Are you wondering why you still have acne in your mid-20â€²s?Â Are you overweight and always fighting a bulge around your middle?Â Do you have irregular periods?Â If this sound like you and youâ€™re still not pregnant after trying for over a year, you could have Polycystic Ovarian Syndrome (PCOS).
What is Polycystic Ovarian Syndrome (PCOS)?
PCOS affects approximately 5%-10% of women of reproductive age (12â€“45 years old) and is thought to be one of the leading causes of poor female fertility.Â Up to 74% of women with PCOS can have difficulty conceiving, but most are able to.Â At fertility clinics PCOS accounts for 7% of all infertility diagnoses.
You are considered to have PCOS if you have 2 out of 3 of the following:
- Polycystic ovaries
- Signs of high testosterone levels
- Irregular periods and/or not ovulating
Polycystic ovaries are multiple cysts on the ovaries.Â This is diagnosed with an ultrasound done by your gynecologist.Â Most ovarian cysts resolve on their own.Â They can cause pain in the lower abdomen, pain with intercourse, and abdominal swelling.Â When many cysts are present and not resolving, as they typically do after healthy ovulation, you are considered to have polycystic ovaries.
High Testosterone levels (aka androgen excess).Â Testosterone is produced by the ovarian cysts.Â Signs include excess body hair, adult acne and sometimes obesity.Â 60% have elevated free testosterone levels on a blood or saliva test.
Irregular periods.Â Periods can become absent, irregular, or infrequent.Â Your menstrual cycle may last more than 35 days.Â Sometimes there can be heavy menstrual bleeding or lack of ovulation (anovulation).Â Â If you are not ovulating, you will not be able to become pregnant, as no egg is released from the ovary.
Metabolic syndrome is also a common symptom of PCOS.Â It is characterized by central obesity,Â elevated triglycerides, hypertension, elevated blood glucose or type II diabetes, and low HDL (high-density lipoprotein on cholesterol panel).Â You may also have sweet and carbohydrate cravings, depression or fatigue.
Can PCOS Affect Your Signs of Ovulation?
Yes, PCOS affects your health, including your menstrual cycle.Â You may not be ovulating at all or perhaps only occasionally.Â Your signs of ovulation occur during your normal menstrual cycle and help you identify your most fertile days.Â They include predictable changes in your cervical mucus, leutenizing hormone and basal body temperature.
During a normal healthy menstrual cycle your cervical mucus will become slippery and then stretchy as you approach ovulation.Â If your cervical mucus becomes only tacky and then drier without these characteristic changes of fertility, then you may not be ovulating.
Just before ovulation there is a rise in leutenizing hormone, known as an LH surge.Â You can use an ovulation predictor kit (OPK) to monitor for this, peeing on a stick each day.Â However, you may get a positive result even if you have not ovulated because this test is not sensitive enough.Â It indicates that leutenizing hormone has increased, but it may not be enough to trigger ovulation.
During a normal menstrual cycle your basal body temperature will rise after ovulation.Â When you see this rise in your cycle it provides confirmation that you have ovulated. Â With PCOS you may not see a rise in your basal body temperature, indicating that you did not ovulate during that cycle.
Carefully observing your signs of ovulation can tell you a lot about the health of your fertility.Â If these signs indicate that you are not ovulating, or if your cycles are irregular, you should be suspicious that something may be wrong.Â Â If you also have acne and are overweight, you may have PCOS.Â However, you can have PCOS and ovulate often enough to get pregnant.Â Monitor carefully to identify these fertile months so that you can increase your chances of conceiving.