Polycystic Ovary Syndrome (PCOS) is the most common hormonal imbalance condition affecting women in their reproductive years. More than 5 million women, suffer from PCOS which can cause a range of symptoms such as; irregular periods or menstruation, skin or hair changes and for some, difficulty in getting pregnant. It is not a disease of the ovaries. If the hormone levels associated with PCOS can be reduced or controlled, the ovaries can often function normally.
Can you get pregnant with PCOS? Yes, certainly. 3/10 women with PCOS experience some difficulties in getting pregnant. It may take longer, but with appropriate changes in diet, lifestyle, exercising regularly and medical treatments, conception is not difficult if PCOS is detected & treated early. Women suffering from PCOS & irregular periods find it harder to time sex to fertile days of their menstrual period. But, surprisingly, women with PCOS have a similar number of children as women without PCOS.
So How Does Polycystic Ovaries Affect Fertility?
Myth: “Poly” means “many”. Polycystic Ovaries Syndrome means many cysts in the ovaries.
Fact: Many people are of the opinion that Polycystic refers to multiple cysts in the ovaries. But that’s not necessarily true. It actually refers to the imbalance in the hormonal levels. An ultrasound suggests that dark areas on the ovaries are follicles occurring due to under-developed eggs which affect fertility as they don’t mature every month.
There are two main hormones associated with PCOS –
An imbalance of these in the ovaries causes the eggs struggle to function normally.
Genes & hormones are carried down generations. An elevated hormonal level before birth in the womb, at birth or early childhood development plays a major role. Scientists say that Women with PCOS are 55% more likely to have a mother / sister or an aunt suffering from PCOS in relation to those without PCOS. Women from Asia, Africa & Aboriginals are more prone to PCOS than women from other ethnic backgrounds.
Unhealthy eating habits, poor nutrition and consumption of junk food, erratic schedule (eg. Night shift jobs for women), sedentary lifestyle, lack of exercise or low physical activity causes increased risk of PCOS. Increased weight (Body Mass Index (BMI)
There are various symptoms of PCOS with irregular periods which differ between individuals & vary at different stages of life. They affect three main areas: reproductive, metabolic and psychological health.
Diagnosis of can be done either by a blood test or an ultrasound.
Not really. But if you are taking contraceptive pills, you should stop taking the pill for three months beforehand. In early teens, your 1st or 2nd year may have irregular periods until your body normalizes to the hormonal changes in your body. But it’s common for PCOS to occur at young age.
If your condition is mild, you may realize only if you are unable to conceive and your weight fluctuates.
There are 3 easy ways to detect pregnancy with PCOS. Pregnancy with PCOS may be difficult to detect accurately due to irregularity in periods.
It is recommended to wait for 7-10 days after a missed period to take a home pregnancy test. Levels of hCG (human chorionic gonadotropin) can also be measured by a blood test in a laboratory. If you get a negative result, you can recheck after a week or so until the hCG levels rise.
Some of common signs of pregnancy with PCOS include
Keep track of your menstrual periods and note the dates. If you have been able to regularize them, a missed period for 7-10 days can possibly mean you are pregnant if intercourse occurred on the suggested dates.
For most women it takes about 3 months to get pregnant. However, if you have Polycystic Ovarian Syndrome and you want to get pregnant quickly, you may take 6months or more depending on –
It takes at least 3 months for an egg or ova to mature and be released from your ovaries. So, altering your diet before trying to conceive will be really helpful when you are trying to conceive.
Since over 30% of women with PCOS experience some difficulties in getting pregnant, it’s highly recommended you start planning a family early as the chances of pregnancy with PCOS declines after 35. Elevates levels of male hormones prevent the release of egg(ovulation).
Women with PCOS experience fertility Issues including Miscarriage. The miscarriage rate for women with PCOS can be as high as 30-50%. They have a 2-fold increase of miscarriage relative to those without PCOS. If you are undergoing assisted reproductive therapies such IVF or IUI, you 50% more likely to have a miscarriage.
If you have had recurrent miscarriages in the past the likelihood of miscarriage is a whooping 40-80%. So, it is better that you start planning early so you have enough time and age by your side.
All women have 2 coin sized ovaries lying on the either side of the uterus. These ovaries store eggs (ova) and produce various hormones such as oestrogen and progesterone. These hormones help in developing breasts & normalize the menstrual cycle. Additionally, they also produce small amounts of male hormones (androgens) such as testosterone.
