Polycystic ovary syndrome (PCOS)
PCOS stands for Polycystic Ovarian Syndrome. It’s a complex hormonal condition that affects approximately 1 in 5 women of reproductive age. While most women who have PCOS can become pregnant, they can take longer to conceive and are more likely to need fertility support. It is one of the most common — but treatable — causes of infertility in women.
What is PCOS?
PCOS often brings a myriad of hormonal imbalances that can impact fertility — specifically, increased androgens (or male sex hormones) and insulin resistance (when the cells do not respond to the normal actions of insulin). When this happens, it stimulates the ovaries to secrete more testosterone — which can result in acne, facial hair growth and hair loss. The good news is that insulin resistance is largely associated with diet, exercise and stress levels.
How is it diagnosed?
Signs and symptoms of PCOS include infertility, facial hair growth (hirsutism), acne, weight gain, irregular periods or no periods at all, hair loss, and/or obesity — in varying degrees. A medical diagnosis of PCOS according to the “Rotterdam Criteria” requires 2 out of 3 of the following:
- Ovulatory dysfunction – leading to irregular periods or no periods at all
- Signs of androgen (ie. excess acne and facial hair); or elevated total or free testosterone on bloodwork
- Polycystic ovaries on an ultrasound
Preconception Healthcare for PCOS
Below you will find the answers to commonly asked questions about Polycystic ovary syndrome (PCOS).
Can Polycystic Ovary Syndrome (PCOS) be cured?
- While there is no cure for PCOS, there are many ways that you can decrease symptoms, balance your hormones, and improve your odds of getting pregnant.
Can you have cystic ovaries without PCOS?
Yes. You can have polycystic ovaries without Polycystic Ovarian Syndrome (PCOS).
Do PCOS and infertility go hand-in-hand?
Yes, classical PCOS (as defined by the “Rotterdam Criteria”) is linked to infertility. One of the criteria for diagnosing PCOS is anovulation, or lack of regular ovulation, which is essential for conception.
If you answer yes to the following questions, you may be experiencing anovulation:
- Do you ovulate regularly?
- Does your cycle fluctuate (ie. one month it’s 25 days, next month it’s 38 days)?
- Is the timing of your menstrual cycle simply hard to predict?
PCOS has many different shades of grey, so fertility challenges — and treatment — will vary from one person to the next.
How does PCOS impact ovulation?
- PCOS often brings high levels of luteinizing hormone and reduced levels of follicle-stimulating hormone — both are essential for ovarian function and ovulation. As well, there is unusually an overproduction of male hormones (testosterone) and an underproduction of female hormones (estrogen), which creates cysts on the ovaries. Together, these hormonal imbalances cause irregular menstrual cycles, with makes conception challenging.
How can I prepare for conception with PCOS?
- One of the things that we know about PCOS is that hormonal imbalances can impact egg quality. The first thing that you will identify with your Conceive Health naturopathic doctor, is the specific type of PCOS and the underlying issues — which may be inflammation, anovulation, insulin resistance, nutrition deficiencies/excesses and others.
How long does it take to balance hormones?
It really depends on the severity of the case. If you haven’t had a period for 3-4 months, then it may take just a couple of months to achieve ovulation. If you haven’t menstruated since you were in your teens, it will take substantially longer.
To improve your chances of getting — and staying — pregnant, you should allow ample time to focus on preconception, prior to any fertility treatment. If you skip right to the fertility treatment, you risk recruiting immature or poor quality eggs during In vitro fertilization (IVF) or Intrauterine insemination (IUI).
Are different medications used during fertility treatment?
- Sometimes. Your fertility team may use medications to encourage your body to ovulate on its own (ie. Clomid or Letrozole). Diet and exercise are essential — particularly for conditions related to insulin resistance, such as PCOS. Meanwhile, certain supplements, such as myo-inositol, may be added to your treatment plan to improve your egg quality. Speak directly with your fertility team to determine the best plan for your specific medical history, needs and goals.
What natural treatments help with PCOS?
As a starting point, a diet with a higher protein, moderate fat, and lower starchy carbs will help to control insulin and glucose levels. We also look at nutrient balances to ensure there are no deficiencies or excesses. Common nutrient imbalances may include: high beta carotene, low or high iron levels, low B12, low vitamin D. Lastly herbs are often used depending on the hormones that may need to be regulated. We recommend working with a naturopath with an expertise in fertility and hormonal balance, such as the team at Conceive Health.
Can acupuncture help with PCOS symptoms?
Yes. Acupuncture can help manage certain symptoms of PCOS (sleep disturbance, weight gain, stress reduction). For best results, acupuncture is combined with herbs in a holistic program that looks at all facets of PCOS, rather than as a stand-alone treatment.
What People are Saying …
“It’s critical to optimize eggs and sperm quality in order to achieve a healthy pregnancy, and in a shorter duration. I rely on Conceive Health with their personalized holistic approach to help patients reach their reproductive potential.”Dr. Dan Nayot, MD, M.Sc., FRCSC, REI