Having Trouble Getting Pregnant? The Problem Could Be PCOS

Polycystic ovary syndrome (PCOS) is not a term most of us are likely to run across in our daily lives, yet it is the most common hormonal problem affecting women of childbearing age. As many as 10 percent of women in the U.S. are believed to have PCOS. They are subject to a wide range of concerning symptoms, including:

• Irregular or infrequent menstrual periods
• Excessive growth of body and facial hair
• Male-pattern baldness or thinning hair
• Oily skin
• Acne
• Excess weight or obesity
• Darkened areas of skin appearing on the back of the neck, in the armpits or under the breasts

As if this weren’t enough, PCOS raises the risk for long-term health problems such as diabetes and heart disease. Most troubling, however, for many women with PCOS is that it can result in infertility.

“Getting pregnant can be a challenge for women with PCOS,” says gynecologist Emily Brophy, MD, with LVPG Obstetrics and Gynecology.

Women might experience symptoms like those listed above for a variety of reasons, but the medical community defines the condition as PCOS when a woman exhibits at least two of the following three conditions:

1. Periods that are irregular or absent
2. High levels of androgens (male hormones)
3. Cysts on the ovaries

There are other characteristics that many women with PCOS share, excess weight for example.

“They tend to have obesity or a BMI [body mass index] that is higher than average,” Dr. Brophy says. She notes too that women with PCOS also frequently come to her looking for help with unwanted hair growth or acne.

Fortunately, there are treatments to help manage such symptoms. “Birth control pills can help with acne, and losing weight can make the all-important difference in fertility,” Dr. Brophy says. “Losing just 2 to 5 percent of body weight can improve a woman’s menstrual cycles and fertility issues,” she says. “The Mediterranean diet appears to be helpful, and exercise in any form will help, too.”

Some issues connected to PCOS are less obvious than others, such as the damage that missing too many periods can do to a woman’s body.

“Women with PCOS need to be conscious of protecting their endometrium, the lining of the uterus,” Dr. Brophy says. “This is because they have four times the standard risk of endometrial cancer.” To protect the uterus lining, a woman might need to be on birth control pills or get an IUD.

“These women need to be in touch with their gynecologist and make sure they don’t go six months or longer without a period, because that can be damaging,” Dr. Brophy says.

Gynecologists like Dr. Brophy will collaborate with a woman’s primary care physician to address comorbidities associated with PCOS, such as diabetes and heart disease, Dr. Brophy says. Women with PCOS might also benefit from seeing an endocrinologist or an obesity management specialist, she adds.

Like many issues in health care, our understanding of PCOS is evolving today, as is the disease itself.

“Twenty years ago, patients with PCOS were more similar – they fit the classic picture, but it’s been changing,” Dr. Brophy says. “Today, a woman with PCOS might be thin. We don’t know why. We don’t know what’s going on.”

Whatever your body type, if you’re having trouble getting pregnant, Dr. Brophy encourages you to reach out to a gynecologist. “We can help them,” she says.

To learn more about PCOS, women should talk with their gynecologist or primary care clinician.