What is PCOS?
PCOS is an abbreviation for Polycystic Ovary Syndrome and is a condition that causes an imbalance in a woman’s hormone levels that can affect ovarian function.
PCOS can affect anyone with ovaries and is one of the leading causes of infertility. There are three main factors associated with PCOS:
- Menstrual cycle irregularities like irregular periods or anovulatory cycles (when your ovaries do not release an egg)
- High levels of androgen, a hormone that is typically more abundant in biologically male bodies.
- Polycystic ovaries
Generally, doctors look for two of these three features to diagnose someone with PCOS, but the condition can also cause many other symptoms.
Having PCOS may also lead to an increased risk of conditions like type 2 diabetes, high cholesterol, heart disease, and endometrial cancer. PCOS can also contribute to your mental health and has been linked to increased levels of anxiety and depression.
Did you know? Women with PCOS may be up to four times more likely than people without PCOS to develop type 2 diabetes.
What are the causes of PCOS?
Doctors and researchers still aren’t sure exactly what causes someone to have PCOS. A high level of androgens is a key characteristic of PCOS. Factors like inflammation, genes, and insulin resistance, have been linked to higher levels of androgen.
- Genes: PCOS tends to run in families, which suggests that there may be a genetic component to the condition. Research suggests that multiple genes may contribute to your likelihood of developing PCOS.
- Insulin resistance: studies suggest that as many as 7 in 10 people with PCOS have insulin resistance. Insulin resistance means your cells cannot properly process insulin. Extra insulin in the body can contribute to an increase in androgen production.
- Inflammation: Some research suggests that inflammation may play a role in PCOS because it is associated with excess androgen levels.
What are the symptoms of PCOS?
The most common symptoms of PCOS include:
- Irregular periods: People with PCOS often have irregular periods or may not have periods at all.
- Excess body hair growth: Excess androgens cause excess hair growth on the face, chest, stomach, and back.
- Thinning hair: PCOS can cause hair loss and thinning hair on the scalp.
- Acne: PCOS most commonly causes acne on the face, chest, and upper back.
- Weight gain: Many people with PCOS have difficulty losing weight or may gain weight quickly.
- Infertility: PCOS can make it more challenging to get pregnant due to hormonal imbalances and irregular ovulation.
- Oily skin: Excess androgen in the body can cause oily skin and dandruff.
- Darkened skin: PCOS can cause dark patches of skin, particularly on the neck, groin, and underarms. This is due to an excess of insulin in the body, which can be a symptom of PCOS.
- Mood changes: Some people with PCOS may experience mood changes, including anxiety and depression.
- Sleep problems: PCOS can cause sleep problems like insomnia.
It is important to note that PCOS is a complex condition and everyone with PCOS is different. It’s even possible to have PCOS and no symptoms at all.
How does PCOS impact fertility?
PCOS is a common cause of infertility. A few aspects of PCOS can make it more difficult for someone to conceive.
- Irregular periods: One of the most common symptoms of PCOS is menstrual cycle irregularity, which can make it more difficult to predict ovulation and time intercourse. People with PCOS may also have anovulatory cycles where ovulation doesn’t occur. Ovulation is the process of the ovary releasing an egg, an essential function that needs to take place to get pregnant.
- Hormonal imbalances: People with PCOS can have hormonal imbalances, including an excess of androgens. These imbalances can disrupt the functioning of the ovaries and lead to the development of small cysts on the ovaries.
- Insulin resistance: Many people with PCOS have insulin resistance, which means their bodies cannot use insulin to regulate blood sugar levels effectively. This can lead to high insulin levels, stimulating the ovaries to produce more androgens.
- Inflammation: Some research suggests that inflammation may play a role in PCOS’s impact on fertility. If the ovaries are inflamed, they may not function correctly and may not release eggs regularly. Inflammation in the ovaries can also lead to the development of small cysts that disrupt the standard hormonal signals that regulate the menstrual cycle and ovulation.
How is PCOS treated?
Treatments for PCOS can include medications, lifestyle changes, or a combination. These options vary based on whether you are trying to get pregnant.
