I was in my 20s. I had no insurance and not a prayer of a relationship on the horizon. Then I got a diagnosis of Polycystic Ovarian Syndrome (PCOS) at my yearly check up at Planned Parenthood.
I was nervous when I asked what this meant and what I could do about it.
I learned that (at the time) there wasn’t really any treatment. Down the line, I may have trouble getting pregnant. I did some more research.
The internet was new in those days, but with a cursory search, I recognized all the symptoms. They included difficulty losing weight, irregular periods, unwanted hair growth, brown patches on the skin… I felt seen and terrified at the same time. A little more digging, and I learned that (at the time) there really was no treatment for PCOS. I also learned that it was very common and most women found themselves unable to conceive.
When fantasizing about your future, you don’t want to read that the life you imagined for yourself may be impossible. You don’t want to fear that you’re doomed to a future as a childless, bearded lady.
Well, cut to years later, I have two gorgeous daughters. The only beard in our house is on my husband. Got PCOS? Don’t panic. We’ve come a long way, baby.
What Is PCOS and How Did I Get It?
PCOS is a hormonal disorder that affects up to 26% of women between the ages of 15 and 44. The ovaries are reproductive organs in women that produce estrogen and progesterone. These hormones are responsible for regulating women’s menstrual cycles. When the ovaries cannot produce the proper balance of hormones, they fail to effectively do their job: releasing follicles, or “sacs” that contain the eggs which are then ready for fertilization.
Instead of releasing these eggs, the ovaries in women with PCOS produce cysts, or sacs. These are filled with fluid that fail to release and mature into eggs. Therefore ovulation is not triggered (“polycystic” means “many cysts”). Without ovulation, the body’s levels of the hormones LH, FSH, progesterone and estrogen are lower than they should be. Additionally, the androgen (typical male hormones) end up higher than usual. This means that menstrual cycles are out of whack, making life incredibly inconvenient and conception particularly difficult.
Science has come a long way in researching PCOS, and while there is no known “cause,” there are links between PCOS and obesity, inflammation, a woman’s genetic makeup as well as connections to insulin resistance and diabetes.
How Can I Treat It?
Now that scientists have discovered the insulin resistance link in women with PCOS (up to 70% of women with PCOS show signs of this disorder), there are some new methods of intervention that are showing promising results.
Lifestyle changes and weight reduction are often the first steps towards improving hormonal balance. Many doctors might recommend a low-carb, low-glycemic diet (I myself followed my nutritionist’s advice and gave up starchy foods, gluten and cane sugar with great results).
Your doctor might also recommend medication to help regulate your periods. Birth control pills, skin patches or vaginal rings that combine estrogen and progestin show good results in lowering the body’s production of androgens. He or she might also suggest progestin therapy, a method of taking progestin for 10-14 days every few months. Just remember, while this may help regulate your periods, it is not a contraceptive, so you may become pregnant with this treatment.
What About Making Babies?
While some women with PCOS may get lucky and get pregnant without intervention, my (and many women’s) journey to having kids included IFV treatment. I worked with a very knowledgeable doctor to get just the right balance of hormones to stimulate egg production, improve chances of implantation, and to keep my hormones balanced throughout the stages of pregnancy. Most doctors map out a plan of fertility injections with “Follistim®, Gonal-F®, Bravelle®, and Menopur® [which] contain the same hormone the brain releases to signal the ovary to produce eggs. Rather than producing one egg in a month, most women on fertility injections will produce two or more eggs.”
If you have been given a diagnosis of PCOS, know that there are changes you can make on your own to improve your health and condition: a change in diet, exercise and some good self care. When the time comes and you’re ready to conceive, you’ll be ahead of the game and a visit to an endocrinologist and fertility specialist will arm you with a plan of action.