You have been trying to get pregnant, but nothing is happening. You visit your doctor and they give you the bad news: you have polycystic ovary syndrome. It may come as a shock, but looking back you realize you may have had the symptoms of PCOS all along but just never knew it. You had acne, but you thought you were eating too much junk food. You seemed to have excess hair here and there, but you thought it was just your genes. You did not get a menstrual period every month, but you attributed it to your birth control pills, and frankly, your good fortune. It turns out, it was PCOS all along.
Your doctor likely decided to check for PCOS based on your infrequent menstrual periods and your trouble conceiving, but they may have confirmed the diagnosis with an ultrasound exam or with a blood test to check hormone levels. Most women with PCOS have enlarged ovaries which contain small sacs of fluid, called follicles, which are visible using ultrasound. These cysts in the ovaries are what gives polycystic ovary syndrome its name. PCOS is also characterized by the presence of high levels of male hormones in a woman’s blood.
Causes of PCOS
One of your first thoughts with a PCOS diagnosis may be: how did I get this? You may wonder if getting PCOS was your fault. The truth is, doctors are not sure exactly what causes PCOS. Researchers believe that PCOS may have a genetic cause; having a mother or sister with PCOS increases your chance of also being diagnosed with PCOS, although researchers have not yet found the gene that increases the risk for PCOS. Another possible trigger for PCOS is low-grade inflammation; research has shown that women with PCOS do have inflammation, although they have not yet determined how inflammation may trigger PCOS. They do know, however, that when a woman with PCOS has inflammation, it can cause their ovaries to produce androgens, which are male hormones. These male hormones then cause many of the symptoms of PCOS. The third possible cause of PCOS is excess insulin in the body, which can be triggered by obesity. Researchers believe this excess insulin may cause the ovaries to produce excess androgens.
What does PCOS do to my body?
One discovery you have just made about PCOS, thanks to your diagnosis, is that it can cause infertility. This is because PCOS increases the amount of male hormones, androgens, in the body. Many of the body’s processes are controlled by female hormones, such as estrogen, so an increase in androgens in a woman can have undesirable effects.
For one, a woman with excess male hormones may have excess facial or body hair, much like a man. This can be unsightly, and the cost of all those electrolysis treatments sure do add up. Women with PCOS may also experience the opposite, when they begin to lose hair from their scalp, called male pattern baldness. For a woman, this can be especially embarrassing. Another beauty-releated effect of these excess androgens is acne, either the presence of acne as an adult or excessive acne as a teenager.
As the ovaries swell because of PCOS, you could experience pain and discomfort. When it comes to fertility, the cysts can block the release of the egg from the ovaries. With no egg released, there is no chance of having an egg fertilized. The male hormones also affect ovulation as they interfere with processes controlled by female hormones. At first, having periods less than eight times a year or not at all seems great. As other women cope with the inconvenience of their monthly cycle, and shell out all that money for tampons, you can enjoy your freedom. However, when it comes time to conceive a child, you realize that not menstruating is not a good thing. When you are not menstruating, it is a sign that you are also not ovulating, which is the one basic requirement of fertility.
What are my treatment options?
You may see your PCOS diagnosis as a sign you will never conceive, but that is not the case at all. The good news is this is a common condition with different treatment options that can help. Women with PCOS can and do go on to have a baby … they just need a little help.
Diet and Exercise for Weight Loss
Your doctor’s first recommendation may be to exercise and adjust your diet to reduce calories. PCOS is often associated with obesity, and losing even just five percent of your body weight might be enough to reduce your PCOS symptoms, including infertility.
The link between PCOS and diabetes may not seem obvious, but doctors believe PCOS may be triggered by insulin resistance and high levels of insulin in the blood, which trigger the ovaries to release androgens. By taking diabetes drugs, such as Glucophage and Metformin, you may be able to lower your insulin levels and improve your insulin resistance. This may reduce the pressure on your ovaries to produce male hormones which interfere with fertility.
Drugs like Clomid and Serophene, with the generic name Clomiphene, help women with and without PCOS to ovulate. Ovulation, which is the release of an egg from the ovaries, is the crucial step towards fertility. Once an egg is released, a sperm can potentially reach the egg, fertilize it, and grow into an embryo.
Gonadotropins are hormones associated with reproduction, including follicle-stimulating hormone (FSH) and luteinizing hormone (LH). Injections of these hormones can help trigger ovulation, releasing an egg that can be fertilized.
Drugs such as Letrozole can block estrogen production. This increases the amount of follicle-stimulating hormone in the body, which stimulates follicles to grow and produce an egg. This egg can then be released from the ovaries through ovulation, to potentially be fertilized.
Ovarian Drilling Surgery
If fertility drugs do not help you get pregnant, surgery may be your next option. In ovarian drilling surgery, your doctor destroys a small part of your ovaries by inserting a thin needle through your abdomen. Destroying part of the ovaries can lower the amount of male hormones your ovaries produce. This means less male hormones in the body to interfere with fertility, and an increased chance of ovulation.
Can I get pregnant with PCOS?
Although a PCOS diagnosis may come as a shock, diagnosing the problem is your first step in treating your infertility. Once your doctor knows why you are having trouble conceiving, they can make recommendations and start you on treatments that can help. You are not alone, with about five million women in the United States diagnosed with PCOS. Women with PCOS do go on to give birth to a healthy baby, and chances are, you can too.