Polycystic Ovarian Syndrome (PCOS), aka Polycystic Ovary Syndrome, or Polycystic Ovary Disorder (PCOD), is a common hormonal condition in women of reproductive age. According to the US Office on Women’s Health, PCOS affects five to 10% of women aged 15 and 44.
In India, an estimated one in five women suffer from it. Yet there’s a lot of misinformation and stigma about PCOS, the most widespread being that the disorder equals infertility.
You’ll find that you can still get pregnant despite PCOS. You merely need to consult the right medical professionals and seek more information.
You might wonder, what is the connection between PCOS and fertility? What is the treatment available? But only when there is awareness can we find the right answers and bust myths. Let’s talk about PCOS and help reassure you that you are not alone in your suffering.
What is PCOS?
The first step to understanding the connection between PCOS and fertility is becoming aware of what PCOS is. This will help you get the necessary treatment.
Polycystic Ovarian Syndrome, commonly known as PCOS, is an imbalance in reproductive hormones. It is a condition caused because of abnormal levels of androgens, i.e. male sex hormones, secreted by the adrenal gland or ovaries. It leads to the growth of benign cysts on ovaries, which cause irregular menses and affect ovulation. However, not every woman with PCOS has cysts.
The most common indication of PCOS is irregular periods: no periods, very light periods, heavy bleeding, or frequent periods. Some other symptoms you should watch out for include:
- Pain in the pelvic region
- Severe mood swings
- Extreme fatigue
- Insomnia or sleep apnea
- Excess hair growth on the face (usually the chin), chest, stomach, and back
- Severe acne
- Weight gain and difficulty in losing weight
- Excessive skin flaps in armpits or the neck area
- Thinning of hair on the scalp
Whom does PCOS affect?
Undeniably, we all wonder, “why me?” When you are diagnosed with PCOS, you might ask yourself the same question. But you are not the only one. PCOS affects many women of childbearing age.
Even though it is common, most women often find out about the disorder when they face difficulty conceiving. For many, PCOS begins after their first period; girls as young as 11 or 12 can develop it. Some women get it in their 20s or 30s, according to the US Center for Diseases Control and Prevention. It is also possible that some girls don’t get their period at all, and their first period itself is induced.
PCOS affects women of all ethnicities and races. What causes it? It can be hereditary or caused by an unhealthy lifestyle. Being overweight can worsen symptoms of PCOS, but it affects women of all sizes.
Unfortunately, the exact cause of PCOS is unknown. High insulin levels and high androgen levels contribute to it.
How is PCOS connected to infertility?
A PCOS diagnosis doesn’t mean that you can’t get pregnant. However, the condition is often connected with infertility. That is because PCOS affects your ovaries and reproductive hormones.
Infertility is a problem that can arise because PCOS makes your ovaries large and causes the growth of cysts. In a regular menstrual cycle, immature eggs develop, and one is released into the fallopian tube during the time of ovulation. But for those with PCOS, ovulation does not occur because the eggs do not mature completely. Fret not; there are solutions to combat PCOS- induced infertility.
Awareness is a strong weapon. Hence, before we move onto the solutions, here are some of the major ways in which PCOS can affect pregnancy:
- PCOS can cause ovary eggs to not mature
- It interferes with the release of eggs. If you don’t ovulate, you won’t get pregnant
- It can hamper the development of the uterus lining
- PCOS causes problems in menses that can create difficulty in pregnancy
- Insulin resistance leads to gestational diabetes that affects both the mother and child
- It thickens the outer shells of your ovaries
How to tackle PCOS-induced infertility?
While PCOS is a lifelong condition, infertility induced by it is treatable. Fertility treatments and making lifestyle changes have proven to be helpful. Be rest assured that your dream of being a mother can be fulfilled even if you have PCOS.
Fertility treatments: Often, birth pills are prescribed to control the symptoms of PCOS. However, these are not ideal when you’re trying to get pregnant. So, you need to opt for ovulation induction, a hormonal treatment that stimulates the development and release of eggs. Drugs like Femara (ovulation jump starter), Clomid (ovulatory simulator), and Gonadotropins (injectable hormones) are prescribed for this therapy.
In case ovulation induction is not successful, assistive reproductive procedures like Intrauterine Insemination (IUI) or In Vitro Fertilisation (IVF) are advised.
- IUI: In this procedure, processed sperm is injected into the uterus. It requires viable eggs, clear fallopian tubes, and 5 to 10 motile sperms.
- IVF: This is a more invasive procedure where the sperm and egg are fertilised outside the body and then placed in the uterus.
Lifestyle changes: Obesity is one of the causes of PCOS. It is advisable to follow a healthy diet and exercise regularly to increase the chances of pregnancy. Weight loss helps in achieving hormonal balance, inducing regular periods. Consulting a doctor before making any lifestyle changes is a must.
Other health implications: The focus on PCOS-induced infertility is so much that it is often ignored that the condition puts you at risk of other serious illnesses too. These can lead to a variety of health complications. Hence, it’s important not to ignore the symptoms related to it. You must speak to your doctor about the various complications related to PCOS and how to prevent them. Such as:
- Irregular and fewer periods increase the risk of endometrial cancer, a tumour in the uterine lining.
- Higher chances of hypertension, leading to cardiovascular diseases.
- PCOS is often caused by high levels of insulin in the body. There is increased insulin resistance, and when the body refuses to respond to the insulin, it causes diabetes.
- A metabolic syndrome includes a group of risk factors that occur together and increase the risk of heart disease, diabetes, and stroke. Some metabolic changes like high blood pressure, fasting sugar, low levels of good cholesterol, and increased abdominal weight might occur.
Break the stigma
While PCOS can lead to a host of health complications, PCOS-induced infertility remains the biggest concern. It’s because we live in a society where a woman’s worth is determined by her children. However, it’s important to change this mindset and break the stigma around PCOS and infertility.
Did you know PCOS often leads to a feeling of loss of womanhood for many, followed by fear, shame, guilt, and anger? This, in turn, can affect your sexual appetite, emotional well-being, self-esteem, and self-confidence. It doesn’t help that the conversation around both PCOS and mental health is not prominent. As a result, women fail to get the help they need to deal with their problems.
If you or your loved one is suffering from PCOS, know that you aren’t alone. Seek help and ensure that you have the support of your family and friends. Most importantly, the right medical aid is of utmost importance.
You must realise that the social stigma associated with PCOS is due to the lack of information about the condition. So, make sure that you reach out to your doctors and equip yourself with accurate knowledge. Start talking about PCOS and fertility with your peers. This will make sure more women around you become aware of how common the disorder is, helping you build a strong support system.
An open and informed conversation on PCOS, fertility, and PCOS-induced fertility will help you overcome challenges. Soon, you’ll learn that you needn’t worry about getting pregnant because there are solutions available. You can read up on the treatments available above and consult a fertility specialist.
Don’t worry, PCOS will not hamper your ability to lead a normal life, as long as you take care of yourself.
What have been your past assumptions about PCOS?
Also Read: Low Oestrogen in Your 20’s? The signs and the causes
My sister experiences some of the PCOS symptoms, and that is why we have decided to start looking for an OBGYN. Well, it never occurred to me that this may cause infertility in the long run. I also never knew that this may cause further complications when not addressed properly.