You’ve likely heard it before (maybe even more than once): if your period is irregular or if something changes, you should head to your doctor’s office to get to the bottom of what is going on. Though it might not be anything major or life-changing, it could be something that warrants a diagnosis—even if it ultimately doesn’t make a huge difference to your day-to-day life.
Polycystic ovary syndrome, or PCOS, is one such diagnosis. “Polycystic ovary syndrome (PCOS) is a hormonal disorder caused by elevated levels of male hormones, which can lead to less frequent ovulation and irregular periods,” said Dr. Jessica Ryniec, board eligible in obstetrics and gynecology and reproductive endocrinology and infertility, who practices at CCRM Fertility in Boston. CCRM is a leading fertility provider specializing in egg freezing, IVF, research, and more. Its doctors work personally with patients throughout their fertility journey. Because PCOS can affect the ease with which people are able to get pregnant, people experiencing PCOS may work with a fertility specialist to help them navigate any challenges that may arise. But PCOS affects more than just someone’s ability to conceive—and it’s actually more common than you think.
“PCOS affects around 10 percent of reproductive-aged women overall and is the underlying problem in 40 percent of [people] with irregular or absent periods,” Dr. Ryniec said. “Normally, a [person’s] brain releases hormones that signal the ovary to grow an egg. Once that egg matures, it is released or ovulated, and if sperm is present there is the chance to become pregnant that month. In [people] with PCOS, the signals from the brain are altered due to excessive male hormones and high insulin levels, and the ovary is unable to mature and ovulate an egg.”
Now that you have a better idea of what PCOS is, you may have some questions about how it’s diagnosed and what a diagnosis might mean for your life. Luckily, Dr. Ryniec is here to break everything down for us. Read on for those answers and more.
How do you know if you have PCOS?
If you’re not someone who is missing a period, you may not even realize you have PCOS, because, Dr. Ryniec said, symptoms can sometimes be disguised by hormonal birth control. Acne and hair growth on your face, chest, or back could also be sneaky signs that you might have PCOS (and might likewise be hidden if you’re using a hormonal form of birth control). That being said, it’s important to get a diagnosis because undiagnosed PCOS could potentially affect your long-term health.
“Because [people] with PCOS are not having regular cycles, their uterine lining is not shedding as normal and this can lead to problems like endometria hyperplasia, which can lead to uterine cancer,” Dr. Ryniec explained. “Other long-term health risks include elevated BMI, diabetes, heart disease, high cholesterol and high blood pressure. Studies show [people] with PCOS are more likely to experience depression and anxiety as well.”
So if you think your symptoms point to (potential) PCOS, the best thing you can do is make an appointment with your doctor. Dr. Ryniec said that because there isn’t a clear-cut test that can tell you for sure if it’s PCOS you’re dealing with, your doctor will likely start by ruling out other things. After that, they’ll look for two of three things: you have fewer than eight menstrual cycles a year, you have levels of androgens, or your doctor notices “multiple small follicles on the ovary” when they do an ultrasound.
“I see so many [people] who were told they have PCOS because they have a history of ovarian cysts or because they have a lot of follicles, but this does not actually mean you have PCOS unless you have the other symptoms,” Dr. Ryniec said. So if that’s the only way you’ve been diagnosed, you may want to consider looking for a second opinion to really get to the bottom of things.
What comes next?
Once you receive a PCOS diagnosis, you’re probably going to start thinking about what’s next. Are there treatments you need to think about? Lifestyle changes to make? Procedures to consider?
“Treatment for PCOS depends on the symptoms that are concerning you, and so it is important to talk to your doctor about what your goals are and make decisions together,” Dr. Ryniec said. Making sure you’re living a well-balanced lifestyle, eating a healthy diet and fitting in exercise (at least 30 minutes, three times a week) can help.
“Birth control blocks male hormones and renders them ineffective, decreasing acne and abnormal hair growth, improving menstrual regularity, and protecting against endometrial hyperplasia. It also provides effective contraception which is important when you can’t predict ovulation and don’t want to become pregnant,” Dr. Ryniec said. “For [people] with insulin resistance as a result of PCOS, doctors might prescribe Metformin or other insulin sensitizing medications.”
Because the exact treatment you’re going to want to move forward with is so dependent on the specific symptoms you’re experiencing, being open and honest with your doctor is essential. They’ll be able to guide you towards what will hopefully help most.
What about if you’re trying to get pregnant?
If you’re actively trying to conceive, getting a PCOS diagnosis might bring up a lot of feelings (good or bad). One thing Dr. Ryniec wants you to know? “Having PCOS does not mean that you can’t get pregnant or even that you can’t get pregnant on your own. But because [people] with PCOS frequently have difficulty ovulating, PCOS is often associated with infertility. Luckily, PCOS is one of the most treatable forms of infertility.”
If you’re trying to get pregnant, your doctor might prescribe a medication to provide a bit of extra help when it comes to ovulation. Beyond medication, some people with PCOS might need additional fertility treatments, such as in vitro fertilization (IVF).
That being said, if you know you have PCOS and you’re struggling to conceive, make sure to talk to your doctor or a fertility specialist like one at CCRM sooner rather than later. “If you aren’t ovulating or aren’t ovulating regularly, there is less of a chance to get pregnant because there is no egg to meet the sperm, so you shouldn’t delay seeking treatment,” Dr. Ryniec explained.
At your appointment, your fertility specialist will, in all likelihood, want to run a few tests to determine how to best move ahead.
“First, we want to make sure your fallopian tubes are open, so that once we help you ovulate, the egg has a way to meet the sperm. Second, we also want to make sure there is sperm for your egg to meet. If you have a male partner, we recommend a semen analysis. If you don’t have a partner or your partner is female, we would discuss the possibility of using a sperm donor,” Dr. Ryniec explained. “After completing the evaluation and assuming all else is normal, we would likely proceed with ovulation induction with Femara or Clomid, to help you ovulate an egg. You could then either time intercourse or have an intrauterine insemination or IUI. If these don’t lead to pregnancy, your doctor may recommend IVF.”
If you’ve been discouraged by the fact that doctors don’t seem to be taking your symptoms seriously, it’s time to find a new doctor. Trust your gut.
“Be confident in knowing that not having a period or having long intervals between periods is likely an indication of a larger problem. Keep looking until you find a doctor who will take it seriously. Not only can there be other hormonal disorders like thyroid disease leading to your symptoms, if you do have PCOS you might be at risk for other health problems, and you deserve a doctor that will work with you to optimize your health,” Dr. Ryniec said. “Share your goals with your doc. Why are you seeking medical care? What are your symptoms? What do you see as the best outcome with treatment? These are things to think about since there are so many facets to PCOS, you want to make sure you address your goals and not get lost in PCOS in general.”
Your health and health goals are important—PCOS or no PCOS—so believing that you know yourself and taking your symptoms seriously (no matter what they are) is so important. Talk to your doctor or another specialist if you think that you might have symptoms of any sort of condition. You’re more than worth it.
CCRM helps patients meet their health and lifestyle goals every single day, no matter what kinds of fertility-related objectives might be involved. Plus, with 25 locations across the United States and Canada, you may be closer to that personalized fertility care than you think. Ensuring that you have a doctor on your side that’s working with you can make all the difference.
This post was sponsored by CCRM, but all of the opinions within are those of The Everygirl editorial board.