If you’ve been reading up on the Fertility Awareness Method, you’ve probably come across the term Polycystic Ovarian Syndrome (PCOS). Or, perhaps you or someone you know has PCOS, as PCOS affects between 5 and 10% of all women of childbearing age. PCOS is pretty common in the US and around the world. It’s also the most common cause of female infertility—but if you have PCOS, don’t despair! There are now lots of ways to treat PCOS so that women with the disorder can achieve regular cycles, get pregnant, and have healthy babies :) Read on:
So, what is Polycystic Ovarian Syndrome? PCOS is a hormonal disorder that may affect a woman’s ability to ovulate. Women with PCOS often have few or no menstrual periods, and heavy or irregular vaginal bleeding when they do have their periods. This means that they ovulate infrequently, if at all.
The name Polycystic Ovarian Syndrome comes from one of the common symptoms of the disorder—having lots of tiny, painless cysts on the ovaries. However, some women have many of these cysts on their ovaries, but ovulate normally and do not display any other symptoms of PCOS. So, there’s more to it than that.
Many women with PCOS have insulin resistance, meaning their bodies can’t process normal levels of insulin. This causes the body to think that there isn’t enough insulin in the system, so it amps up insulin production. The now-excessive amounts of insulin in the system cause the body to increase its production of androgens (male hormones, like testosterone), which can lead to some common symptoms of PCOS—acne, hair growth on the face and/or body, hair loss from the scalp, and weight gain. The excess of male hormones in the body may also be due to lower-than-normal progesterone levels in the body. Many experts now also believe that PCOS is linked to genetics—so, a woman whose sister, mother, or grandmother has PCOS is more likely to have it herself.
Not all women experience the typical symptoms of PCOS--some women may have hormonal levels that indicate PCOS, but display no outward symptoms of the disorder at all. So, diagnosing PCOS can be tricky for some. Typically, a diagnosis of PCOS requires at least two of the following three symptoms to be present: 1) anovulation or irregular periods, 2) high levels of androgens in the body, 3) the presence of many small cysts on the ovaries (detected by ultrasounds). Also, high levels of the luteinizing hormone (LH) and follicle-stimulating hormone (FSH) in the body can indicate PCOS. If you’re charting your fertility signs, cycles that last two months or longer or cycles with a ‘false peak’ once or more a year (in which cervical fluid builds up from sticky to eggwhite/watery but ovulation does not occur) indicate a possibility of PCOS. (For more on how charting is affected by PCOS, click here!)
Currently, there is no complete cure for PCOS—however, proper treatment can lessen or take away some or all of the symptoms and help women to ovulate regularly (and get pregnant, if they want!). The first line of treatment for most women is to adopt a healthy lifestyle with regular exercise and a PCOS-friendly diet. Although it may be difficult for women with PCOS to lose weight, doing so can be really helpful in easing the symptoms of the disorder. Quitting smoking can also be helpful, as women who smoke cigarettes often have higher androgen levels than women who do not. Many women with PCOS also swear to the effectiveness of acupuncture as a natural method of treatment. Natural progesterone cream or pills can also help balance a woman’s progesterone levels and regulate her cycle.
If these forms of treatment don’t work, there are several medical options available. The two drugs most commonly prescribed to women with PCOS are Clomid and Metformin. Clomid, which helps to jumpstart ovulation, will start ovulation in 80% of patients, and 40-45% of women taking Clomid to get pregnant will get pregnant within 6 cycles of use. Metformin, a drug originally intended to treat diabetes, reduces androgen levels and helps the body to process insulin.
Some doctors may recommend that women with PCOS go on the Pill to regulate their cycles. But while the Pill may lessen some of the symptoms of PCOS and make your cycles appear to be regular, it doesn’t treat the actual problem—it just masks it until you go back off the Pill. And, some studies have shown that the Pill may actually INCREASE insulin resistance, making the problem worse in the long run. Ultimately, the decision is up to you—but these are just a few things to keep in mind!