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Polycystic Ovary Syndrome (PCOS)
and Pregnancy
Understanding the symptoms of pregnancy with PCOS, what precautions to take during pregnancy and possible treatments
Polycystic ovary syndrome (PCOS) occurs due to a reproductive hormone imbalance that can create ovary problems. In a healthy menstrual cycle, ovaries release an egg every month during ovulation. When the egg isn’t fertilized, it’s expelled from a woman’s body a couple of weeks later during her period.
PCOS can disrupt this process by preventing a woman’s ovaries from releasing an egg during ovulation. PCOS causes the ovaries to produce an unusually high amount of male sex hormones (androgens) that are normally only present in small amounts in women.
A high level of androgens triggers menstrual cycle problems and prevents a woman’s body from making enough hormones for ovulation. PCOS can make periods irregular or stop altogether, often making conception more difficult.
How common is PCOS in the U.S.?
PCOS is a widespread endocrine disorder that causes many cases of female infertility. According to the Centers for Disease Control and Prevention (CDC), PCOS affects 5 million U.S. women, which is approximately 6-12 percent of women of reproductive age. The condition can also continue beyond childbearing age.
PCOS and pregnancy
PCOS affects the ability to conceive by causing irregular or missed menstrual periods, which can lead to infertility. In fact, PCOS is one of the most common causes of infertility in women. PCOS causes cysts to develop in the ovaries. These cysts are tiny fluid-filled sacs that produce androgens hormones that interfere with the menstrual cycle.
Despite an increased difficulty with conceiving, women with PCOS can sometimes conceive naturally if they’re under 35 and ovulate regularly. Conception often occurs within a year if a woman and her partner don’t have other medical conditions affecting fertility. Some women may choose to undergo fertility treatments if they have continued difficulty getting pregnant.
PCOS signs and symptoms
PCOS usually becomes prominent during the late teens or early 20s. Signs include:
- Irregular, infrequent, prolonged or missed periods
- Hirsutism (excess hair growth) on the face, back, chest and buttocks
- Acne or an oily skin
- Hair thinning and baldness
- Weight gain around the middle body
- Excess skin (skin tags) under the armpits or on the neck
- Thick, dark patches of skin under the armpits, breasts and neck
PCOS also increases the risk of developing health conditions like elevated cholesterol and type 2 diabetes later in life.
Side effects of PCOS during pregnancy
Pregnant women with PCOS are more likely to develop complications at different stages of their pregnancy. Complications include:
- Mood disorders
- Preterm birth before 37 weeks
PCOS pregnancies are higher risk, but that doesn’t mean a mother with PCOS can’t deliver a healthy full-term baby. However, pregnancy complications like high blood pressure make a cesarean delivery (C-section) more likely. Recovery after a C-section delivery takes longer than a vaginal birth because it’s a surgical procedure.
PCOS diagnosis
In order to diagnose PCOS, your doctor will ask you questions about your medical history, perform a thorough physical exam and order tests including:
- Blood tests to analyze hormone levels. Additional blood testing may be necessary to measure triglyceride, cholesterol, and glucose tolerance levels.
- Pelvic exam to check reproductive organs for growths, masses, or other abnormalities.
- An ultrasound to check the ovaries and uterus for any abnormalities, including cysts, tumors or a thickened uterine wall.
Common myths about PCOS
MYTH: PCOS is rare.
FACT: PCOS affects 6-12 percent of women who are childbearing age, so it is not considered a rare condition.
MYTH: Women with PCOS cannot conceive.
FACT: Women with PCOS may have increased difficulties getting pregnant, but many will end up conceiving naturally or with fertility treatment and lifestyle changes.
MYTH: PCOS only affects overweight women.
FACT: Many women with PCOS are overweight, but PCOS can affect women of any weight. The relationship between PCOS and weight often results from the body’s inability to utilize insulin, which leads to weight gain.
MYTH: Women with PCOS always have ovarian cysts.
FACT: While many women with PCOS have ovarian cysts that are visible on ultrasound, not all women with PCOS will have ovarian cysts.
MYTH: PCOS cannot be managed.
FACT: While there isn’t currently a cure for PCOS, it’s often possible to manage the symptoms through methods like medications, lifestyle modifications and weight reduction.
MYTH: Irregular menstrual cycles mean you have PCOS.
FACT: PCOS is just 1 cause of irregular menstrual cycles, but there are also other causes like fibroids, thyroid disorders and stress.
Precautions to take during pregnancy with PCOS
Pregnant women with PCOS should exercise regularly and monitor their weight and blood sugar levels. Eating protein-rich foods can help to stabilize blood sugar levels. In addition, it’s essential to eat a healthy diet consisting of high fiber, whole grains and reduced carbohydrates and avoid caffeine, nicotine and alcoholic beverages.
Regular blood pressure tests, prenatal vitamins and regular medical checkups help ensure the safety of a woman with PCOS throughout her pregnancy.
Best age to get pregnant with PCOS
The best time for women with PCOS to get pregnant is before they turn 30. It’s possible to conceive up to the age of 37, but fertility declines after the age of 32 with steeper decline occurring after age 37. The highest odds of natural conception for women with PCOS occurs before age 35 with regular ovulation and lack of other fertility challenges.
Conception can happen within a year if your body mass index (BMI) and metabolic and hormonal parameters are under control. A woman who does not get pregnant after 1 year of frequent unprotected sex should consider consulting with a fertility specialist. Women over 35 may also require fertility treatments.