Polycystic ovary syndrome - or PCOS - is fairly common yet under-diagnosed condition affecting, by some estimates, up to 4 - 18% of women of reproductive age. Part of what makes PCOS so difficult to dianose and understand is the symptoms of PCOS can take many forms. Some women with PCOS will have heavy and prolonged periods, while others will have only irregular periods, and some won’t menstruate at all.
Since the symptoms may vary, it often falls to each individual woman to advocate for herself to her doctor to diagnosis and treatment. This becomes especially important for women who are trying to conceive now or in the future. Understanding this condition and how it may (or may not!) create fertility challenges can empower you to get the treatment that you need.
What is PCOS?
There’s a lot we don’t know about PCOS, but based on current research, the main cause of PCOS seems to be related to elevated androgens – male hormones including testosterone – which are made in the ovaries and the adrenal glands. This may inhibit the recruitment of a dominant follicle and multiple smaller follicles - small collections of fluid - to persist throughout the cycle and can prevent normal ovulation.
Symptoms of PCOS often first occur at the onset of puberty, but may also develop later in life, and are often associated with weight gain. Some of the symptoms of PCOS include:
- Menstrual cycle irregularities, including heavy or prolonged bleeding, infrequent periods or no periods at all
- Increase in weight
- Insulin resistance
- Skin irregularities including severe acne
- Multiple follicles in ovaries
- Hirsutism – excessive growth of body hair, including on the face
- Hair loss
The variety of ways that the symptoms of PCOS can present makes it notoriously difficult to diagnose, but if you’re struggling to get pregnant understanding what is going on with your body is incredibly important.
Diagnosing PCOS is usually done through a combination of tests, including a pelvic exam, blood tests, and an ultrasound. Through these tests, elevated hormone levels and polycystic ovaries can be identified.
How PCOS May Cause Fertility Challenges
When menstruation doesn’t occur regularly or normally it can become difficult to get pregnant without intervention. Another challenge to fertility is being overweight or underweight. There is also a higher risk of miscarriage and gestational diabetes associated with PCOS. For all of these reasons it is good to identify the risk of PCOS and begin treatments before trying to get pregnant.
Since PCOS is most likely caused by hormonal imbalances, many of the most effective treatments involve hormone therapy. This often takes the form of different varieties of hormonal birth control including:
- birth control pills
- Progestin therapy
- Hormonal IUDs
- Vaginal rings
These therapies aren’t always appropriate, especially if you are trying to get pregnant. There are other types of medication that can be prescribed to help increase ovulation if you’re trying to conceive. If these treatments aren’t successful, you may need to consider a more aggressive intervention, most likely in vitro fertilization.
Whatever your needs, our fertility experts can advise you along the way. Navigating PCOS and fertility treatments can feel complicated, which is why we offer a free 30-minute consultation to get you started. Schedule yours today!