Trying for a baby can be a difficult and frustrating process for families, and you might be surprised to learn that one of the most common causes of female infertility is PCOS.
Although you might have heard of this condition, it’s often not diagnosed until women start to try for a baby. Fertility Family surveyed 395 women with PCOS, and found that 49 per cent of women are first diagnosed when trying to conceive, with 58 per cent of couples continuing to seek fertility advice after their diagnosis.
If you’re concerned about PCOS and want to find out more, we’ve put together some advice for you, with help from Fertility Family.
What is PCOS?
PCOS stands for Polycystic ovary syndrome and is a condition that affects a woman's hormone levels. Women living with PCOS produce higher-than-normal amounts of male hormones, and this hormone imbalance can cause their body to miss periods and as a result, it can be a sign you can't get pregnant.
Seeking advice on PCOS before trying for a baby can help women understand how to manage PCOS before starting a family.
What are the symptoms of PCOS?
Most of the signs and symptoms of PCOS will become apparent during your late teens or early 20s.
Common symptoms of PCOS can include:
• irregular periods or no periods at all. This may also include period pain with no period
• difficulty getting pregnant as a result of irregular or late ovulation or failure to ovulate
• excessive hair growth (hirsutism) – usually on the face, chest, back or buttocks
• weight gain
• thinning hair and hair loss from the head
• oily skin or acne
• depression and mood swings
Himanshu Borase, Fertility Specialist and Consultant Gynaecologist at Hertsfertility says:
“One third of the people who I see at fertility clinics suffer from PCOS and we always try our best to educate and empower them. There is a great need for more understanding of the options available and a more open conversation around fertility”.
If you think you might have PCOS, it's important to see your doctor and begin the diagnosis process.
How can PCOS impact fertility?
Women with PCOS don’t regularly release eggs, so conceiving can be difficult. Another contributing factor is that almost 70 per cent of PCOS patients have a high BMI and this can also impact fertility.
Management and treatment is usually assessed on a case-by-case basis and treatment options can involve dietary changes, reducing BMI, supplements to reduce insulin resistance, and other special treatments such as ovulation induction (medicine to release the egg and timed intercourse), surgery for ovarian diathermy and IVF. The aim is to help patients conceive spontaneously where possible.
Fertility Family share the following advice:
“Openly discussing personal issues such as PCOS and infertility can be difficult, but the more we encourage these conversations, the more open women will become about fertility issues and the need for further education. Many women with PCOS will have difficulties getting pregnant, there are actions these women can take to improve their chances such as; lifestyle changes, losing weight where necessary, taking a suitable fertility supplement for PCOS, and seeking specialist help early. It is also important to remember that fertility problems can be due to male factors, so always consider both partners in all scenarios regarding fertility”.
How to manage PCOS
It’s important to identify these symptoms as early on as possible and get advice from a specialist and a fertility expert if you are planning to conceive or struggling to conceive. The best way to manage it depends on the severity of the symptoms and the extent to which they affect your quality of life. Where someone might be uncomfortable and another may want to conceive, management for all these will be different. General advice is to lead a healthy lifestyle, maintain a BMI between 19-25 and take regular exercise.
“When I am working with PCOS clients my first aim is to get their blood sugars under control.’ says Registered Nutritional Therapist Harriett Eldridge. “Secondly, I want to ensure that they are having healthy regular bowel movements (type 3-4 on the Bristol stool chart) and thirdly support their gut health.”
Any diets should be all about balance in what you eat. You might want to start by reducing your intake of refined carbohydrates such as white bread, white pasta, potato, cakes and pastries and swap these for high protein options like hummus, eggs, chickpeas & avocado. This will help to balance blood sugars, reduce cravings and support weight management.
You should also minimise processed foods and aim for a diet rich in fruits, vegetables, beans, legumes, whole grains, healthy fats and fibre to support your gut health.
It might surprise you to hear that there is a close link between PCOS and mental health, particularly anxiety and depression. Not only is exercise important for keeping healthy, it can also benefit you mentally too.
Exercise can help increase your metabolic rate, reduce insulin resistance and stabilise mood. When you’re doing your workouts, try to incorporate a good amount of both cardio and strength training, aiming for at least 30 minutes of exercise every other day.
• Cardio workouts include: brisk walks, jogging, cycling, swimming.
• Strength Training includes: Squats, press ups and core exercises (using your body weight rather than weights) can help increase your muscle mass and therefore the function of insulin in the body.
Many women have been turning to CBD to help treat both the emotional and physical pain often brought on by PCOS.
Jen, 22, who lives with PCOS said: “I was diagnosed with PCOS and have quite a lot of side effects including bloating, erratic mood swings, and bad cramps in my stomach. I was tired of putting on a brave face”.
After making lifestyle and diet changes, she was still struggling, so tried CBD to find out if it could help. “My mood literally changed within like literally a couple of days. It was magical. Within three days I went back to being on top form.”
CBD drops are administered under the tongue with dosage and time of application done to meet individual needs “The pain completely disappeared within a week and I honestly haven’t had any pain since. It’s kind of hard to fathom the fact that this bit of CBD oil might actually have changed my whole pain and made all those symptoms go away, but it genuinely has.”
Supplements shouldn’t be taken to replace food groups or a healthy diet, but they can help to top up levels of what you need without you having to eat four platefuls of broccoli each sitting, which lets be honest, isn’t going to happen.
In general, these are some of the commonly recognised supplements that are beneficial for PCOS.
• Vitamin D
• Omega 3
Be aware that these certainly aren’t a one pill fix, and if you do decide to take supplements along with your usual diet, take the time to consider any changes positive or negative to your emotional and physical state to ensure you’re only making changes that work for you. It might be a good idea to keep a diary to record any diet and lifestyle changes and how your mood and physical symptoms change.
It’s important to speak to your doctor if you feel you’re struggling with PCOS as there are prescription medicines available to help ease the symptoms.
• Hair Growth - Increased hair and acne: the oral contraceptive pill, and referral to a dermatologist. Anti-androgen drugs can also be prescribed.
• Period Regulation - the oral contraceptive pill is the first line of treatment. In patients who do not want to take the pill, cyclical progestogen drugs can be prescribed.
All of these must be prescribed by a medical health professional.
Where can people seek support for PCOS?
Additional information and advice on PCOS and infertility:
Hertsfertility multidisciplinary team patient education leaflet on the long-term effects of PCOS and management advice
Verity is a charity that aims to educate, support and empower women with PCOS through encouraging research and improving access to treatment.
Wellbeing of Women is a charity that invests in pioneering women’s health research to develop new tests, treatments and cures.
HFEA, the government regulator, provides free, clear and impartial information on UK fertility clinics, IVF and other types of fertility treatment, and donation.
Fertility Network UK is the number one charity for anyone experiencing fertility problems in the UK. They run a range of local online support groups.