Ovulation normally occurs once a month when an egg (ovum) travels through the fallopian tube into the uterus to fertilize with the sperm if sexual intercourse has occurred in that period. Before an egg is released at ovulation, it develops within a little swelling of the ovary, called a follicle (a fluid filled sac). Every month several follicles start to develop but normally just one fully develops and releases its egg from the ovary into the fallopian tube. An egg may be released or no eggs in that cycle may be released (anovulation). Contraceptive pills are still recommended for women with PCOS who don’t want to be pregnant.
For women suffering from PCOS in their twenties, there is still light at the end of the tunnel. In fact, the sooner you start trying to conceive, the better. By beginning in your twenties, you are giving yourself a higher chance of getting pregnant as opposed to waiting until you turn 30. Women in their 20 have a very small chance of being infertile – a mere 6%, whereas this number increases to 64% for a 40 year old woman. If you are a young 20-something year old, struggling to conceive, health experts recommend trying naturally at first before approaching doctors for more medically advanced techniques.
Can I still get pregnant if I have PCOS? Yes, you definitely can. It may take longer than usual, but early detection and cure can help you sail through smoothly. Does PCOS make you a high risk pregnancy? Women who are in the clutch of PCOS or PCOD, in their 30’s may have a higher risk age related birth defects such as chromosomal abnormalities. Body fat redistribution along with slight height loss explains why women with PCOS had larger waist circumference measurements and increased BMI values as they got older. How To Get Pregnant With PCOS After 30? What are the chances of pregnancy with PCOS after 30? It is difficult to give statistics as each case varies. However, women over 30-35 have a higher risk of delayed pregnancy. Planning early especially if you have detected PCOS gives you more room for early treatment.
Over 30% of women between 40-45years experience infertility. Your chances of conceiving in any given month are also lower once you pass the big 40. A 40 year old woman only has a 5% chance of getting pregnant naturally every month. Getting pregnant after 40 has more risks in general related to birth defects like Spina Bifida or Down’s Syndrome.
Ovarian cysts are fluid-filled sacs in the ovary. If they are few or small you may not see any visible symptoms. Some of the common ovarian cyst symptoms include lower abdominal pressure, bloating, swelling or sharp/dull pain.
You will experience sudden, severe, acute pain alongside nausea and vomiting.
Other symptoms of ovarian cysts in extreme cases may include:
Ovarian cancer often is undetected until it has spread to the pelvis and / or abdomen, making it even more difficult to treat.
Ovarian Cancer treatment includes surgery and chemotherapy.
This is a painful disorder that causes uterine endometrial cells to grow outside your uterus instead of inside in the endometrium (the inner lining of the womb). Some tissues can attach to your ovary and form a growth outside the uterus affecting the ovaries, fallopian tubes, lymph nodes & the peritonium. Around 7-10% of women are affected by this condition.
You are prone to endometriosis if you have any allergies or chemical sensitiveness, breast cancer, ovarian cancer, auto immune disease (or genetic) or asthma.
Insulin controls the blood sugar (glucose) levels in the body. Cells need glucose to produce energy for various activities or store it for future needs. If you have PCOS, you are likely to have insulin resistance, leading to higher levels of sugar in the body thereby increasing the tendency to put on weight easily. This is more likely to be concentrated around the abdominal (stomach) region. The excess insulin in the body also disrupts the hormones produced by the ovaries and pituitary gland, interfering with ovulation.
Obese women often have fertility issues. Many women with PCOS have a tendency to put on weight since the condition affects how your body processes insulin. Obesity also influences irregular periods, missed periods or anovulation (no production of eggs or ovum).
PCOS Diet is a proven way to lose weight with no side effects. There are 13 Principles between PCOS Diet & Weight Loss. PCOS diet plan for Indians may not have some of the foods included below such as Kimchi, Currants, Zucchini and more. However, many of these are now easily available but should be incorporated in our diet if possible.
Foods with high glycemic levels or can spike up your insulin. Avoid them as much as you can as they can add to your weight gain and potentially lead to Type II diabetes. To get you started, avoid foods like white potatoes, rice, flour, sugary and processed foods, watermelon, cornflakes, etc. Opt instead for soy milk, oatmeal, legumes, apple juice, pineapple juice, carrot juice, low-fat yoghurt, whole grain cereals and multigrain bread.
Anti-inflammatory foods also help bringing down your insulin levels. Try to include spinach, green tea, olives, dark chocolate, beans and lentils, coconut, turmeric, cinnamon and extra virgin olive oil. You may be intolerant to some other foods that you may not be aware of. Some common foods are tree nuts, fish, eggs, etc.
