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PCOS and Pregnancy

a blog by Jane Frederick, M.D., HRC Fertility, September 25, 2014

Polycystic ovarian syndrome (PCOS) is a condition that affects a woman’s menstrual cycle, fertility, hormones, insulin production, circulatory system, and appearance. Women have both male and female hormones, but women who have PCOS have higher levels of male hormones and experience irregular or absent menstrual cycles and small cysts on their ovaries. It is estimated that 5 to 10% of women who are of child bearing age have PCOS.

What happens with PCOS during pregnancy? What are the dangers? For the mother? For the baby?
Women with PCOS who become pregnant may experience more health problems than the general population including:

  • High blood sugar levels which can lead to diabetes
  • Pregnancy-induced high blood pressure
  • Miscarriage
  • Premature delivery
  • Pre-eclampsia (high blood pressure, protein traces in the urine)
  • Macrosomia (a newborn with an excessive birth weight)

All of these serious problems are yet more evidence that it is extremely important to address PCOS and make the lifestyle changes necessary to reverse it and the underlying cause of insulin resistance. This is vital to prevent the health issues that can compromise long term wellness for both mother and child during and after pregnancy.

Insulin resistance reduces the insulin sensitivity of your cell walls. Glucose has to pass through the cells walls to be converted to energy. Insulin assists this process. When the cells walls have become de-sensitized to insulin by insulin resistance, the process can break down. Glucose cannot get into the cell, and remains in the blood stream, causing elevated blood sugar levels. This process can lead to weight gain and obesity, key factors in creating PCOS.

What should PCOS patients do about the condition during pregnancy?/ After pregnancy are there any special considerations for women with PCOS? Metformin (Glucophage) is a drug often prescribed for women with PCOS who are trying to get pregnant, and in the early stages of pregnancy. Metformin improves the cell’s response to insulin, and helps move glucose into the cell. As a result, the body will not be required to make as much insulin, and helps to balance the hormones in PCOS. Weight loss through exercise and changes in diet and lifestyle can also be effective in treatment for PCOS and pregnancy. Women should seek out the specialist who can provide nutritional and exercise guidelines to enhance their weight loss success. This is critical for the health of the women and her baby.

What is PCOS?
Polycystic ovarian syndrome, known commonly as PCOS, refers to a hormone disorder affecting 3-10 percent of reproductive-aged women. Considered a leading cause of female infertility, PCOS reduces the ability of the ovaries to mature and release eggs into the uterus. Other reproductive symptoms of PCOS include the creation of polycystic ovaries, characterized by multiple cysts and small follicles; chronic anovulation, or an inability to ovulate; and hormonal imbalance, including high levels of the male hormone androgen.

Can PCOS cause infertility or difficult conceiving?
Women with PCOS frequently suffer from chronic anovulation, a condition that can cause them to go through fewer than eight menstrual cycles each year; frequently, they skip their periods altogether. Furthermore, the hormonal imbalance associated with PCOS can result in symptoms ranging from an excess of estrogen or androgen to decreased levels of progesterone (the hormone important to the menstrual cycle) and resistance to insulin.

How can PCOS be treated? When?
Infertility specialists typically treat hormonal symptoms, in particular the excessive level of androgen, by prescribing low-dose oral contraceptives. This approach should reduce the acne and hair growth; however, the latter symptom may require electrolysis, waxing, or some other removal method performed in conjuction with medical treatment. In cases of excessive hirsutism, and anti-androgen drug can be prescribed.


Comments (1)

Many women are not aware of PCOS and I have known one of my friend diagnosed with this condition. It was terrible. She was told only pills, therapy and healthy diet can cure PCOS. Thanks for sharing this useful post. Good luck to all ladies and stay strong!

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