If you are not actively trying to get pregnant, treatment options include:
- Hormonal birth control: Birth control pills can help regulate periods and reduce the production of androgens (male hormones). This can help manage the symptoms of PCOS.
- Medication: Drugs like Metformin which are often used to treat diabetes, can be effective in managing the symptoms of PCOS. These medications can help improve insulin resistance and reduce the production of androgens.
- Lifestyle changes: Making lifestyle adjustments, such as ensuring your weight is at a healthy level for your body, exercising regularly, and eating a healthy diet, can help manage the symptoms of PCOS and improve fertility.
Is it possible to conceive if I live with PCOS?
Yes. Many people with PCOS do get pregnant. Some people with PCOS even get pregnant without treatment or intervention.
While PCOS can make getting pregnant challenging, it is not impossible. Many people with PCOS can get pregnant with the help of fertility treatments such as medication or assisted reproductive techniques.
It’s important to note that everyone is different, and not everyone with PCOS will have difficulty getting pregnant.
Working with a healthcare provider can help you determine the best treatment plan for you if you’re trying to conceive with PCOS and are having difficulty.
What fertility options do people with PCOS have?
Getting pregnant with PCOS involves some of the same steps women without PCOS should take for a healthy pregnancy, like maintaining a healthy weight, eating foods high in vitamins and minerals, and keeping balanced blood sugar levels. Some people with PCOS need additional support to get pregnant. Common fertility treatments for people with PCOS include
- Clomiphene: Clomiphene (Clomid) is a medication your doctor may prescribe to help stimulate ovulation. It works by blocking the effects of estrogen on the brain and causing the pituitary gland to release more follicle-stimulating hormone (FSH) and luteinizing hormone (LH). These hormones help stimulate the growth and release of an egg from the ovary.
- Metformin: Metformin is a medication often used to treat type 2 diabetes. It can also improve insulin resistance and reduce androgens production in people with PCOS. Metformin may help improve fertility in people with PCOS by improving insulin resistance and reducing androgen levels. Early research studies also suggest that Metformin may help reduce the risk of miscarriage in people with PCOS.
- Letrozole: Like Clomiphene, Letrozole is a medication that can also help stimulate ovulation by inhibiting estrogen production in the body. Letrozole does this by inhibiting aromatase, an enzyme responsible for converting androgens into estrogen. Limiting aromatase helps reduce estrogen production to stimulate the brain’s pituitary gland to release more FSH and LH.
- Assisted reproductive techniques: Assisted reproductive techniques such as in vitro fertilization (IVF) may be recommended for people with PCOS who do not respond to drug treatments alone. IVF involves retrieving eggs and fertilizing them with sperm in a laboratory dish. The fertilized embryos are then transferred back into the uterus.
What are the risks of getting pregnant if I have PCOS?
There are several risks associated with getting pregnant when you have PCOS. The most common risks are:
- Gestational diabetes
- High blood pressure
- Preterm delivery (before 37 weeks of pregnancy).
- Large babies and associated delivery risks
It’s important to remember that if you are pregnant and have PCOS, your doctor will monitor these risks closely so that any potential issues are addressed quickly.
Does insurance cover PCOS treatment?
Most health insurance policies cover the diagnosis and treatment of pre-existing conditions, including PCOS.
While many insurance companies do not cover fertility treatment, they can cover treatment for addressing symptoms of PCOS, which could improve the chances of conception.
How can Oova help someone living with PCOS?
Because many people with PCOS do not have regular cycles, or experience anovulatory cycles, relying on traditional ovulation test kits just doesn’t cut it. Oova was designed to work for anyone with a menstrual cycle, not just people with "perfect" 28-day cycles. This makes Oova a great option for people with PCOS.
Oova allows you to track your unique hormone patterns and delivers lab-quality results in real time.
Tracking both luteinizing hormone (LH) and progesterone can give you a better sense of your menstrual cycle and predict when you are most likely to ovulate. This information can be game-changing if you live with PCOS and are trying to get pregnant.
Measuring your hormones at home can help you manage your health even if you are not trying to conceive. While you view your results in the Oova App, your healthcare provider can see them instantly on our Clinician Dashboard. This allows you and your doctor to work together to monitor your symptoms and response to treatments or lifestyle changes.
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