Polycystic ovarian syndrome (PCOS) is one of the most common fertility issues in women.
You may have heard of PCOS before. It affects between 5-10% percent of women in their childbearing years and is characterized by ovarian cysts, pelvic pain, severe period cramps, heavy menstrual bleeding, and trouble conceiving.
It’s difficult to get pregnant if you have PCOS, but it’s not impossible. As an integrative physician, I’ve worked with more than a thousand women over the past decade, many of whom had fertility issues from PCOS. While PCOS makes some women infertile, with the right strategies, you can increase your odds of having a child and a healthy pregnancy.
What is PCOS?
Polycystic ovarian syndrome is the result of an imbalance in your sex hormones. Women with PCOS typically have low estrogen and progesterone, the two female sex hormones, and high male sex hormones like testosterone.
Your cycle (and much of your fertility) is dictated by your hormones. In PCOS, hormonal imbalance causes a few different symptoms:
- Absent/irregular period. Normally, your eggs develop in small, fluid-filled sacs called follicles that attach to your uterus. When ovulation starts, one follicle bursts, releasing a mature egg that’s ready for fertilization. With PCOS, high male sex hormones prevent your follicles from releasing their eggs, which can cause absent or irregular periods and no ovulation.
- Pain and cramping. High male sex hormones and low estrogen and progesterone cause follicles to build up in your ovaries, causing pain and cramping. PCOS may also cause enlarged ovaries.
- Facial hair. High testosterone can cause women with PCOS to develop facial hair.
- Hair loss. Low estrogen can also make your hair thin and eventually fall out.
- Hypoglycemia (low blood sugar). PCOS can cause blood sugar to drop, triggering fatigue, lightheadedness, and food cravings.
If you experience several of these symptoms simultaneously or you have fewer than eight periods a year, I suggest talking to your healthcare provider. He/she may prescribe a hormone test and an ovarian ultrasound to determine whether or not you have PCOS.
Can you get pregnant with PCOS?
For some women, PCOS causes infertility. Their eggs don’t mature and release, which means they don’t ovulate and cannot conceive. Women with PCOS who do get pregnant have a higher risk of miscarriage as well.
However, there are a lot of recent advances in fertility medicine, as well as lifestyle changes that can help you ovulate and have a healthy pregnancy, even with PCOS.
- Bioidentical hormone therapy. If you’re trying to conceive with PCOS, your doctor may prescribe bioidentical progesterone, follicle-stimulating hormone, and/or luteinizing hormone, all of which can bring your hormones back into balance and trigger ovulation.
- Weight loss. Being overweight can interfere with sex hormones, triggering or worsening PCOS symptoms. Overweight women who lose weight have more regular periods, more success conceiving, and a better chance of a healthy pregnancy . Typically, weight loss improves your hormonal balance, especially when it comes to sex hormones.
- Exercise. Working out is another way to balance your sex hormones. Exercise also decreases inflammation, helps you lose excess body fat, improves organ function, reduces pain, and increases your odds of conception . That said, be wary of overtraining. Chronic, intense exercise without enough recovery can have the opposite effect, decreasing fertility in women. Listen to your body and give yourself time to recover.
- Relaxation and stress relief. Stress can make PCOS worse, and chronically high cortisol (your body’s stress hormone) can increase the risk of complications during pregnancy. If you’re trying to get pregnant, it’s not the time to push yourself in other areas of your life. Take it easy, relax, and incorporate calming practices like meditation and massage into your life.
If you’re missing your period regularly, you have intense cramps or pain, hair loss, facial hair growth, or other symptoms of PCOS, talk to your healthcare provider immediately. If you’ve already been diagnosed with PCOS, work closely with your doctor to create a plan to manage the symptoms and provide relief.
And if you’re trying to conceive with PCOS, talk to a fertility doctor or women’s health specialist about how to change your lifestyle and what hormones can help you ovulate and keep you healthy throughout pregnancy.
At my clinic, Centresping MD, we specialize in women’s health and hormonal balance. Our team has helped thousands of women over the last decade, many of whom struggled with fertility or PCOS. Sign up for a virtual consultation today to work with a knowledgeable physician who will help you meet your health goals.
- Best, D., Avenell, A., & Bhattacharya, S. (2017). How effective are weight-loss interventions for improving fertility in women and men who are overweight or obese? A systematic review and meta-analysis of the evidence. Human reproduction update, 23(6), 681-705. https://www.ncbi.nlm.nih.gov/pubmed/28961722
- Olive, D. L. (2010). Exercise and fertility: an update. Current Opinion in Obstetrics and Gynecology, 22(4), 259-263. https://journals.lww.com/co-obgyn/Citation/2010/08000/Exercise_and_fertility__an_update.2.aspx