What is PCOS and Why Should You Care?
Polycystic ovary syndrome (PCOS) is the most common reason for infertility in women. It’s a hormonal disorder, named as it is because most women with the condition have numerous small cysts in their ovaries. As many as 5 million women in the U.S. may be affected by it, according to the Office on Women’s Health of the U.S. Department of Health and Human Services.
If you have PCOS, what steps can you take to improve your chances of having a baby? Read on to find out about symptoms, treatments and lifestyle changes that can help you overcome fertility problems caused by PCOS.
Symptoms and Cause of PCOS
The cause of PCOS is unknown, but most experts think genetics plays a role. Women with PCOS are more likely to have a mother or sister with the condition. Other factors may also affect it. A main underlying problem is a hormonal imbalance. The ovaries of women with PCOS produce more androgens than normal. Yes, androgens are male hormones, but women produce them as well! However, too much of these hormones affects the development and release of eggs. That’s where the infertility comes in.
Another potential problem is insulin. Researchers have found that many women with PCOS have too much insulin in their bodies because they are insulin-resistant. Excess insulin appears to increase production of androgen. High production of androgen leads to some of the symptoms of PCOS, including acne, excessive hair growth (hirsutism), weight gain and problems with ovulation.
Other symptoms of PCOS in addition to infertility include infrequent or irregular menstrual periods, cysts on the ovaries, acne, weight gain or obesity, male pattern baldness or thinning hair, and dark patches on the skin of the neck, arms, breasts or thighs. If you suspect you have PCOS see your doctor, who will give you a physical exam, take your medical history, and perform a pelvic exam. Your doctor may also order blood tests to see the levels of androgen and glucose in your blood and perform a vaginal ultrasound to check for ovarian cysts and signs of endometriosis, a thickening of the lining of your womb.
How Can You Manage PCOS If You Want to Get Pregnant?
If you don’t want to get pregnant, birth control pills can alleviate many of the symptoms. If you do want to get pregnant, tell your doctor, and you can work together toward that goal.
One of the most important things you can do to improve your fertility problems is to lose weight. Many women with PCOS are overweight or obese. It’s kind of a chicken-or-egg issue: Obesity may contribute to PCOS, and PCOS may contribute to becoming obese. Losing weight with a healthy diet and moderate exercise helps to lower blood glucose levels, improve how your body uses insulin so you don’t have too much insulin in your bloodstream, and helps normalize hormones in your body. Losing just 10 percent of your body weight can restore a normal period and make your cycle more regular.
There are a lot of theories circulating on the Internet and social media about what kind of diet will affect fertility if you have PCOS. The scientific evidence is not there for eating certain foods to improve fertility. The key lifestyle change if you are overweight or obese is simply to lose weight in a healthy way.
If you are not overweight but are insulin resistant, using diet to control your insulin levels may be of help. A study of 60 women with PCOS who had a normal body mass index was carried out recently by researchers at the University of Tel Aviv. Both groups ate 1800 calories daily, but one group ate over half the day’s calories at breakfast and ate less than 200 at dinner, while the other group ate less than 200 at breakfast and more than 900 at dinner. The “big breakfast” group showed 56% less insulin resistance and a 50% fall in testosterone levels (androgens), which led to a 50% increase in ovulation.
The medicine metformin (Glucophage), which is used to treat type 2 diabetes, has also been found to help with PCOS symptoms, although this is an off-label use, not approved by the Food and Drug Administration. After a few months of use it may help ovulation to return by affecting the way insulin controls blood glucose and lowering testosterone production.
If you are trying to get pregnant and have not been successful, a fertility specialist can help you with the best advice for dealing with your PCOS as it relates to getting pregnant (fertility treatments may not be initially indicated.) Your fertility doctor will use your medical history and test results to determine the right course of treatment to help you get pregnant. If weight loss does not help or isn’t needed, your doctor may recommend fertility drugs to induce ovulation or in vitro fertilization (IVF), which gives more control over multiple births.
Find a Fertility Clinic and Financing for Fertility Treatment
Many people want help starting a family but are worried about how to afford fertility treatment. If your insurance does not cover fertility treatment your fertility center can help you find alternative ways to finance treatment.