Several dairy products can lead to inflammation and cause a spike insulin production. Since cutting out dairy from your diet is not entirely possible, opt instead for some non-dairy or vegan alternatives including oat milk, soy milk, almond milk, coconut milk or rice milk. Butter and ghee are better alternatives, but in limited quantities only if you are lactose intolerant. Check for glucose intolerance. Non-celiac gluten sensitivity can be avoided by swapping your favourite pasta (maida or refined wheat flour) with Zucchini noodles and wheat. Including flaxseed, almonds, lettuce is a good idea.
Body fat accumulates because of poor insulin regulation and NOT because of excess energy in your diet. So restriction on food & dieting is a fool’s errand. 1 of 3 women will tend to put on more weight than normal once they are out of FAD diets. Heavy breakfast and light dinners are an ideal way to control your blood sugar level. Indulge in nutrient-rich high protein & GLV (green leafy vegetable) foods. Detox your diet. This has a major impact on getting pregnant naturally with PCOS.
While it’s becoming popular, it is not recommended if you have PCOS. Ketogenic Diet consists of very low carbohydrates – i.e < 20gms per day. When there’s not enough glucose in your body to keep you functioning normally, your metabolism switches to consuming fats instead. This metabolic state mimics starvation and is known as ketosis. You can lose weight even without Keto diet. Consuming animal protein like fish & meat contains all the 9 essential amino acids.
Women who consume processed foods are 3 times more prone to PCOS. Vegetable oils & sugar should be avoided as they are pro-inflammatory. They contain carcinogenic compounds like chemical food coloring, potassium bromate, butylated hydroxytoluene (E321) and butylated hydroxyanisole. Nutrient-dense Whole Foods include Salmon, Kale, Garlic, Seaweed, Potato, Fish Cod Liver Oil, Blueberries, Egg Yolk, Dark Chocolate and more.
Who is not addicted to sugar? We all love our Tiramisu, Gulab Jamun and Chocolate Icecream. Isn’t it? Sugar is more addictive than cocaine. It causes your body to store fat rather than burn it. It promotes unwanted facial hair, acne and male-pattern baldness. You will feel emotionally depressed with all these even if you weren’t suffering from PCOS. If you can’t refrain from desserts and sugar, include healthy fats in your daily diet like fish oil, olive oil, avocados and dried nuts to curb the sudden spike of glucose levels.
While all vegetables are good, non-starchy vegetables contain phytonutrients only available in plants. Include foods like carrots, tomatoes, capsicum, spinach, broccoli, garlic, ginger, kale, onion, leek, beetroot, peas, cabbage, sweet corn and brussel sprouts. You will definitely cleanse your system, detox and feel a lot more energytic.
Fruits are high on fructose sugar. Fructose powerfully ruins your insulin sensitivity and increases inflammation resulting in weight gain, infertility, gut issues, anxiety and depression. Still craving for some sugar? So, which fruits are better to consume? Avoid all sugary and canned juices. Include more currants, berries and melons. Avoid apples, grapes, and bananas.
Not more than 30% of you energy should be derived from Carbs. This reduces the amount of insulin our bodies need to produce. Include starchy vegetables like sweet potato, yam, beans and lentils, grains like quinoa, buckwheat, or red, black or wild rice.
Diagnosis of PCOS is difficult if you are high on coffee & alcohol. Caffeine increases production of stress hormones which elevates insulin levels & decreases insulin sensitivity. Coffee causes anxiety, acidity, discomfort, indigestion, heart burn and disrupts sleep.
Breaking free from the ingrained idea that any fat makes us very fat is a major cognitive obstacle for women wanting to switch to a PCOS diet. Include avocados, coconut oil, nuts, seeds, olives and more. Remember fat is soluble only in fat. Not in water. So don’t starve your body of fat.
Vegetable oils are pro-inflammatory as they are high in omega-6 fatty acids. Avoid seed oils coming from soybeans, sunflower, corn, canola and safflower. Switch to coconut oil, ghee, butter, olive oil, avocado oil instead.
Sugar is evil for those with gut issues. Probiotic foods contain live strains of healthy gut bacteria and prebiotic foods contain soluble fiber that enables these microorganisms to thrive better. Coconut, yoghurt, kimchi, pickles, buttermilk work wonderfully on improving your gut health.
Exercise is the cheapest, fastest and the easiest way to getting pregnant with PCOS quickly. Around 10% weight loss without short-term fad diets increases fertility – restarts ovulation and regularizes menstrual cycle by 50%.
It lowers testosterone and free androgen levels in the woman’s body.
When we workout everyday, we are actually increasing the density of mitochondria, the cellular organs that power our muscles. More mitochondria in our muscle cells means more sensitivity to insulin, and the more sensitive they are to insulin, the better our hormone balance.
