Polycystic ovarian syndrome (PCOS) is one of the leading causes of female infertility in the United States. As such, your future fertility may rely on accurate diagnosis of this commonly misunderstood and under-diagnosed condition. PCOS is not a disease, it is a syndrome – which means it is signified by a collective of symptoms, but there is no cure, nor is there a precise way to diagnose it at this point.
However, we have learned that lifestyle and insulin management (sometimes using Metformin or other diabetes medications) can significantly mitigate its symptoms. With the right treatment, the majority of women with PCOS will be able to get pregnant.
Do You Have Symptoms of PCOS?
While there are exceptions to the rule, most women with PCOS have very telling symptoms, as long as somebody’s paying attention to them. Undiagnosed PCOS can lead to more severe health risks later on, and it can make it more difficult for you to get pregnant without the help of a fertility specialist.
First, please make sure you visit your OB/GYN every single year so she remains in touch 
with your overall physical and reproductive well-being. Second, make sure you are honest with your gynecologist or midwife, and let them know all the little things that may not be normal – like skipped or irregular periods, hair growing where it shouldn’t be, weight you’re struggling to control, and so on.
And, on that note, here are some of the symptoms that indicate PCOS may be a factor. Do any of them sound familiar? If so, schedule a consult with your OB/GYN and let him/her know you think you might have PCOS:
- Male hair growth patterns. Women with PCOS typically have higher androgen (male hormone) levels, which can result in thinning hair on the top of the head as well as excess hair on the chest, shoulders, arms, back and/or abdomen.
- Weight that’s very difficult or impossible to take off. Most women with PCOS struggle with their weight – particularly weight around their middle. This can create an apple- or barrel-like shape, with thinner legs and a rounder, boxier trunk. Additional weight is partially the result of insulin resistance, similar to that of a person with Type 2 diabetes. And, in fact, women with PCOS have a higher rate of developing Type 2 diabetes later on in life as well as gestational diabetes during pregnancy.
- Skipped periods. The combination of higher androgen levels and insulin sensitivity can disrupt ovulation. This results in skipped or irregular periods. While it’s true that all menstrual cycles are different, skipping periods is not normal, either are menstrual cycles that last fewer than 20 days or longer than 25. If you sense your menstrual cycle is a little wonky, bring it to your doctor’s attention, as it’s a sign that something is up.
- Ovarian cysts. As its name suggests, women with PCOS often have a string of cysts in their ovaries. These cysts may or may not cause pelvic pain or discomfort, but they can certainly compromise fertility when you’re ready to get pregnant. A simple ultrasound can reveal what we refer to as a “string of pearls,” and this is a strong sign you have PCOS.
- Pelvic pain or discomfort. The result of the ovarian cysts.
- Sugar cravings. Because you’re insulin resistant, your body suffers extreme blood sugar highs and lows – and those lows will cause you to crave sugar. Eating like a diabetic can go a long way towards regulating insulin, losing weight, balancing blood sugar and eliminating sugar and carb cravings.
Other common symptoms of PCOS include darker patches of skin or irregular skin pigmentation, skin tags – particularly on the chest, under the breasts, in the armpits and neck, depression – and sleep apnea.
Lifestyle Changes and Treatment Can Increase Fertility for Women with PCOS
Fortunately, the first step in treating PCOS is making simple changes to your lifestyle that support a healthy weight and give your pancreas a break from producing all that insulin. A low-carb, anti-inflammatory diet is a great place to start (South Beach and Atkins are effective, but speak to your doctor before starting any new diet program). Exercising at least 30-minutes at a time, five days a week will also help to balance blood sugar and support your improved lifestyle. These changes can minimize symptoms for many women.
Women with more severe PCOS may need additional support, especially when they’re trying to get pregnant. As mentioned above, medications for pre- or type 2 diabetes can be used to regulate blood sugar, which often reduces PCOS symptoms so speak with your doctor if lifestyle changes aren’t enough to reverse the symptoms.
Fertility treatment options are usually quite successful for women with PCOS. However, it’s important that you receive an accurate diagnosis and then work with a fertility specialist. Women who have undiagnosed PCOS can wind up having fertility treatments that lead to high orders of multiples (twins, triplets or more). This is because while they don’t ovulate regularly (or at all) on their own, they have lots of healthy eggs waiting to mature in the ovaries. The combination of a young woman with PCOS, dozens of healthy eggs and injectable fertility medications can result in an octomom scenario.
Do you suspect you have PCOS? Contact us here at Overlake and schedule a consultation. Together, we’ll establish what your symptoms mean and the create a personalized treatment plan to minimize their effects and to support your health future fertility.