It’s arguably the most well-known hormonal disorder around and is estimated to affect up to to 10% of women. Alongside weight-management issues, acne, hair loss, hirsutism and an irregular menstrual cycle, one of the biggest concerns about PCOS is that it can impact fertility later in life. Here’s what you need to know:
The basics
While you’ve probably heard of PCOS, the majority of people know it for its side effects, so it’s worth recapping on what it actually means for your reproductive system. The main ways that PCOS impacts fertility is due to an imbalance of hormones that causes absent or irregular periods (including those that come too frequently or seem never to end), which inherently lends itself to a lack of ovulation, which of course makes it impossible to get pregnant.
The presence of cysts—small, fluid-filled sacks in the ovaries can also make conception difficult—although these are not present in every woman with PCOS.
There are four diagnostic categories for PCOS, which are:
1. Classic PCOS: characterised by high androgen levels, irregular or absent ovulation, and a polycystic ovary
2. Hyperandrogenic anovulatory PCOS: characterised by excess androgens with irregular or absent ovulation, but no polycystic ovary
3. Ovulatory PCOS: characterised by excess androgens with a polycystic ovary, but without ovulatory dysfunction
4. Non-hyperandrogenic PCOS: characterised by irregular or absent ovulation and a polycystic ovary
Knowing which one you are can impact courses of treatment, so it’s worth using your symptoms as a guide to working out where you sit on the scale.
Tips for falling pregnant with PCOS
Getting your PCOS under control well in advance can save a lot of heartache later on when it comes to trying to fall pregnant. Holistic health practitioners will advocate for a natural approach to balancing hormones; encompassing lifestyle factors like diet, exercise, stress-management and using natural personal care prods.
It probably goes without saying (but we’ll say it anyway), but sugar, caffeine, processed foods and alcohol are going to do sweet FA to help manage your PCOS, and adopting a whole foods diet that is rich in iron, magnesium and gut-friendly foods is going to pay dividends.
When it comes to exercise, cutting back on the high-intensity training and favouring exercises like pilates, yoga and walking can be helpful in managing hormone imbalances, however as we already know—everyone is super different and it’s important to find what works for you, your body and your PCOS.
In a more medicalised approach, medications can be prescribed to help you ovulate, and IVF may be an option if prescription medicine and lifestyle changes do not work. Surgery is also an option, but usually only in cases where other options are unsuccessful. Ovarian drilling is a surgery in which a few holes are made on the surface of the ovary using lasers or a fine needle heated with electricity. Surgery usually restores ovulation, but only for 6 to 8 months.
The risks of falling pregnant with PCOS
Women with PCOS tend to have higher rates of miscarriage, gestational diabetes and preeclampsia, which can put your pregnancy in the ‘higher risk’ categories. These risks can be lowered by reaching a healthy weight before you get pregnant, achieving healthy blood sugar levels before getting pregnant and taking a good folic acid supplement, and of course, getting professional help on navigating these potential obstacles is a no-brainer.
