Polycystic ovarian syndrome (PCOS) is a condition that affects between 6 and 15 percent of women of childbearing age. If you’re diagnosed with PCOS, it may be more difficult to become pregnant. And if you’re able to become pregnant, you’re at risk for more complications during pregnancy, labor, and delivery.
Women with PCOS are three times more likely to have a miscarriage, as compared to women who don’t have PCOS. They are also more likely to develop preeclampsia, gestational diabetes, and have a larger baby and premature delivery. This could lead to difficulty during delivery or a cesarean delivery.
Having PCOS might make it harder for you to get pregnant. Hormonal imbalances might be to blame.
Women with PCOS are more likely to be obese and to rely on reproductive technology to get pregnant. One study found that of women with PCOS are obese. Almost 14 percent required reproductive technology to get pregnant.
Women with PCOS have an increased risk of developing several medical complications throughout life, including:
- insulin resistance
- type 2 diabetes
- high cholesterol
- high blood pressure
- heart disease
- sleep apnea
- possibly an increased risk of endometrial cancer
For pregnant women, PCOS brings an increased risk of complications. This includes preeclampsia, a dangerous condition for both mother and baby-to-be. The recommended treatment to resolve symptoms is delivery of the baby and placenta. Your doctor will discuss the risks and benefits regarding timing of delivery based on the severity of your symptoms and your baby’s gestational age. If you develop preeclampsia during your pregnancy, you will have to be monitored extremely closely. Other concerns include pregnancy-induced hypertension (high blood pressure) and gestational diabetes.
Having gestational diabetes could lead to you having a larger-than-average baby. This could lead to problems during delivery. For example, larger babies are more at risk for shoulder dystocia (when the baby's shoulder gets stuck during labor).
Most PCOS symptoms during pregnancy can be treated with careful monitoring. If you develop gestational diabetes, insulin may be required to keep your blood sugar levels stable.
Unfortunately, having PCOS during pregnancy makes things a little more complicated. It will require more monitoring for both you and your baby.
The potential risks with PCOS for the baby include:
- premature birth
- large for gestational age
- lower Apgar score
If your baby is a girl, some studies have shown that there is up to a 50 percent chance that she will also have PCOS.
Women with PCOS are also more likely to deliver by cesarean because they tend to have larger-sized babies. Other complications may also come up during labor and delivery.
Some women may not realize they have PCOS until they try to conceive. PCOS often goes unnoticed. But if you’ve been trying to conceive naturally for over a year, you should speak to your doctor about getting tested.
Your doctor can help you develop a plan for getting pregnant. Some strategies, such as losing weight, healthy eating, and in certain cases, medications, can increase your chances for getting pregnant.
If you’re diagnosed with PCOS, you may need to continue to manage symptoms even after pregnancy. But symptoms and severity can vary. Sometimes the hormonal fluctuations after pregnancy and breast-feeding can change the symptoms, so it may be awhile before you settle into your new "normal."
It’s safe to breast-feed with PCOS, even if you’re on insulin medication to help control your blood sugar. Women who have gestational diabetes are at risk for developing type 2 diabetes later in life, but breast-feeding can help lower that risk.
Breast-feeding has many benefits for both you and your baby, so if it fits your family, be sure to explore the options and available resources so you can have a successful breast-feeding experience.
PCOS, also known as Stein-Leventhal syndrome, is a hormonal imbalance that affects women. It’s characterized by the production of too many androgens, or "male" hormones.
PCOS can cause women to develop excessive hair and acne. It can also cause cysts on the ovaries and interrupt normal menstrual cycles.
It's a tricky condition because there’s not one single test to diagnose it. Instead, doctors look at the clues of what's going on in your body. Excessive hair growth or irregular periods might be signs. Doctors can then piece together a picture of PCOS.
PCOS often gets missed in women because of the difficulty of making a diagnosis. The symptoms can vary and occur in many different types of women.
Obesity or weight gain, for example, can be a frequent occurrence with PCOS. But it's not a given. Many women with PCOS have lean body shapes.
Unfortunately, up to 50 percent of women who have PCOS never actually get diagnosed. Because of this, PCOS is sometimes called the silent killer.
Some of the more common symptoms of PCOS include:
- "string of pearl" cysts on the ovaries
- insulin resistance
- high testosterone causing excessive hair growth, male pattern baldness, and acne
- suppressed ovulation
- excessive weight gain
- weight gain on the waistline
- dark, thick patches of skin on the neck, arms, breasts, or thighs
- skin tags in the armpits or neck area
- pelvic pain
- anxiety or depression
- sleep apnea
There’s currently no cure for PCOS. But it’s possible to manage symptoms.
Options to help manage symptoms include:
- birth control pills
- weight loss
- other androgen blockers
Along with other fertility drugs, metformin, which helps to control blood sugar, is commonly prescribed to help induce ovulation.
Note: You’ll need to stop taking some of these medications if you become pregnant. Work with your doctor to develop a plan that fits your needs.
The most important thing to know about PCOS and pregnancy is that complications are very real. That’s why it’s more important than ever to take steps to have a healthy pregnancy.
Talk to your doctor, follow a pregnancy-safe exercise and diet program, and take medication as directed. These are all recommended regimens for controlling PCOS during pregnancy.