Exercising has an anti-inflammatory effect on the tissues of the body.
You can curb many signs and symptoms of PCOS with a good workout. Here are a few options to get you started:
Ideally you should work out for 30 minutes every day. Fitness specialists recommend to get your heart rate up and maintained at 60% to 75% your maximum rate.
One of the most under-rated activities is brisk walking. Alternate between moderate and fast pace/jogging every 5-7 minutes to strengthen your muscles and listen to your favourite music while you enjoy the fresh breeze in the park. Try walking uphill or on elevated surface this will require more energy, but, will build better stamina. These are great to counter your PCOS as they help in reducing insulin resistance, stabilise your mood and help boost fertility.
Lifting weights 2-3 times a week expedites muscle and strength training for PCOS. Remember Mitochondria is the “Power House Of The Cell”? You will feel energetic throughout the day. Your personal trainer will recommend a change in routine time to time. Bodyweight exercises like pushups, squats, tricep dips etc, not only help build muscle mass, but also boost metabolism and help you achieve a healthy BMI.
Vigourous workouts help burn calories much faster. Dance & Zumba are our favourites. It’s fun, it’s not monotonous and works on the entire body. And there is peppy music. Do we need more?
With high intensity interval training, you will be able to lose about 5-10% of your body weight. Studies have shown that HIIT drastically reduce PCOS symptoms, by reducing excess testosterone and improving insulin resistance.
Learn a new sport like Tennis, Badminton or Squash. Develop new skills and shed that extra fat.
From “Flab to Fab” in 3 months is guaranteed if you abide by our PCOS Exercise & Diet Plan.
Keep obesity at bay. The recommended waist circumference is less than 80cm for adult women.
|Waist circumference||Health complications|
|80-88cm||Increased risk of obesity, cardiovascular disease and development of type 2 diabetes.|
|More than 88cm||Substantially increased risk of developing type 2 diabetes and cardiovascular disease|
PCOS does affect several women, but it isn’t a debilitating disease. With a few key lifestyle changes, you can easily curb the effects PCOS may be inflicting on your life. Here are a few important things to keep in mind.
Many people turn to binge eating when stressed and this could adversely impact your body, particularly when you are trying to conceive. Try to find a healthy outlet for your stress – either through yoga, regular exercise, meditation, baking, etc.
They mistakenly ignore the psychological impact of infertility on the reproductive function. Women with PCOS have elevated levels of cortisol hormone under stress. Cortisol causes fat to accumulate on our stomachs and thighs, increases insulin resistance, and markedly increases our probability of suffering from cardio vascular & heart diseases.
Women with higher stress levels have >50% more chance of Infertility than those who are more relaxed. Relaxation exercises are fantastic for acute stress and insomnia and certain essential oils can be of great help too.
Your endocrine system consists of glands that send out hormones to the rest of your body. These hormones then bind themselves to target receptors of several specific cells. Endocrine disruptors, therefore are substances that mimic our hormones and can cause multiple reactions and changes in our body. Because of their stable nature, Endocrine Disruptors are used in several household cleaning products as well as beauty products, food, soil, air, etc. If you are suffering from PCOS be cautious about the types of products you purchase.
Symptoms such as acne, weight gain, excess hair and difficulties getting pregnant may cause women to feel they do not fit the image of how females are supposed to look. Seek support from health professionals such as doctors, psychologists, counsellors, exercise physiologists and the social support of family &.
These can be hard to predict and can seem overwhelming at times. The important thing is to keep your eye on your goals and to keep going. Some days you will succeed and others you will not but in the end you will make progress.
How to cure PCOS naturally fast? Ayurvedic treatment for PCOS has proven to be effective with no harmful side effects unlike surgery & medication. It is recommended to cut down intake of milk & dairy products.
However, it may take longer than usual. Some herbs that help boost fertility & treat PCOs are –
Stop taking the birth control pill at least 3 months in advance. Allow your body to resume a normal cycle. Normally you may take ~3 months to conceive. With PCOS, it may take a lot longer due to irregular periods. However, be sure to consult your gynecologist before taking this step.
Natural supplements like Vitex, Evening Primrose Oil, DIM, Inositol and Maca are much better than oral administration of medicines. Ovasitol or inositol(prevents Spina Bifida birth defect and increases progesterone), Folic acid(5mg) or Folivite, Minerals and Vitamin D are recommended if you are planning a family. Folic Acid is important during pregnancy.
