Illustration of an ovary with PCOS
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What is PCOS?

PCOS stands for polycystic ovary syndrome. Consider your ovaries as bunches of seeded grapes on a much smaller scale. The seed in the centre of the grape is an immature egg cell and the flesh of the grape is what we call the fluid-filled follicle. They’re like little sacs that contain the immature eggs. PCOS is when some of these sacs are unable to release an egg, which means that ovulation does not take place.

My working experience with PCOS

Having worked in the field of fertility for almost a decade, PCOS has been a common topic for discussion in women of reproductive age. The cystic and syndrome elements to its name often evoke fear and worry amongst young women and I wanted to share the knowledge that we currently have on the condition, and how worried you should be if you think you might have it. 

How common is PCOS?

It's hard to say exactly how many women suffer from PCOS, but it's thought to be very common (one in five). However, over half of these women do not have any symptoms, making it extremely hard to tell if they are affected! 

What causes PCOS?

Unfortunately, the cause is unknown, but there are ways to help manage the condition. It's thought that PCOS is related to abnormal levels of hormones in the body, one of which is insulin. This is the hormone that controls blood sugar. When you eat, insulin is released however, women with PCOS are resistant to the effect of this insulin and therefore produce more. 

Higher insulin results in higher testosterone (a hormone usually associated with male fertility but it's normal to have testosterone in women too!). This high testosterone prevents ovulation, and disrupts the menstrual cycle making it potentially an irregular or anovulatory cycle (no egg is released).

This insulin resistance also means that the body is more susceptible to gaining weight. However, that same weight gain can in turn make PCOS worse, so choosing a balanced lifestyle and maintaining a healthy weight can relieve PCOS symptoms.  

Symptoms of PCOS

Unfortunately, this is going to be a long list, but remember that many women do not have any symptoms of PCOS at all and go throughout their reproductive lives never knowing that they’ve even had the condition. You may suffer from one or more of the following symptoms:

  • Irregular periods or none at all
  • Difficulty getting pregnant (because your ovulation is irregular or not occurring)
  • Excessive hair growth- usually in the face, chest, back or bum
  • Weight gain
  • Thinning hair on the head
  • Oily skin or acne

Diagnosis and treatment of PCOS

By visiting your doctor, you can get help diagnosing the condition. Healthcare professionals will be looking for irregular or infrequent periods, high levels of male hormones (testosterone) in your blood, and they may perform an ultrasound scan to see the polycystic ovaries.

Treatment will begin with lifestyle changes, along with some medication, should it be necessary. Weight loss of just 5% can really improve symptoms of PCOS, so some women find it's really worthwhile changing diet and lifestyle.  The contraceptive pill can also be used to help manage those cycle irregularities - but hormonal birth control is not a fit for everyone. If things do not improve, you may be referred to a specialist who can potentially perform a small surgical procedure to remove the cysts that are causing the hormone imbalance, but for most women with PCOS, this is not likely to be necessary. 

Getting pregnant with PCOS

PCOS may increase the time it takes to get pregnant naturally, but it does not mean it's impossible! I have seen many women with PCOS successfully get pregnant, some only realizing they had PCOS after conception. Couples should aim to try for around 12 months (depending on country and circumstance) before seeking advice from their healthcare professional. If you’ve already got a diagnosis, read on to find out what might happen next….

The majority of women successfully conceive following a course of tablets taken at the beginning of each cycle for several cycles. This medication encourages the release of an egg each month from the ovaries. In much rarer cases, women can go on to have IVF treatment.

So, overall PCOS is really common and something you can keep an eye on should you start to notice changes to your menstrual cycle. It helps to be able to track your cycles in some way and compare them over time. There is a lot to gain from improving your diet and increasing exercise as losing weight is a natural form of treatment. And remember, the majority of women with PCOS still conceive naturally, and there are further options available should you need them. Never hesitate to contact your healthcare professional should you have any concerns.

Using Natural Cycles with PCOS

For those who have PCOS, Natural Cycles can help visualize and track your cycles. It can capture whether or not you have ovulated, and how long your cycles are - useful information to take to your doctor or fertility clinic when discussing the condition. 

Irregular cycles as a result of PCOS do not affect the effectiveness of Natural Cycles as a birth control method. However, you may experience an increased number of red days as the app allows for your ovulation day to shift from cycle to cycle.

A fertility app that’s tailored to you

If you’re interested in getting to know your body better, Natural Cycles is a fertility app that learns the pattern of your unique menstrual cycle. By taking your temperature every day and inputting it in the app, our algorithm can then find your ovulation, and can tell you your own personal fertile window. This science can then be used either as non-hormonal birth control or to plan a pregnancy. Becoming aware of the pattern of your own cycle is also useful for those with conditions such as PCOS or endometriosis.

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Written By

Jack Pearson

Dr. Jack Pearson is a previously HCPC registered Embryologist with a PhD in reproductive medicine. Prior to joining Natural Cycles leading Medical Affairs, he worked for more than 10 years in a clinical setting working at some of the busiest fertility clinics in the UK. Today he spends most of his time working with experts at the world’s leading institutions to carry out important research with the vision to further the field of female health. He earned his PhD from the University of Sheffield specializing in Sperm Metabolism and currently lives in London.

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