that proves these options help with inducing ovulation for pregnancy.
3. Have sex
Or if it’s not your style, explore lesbian pregnancy options!
Managing a PCOS pregnancy
A lil’ heads-up: Women with PCOS may experience higher risk of pregnancy complications including miscarriage, pre-eclampsia, gestational diabetes, and c-section birth. Um, what?! Getting pregnant may have been tough enough for you – now the pregnancy’s gonna be hard too?
Truth is, pregnancy can be hard work whether you have PCOS or not. The best thing to do is chat with your doctor about ways to stay healthy throughout your pregnancy. And then follow their advice, obvs.
Eating well, staying active, maintaining blood glucose levels (maybe with help from medication), and taking a folic acid supplement can all help your PCOS pregnancy go down without a hitch.
So to summarize – PCOS might throw a spanner in the works (and be a right pain in the uterus!), but it doesn’t mean you can’t get pregnant.