Ovulation cycle can be done with test strips at home. A naturopathic doctor will prescribe a complete hormone panel test (including estrogen and progesterone to thyroid, testosterone, DHEA, etc.) 3-4 times a year to measure 11 hormones that impact your menstruation, fertility, thyroid and weight.
Many women have undiagnosed hypothyroidism, which can cause infertility. If you suffer from irregular periods, low libido, low body temperature, imbalanced thyroid hormone levels, anxiety, depression, treat for hypothyroidism.
You won’t be able to get pregnant while you are taking birth control pills for PCOS. But if you need help ovulating so that you can become pregnant, certain medicines like Clomiphene, Metformin, FSH, LH or Letrozole may help.
Most women with PCOS are likely to become pregnant with medical support. Your gynecologist or infertility specialist will help you ascertain the best medical treatment for PCOS if conditions like blocked fallopian tubes, fibroids, low sperm count or inferior quality of sperms have been tested for & ruled out.
Your gynec may prescribe birth control pills that contain a combination of hormones estrogen and progestin. These pills can help regulate your menstrual cycle by reducing androgen production. You may be prescribed to take this pill for about 2 weeks a month, for a duration of 1-2 months.
Oral administration, injections or minor ovarian surgery coupled with diet & lifestyle changes may help in conceiving faster.
If you are insulin resistant, consult your gynecologist. Administration of Metformin will help in treating insulin resistance and aid in weight loss. In some cases losing weight does not necessarily jump-start regular periods and ovulation, but, definitely significantly increases your chances of pregnancy & promotes healthier lifestyle. It may also improve the effectiveness of some fertility drugs.
Letrozole is predominantly a cancer-combating oral administration drug. This is proven to be more effective than Clomid to rekindle ovulation and increase chances of fertility. It’s also known as Femara.
If you are unable to conceive with Clomid & Letrozole successfully over a period of 4-6months, injecting fertility drugs like Gonadotropins maybe recommended by your gynecologist and infertility specialist. Gonadotropin is a hormone made of LH (Luteinizing Hormone) & FSH (Follicle Stimulating Hormone). Repeated oral administration on Clomid can cause ovarian cancer.
Laparoscopic ovarian drilling is making small holes in the ovary with heat or laser, to increasing the rates of ovulation and pregnancy. When oral medication fails to work, LOD can be performed. This kills the tissue on the ovaries that is produces the testosterone(male hormone) interfering with conception.
IUI refers to the injection of carefully chosen healthy sperms either from your partner or a sperm donor (incase of Male Infertility issues) directly into the uterus during ovulation. Oral administration with injection of fertility drugs maybe combined with IUI(Intrauterine Insemination) accelerates the chances of pregnancy significantly. Fertility injections can cause some side-effects and complications, your doctor will recommend a low dosage to begin with.
In Vitro Fertilization or IVF boasts upto 90% success rate for pregnancy in patients who suffer from infertility. In fact, IVF may be the best possible chance for women suffering from PCOS to conceive as the last resort. The other wonderful benefit of IVF is that pregnancy can offer short-term relief from PCOS.
Invitro Fertilization starts with ovulation induction by taking in a lot more hormones. The goal is to intentionally mature 12 – 20 eggs in each month, so that the IVF specialist can “harvest” these for fertilizing in the lab.
Unfortunately, even after the implantation of the egg, the IVF cycle may be unsuccessful. Pregnancy tests performed after 15 days can clearly confirm if the IVF cycle was successful.
It is a known fact that fertility drugs which are either injected or orally administered have short-term or long-term side effects as there is extreme hormonal imbalance in the body. Some of them include –
Over stimulation of ovaries – High dosage of fertility eggs causes production of several mature eggs to increase chances of pregnancy and fertilization. To avoid this, IVM (Invitro Maturation) is recommended by doctors. In IVM, the drug dosage is relatively very low if at all injected. IVM refers to the retrieval of partially or immature eggs from the ovaries and maturing them in the lab under controlled conditions.
The latest in IVF technology is PGS testing (Pre-implantation Genetic Screening). This involves ascertaining if an embryo has a normal set of genes before inserting it back into your uterus. This test is very expensive, but can make one of the biggest possible differences to your chances of success. PGS can increase the IVF success rate probability from 35% per transfer to 70% which essentially halves the chances of an early miscarriage.
Dr.Silva explains how PCOS affects fertility. Around 5-13% of the world’s population suffers from infertility.
For these treatments, it is important that the Fallopian tubes are open and the sperm counts are normal.
It may be difficult to eradicate PCOS and overcome completely in many cases. However, the recovery with medication, diet & lifestyle changes can see a marked difference. Some of the common visible PCOS recovery symptoms are –