What is PCOS and how does it affect fertility?

PCOS stands for Poly Cystic Ovarian Syndrome. It is a condition affecting somewhere between 3 and 10% of the female population¹, although many people may have the condition but are un-diagnosed. You may be told that you have poly cystic ovaries, but this does not mean you have PCOS - ovaries change from month to month, and poly cystic ovaries can even be found in women taking the pill and in women with normal ovulatory cycles.

PCOS is a common diagnosis for the clients that I see in my Weymouth studio or online, whether they are trying to conceive, preparing for assisted fertility treatment (IVF) or trying to manage their cycles for health and wellbeing.

How is PCOS diagnosed?

PCOS is a syndrome which affects people with female reproductive systems. The diagnosis of PCOS (from the Androgen Excess and PCOS Society²) is made when your symptoms meet any two of the following criteria:

* periods less regular - more or less often than monthly
* higher levels of androgen hormones found from blood tests or symptoms such as excess body hair
* appearance of more than 20 follicles per ovary observed on ultrasound

This criteria is preferable to Rotterdam's criteria for diagnosing PCOS, since it focuses on both of the main causes of the condition - a problem with ovulation and an overproduction of male hormones (androgens) like testosterone.

- PCOS is the single most common cause of infertility in young women³
- PCOS is the underlying cause in 75% of women who have infertility due to anovulation⁴
- Women with PCOS have a clinically significant increased risk of pregnancy complications compared with women without PCOS⁵

PCOS is not one disease

PCOS is not one disease - it’s a group of symptoms that relate to anovulation and high levels of androgens, and which result from a diverse group of underlying factors, which include insulin, inflammation, adrenal androgens and post pill androgens. It also generally falls into one of these types: post-pill, insulin-resistant, inflammatory and adrenal. Each type will affect you in different ways, and the type you have can mean the management of your symptoms might vary.

Symptoms of PCOS which are common include:

* Irregular or no periods
* Weight management
* Acne
* Hair loss
* Excessive facial and body hair (hirsutism)
* Difficulties in trying to conceive
* Higher risk of miscarriage
* Mood swings

PCOS is conventionally managed with the use of the oral contraceptive pill, however this tends to mask the symptoms and does not get to the root causes of the condition. Once you stop taking the pill, your PCOS symptoms will return.

PCOS and conception

Around 30% of people with PCOS will have no problems getting pregnant, but this does mean that around 70% of people with PCOS may have issues. As PCOS is a collection of symptoms that affect your health, being as healthy as you can when preparing for pregnancy may help to reduce your risk of possible problems such as recurrent miscarriage, and during pregnancy that of gestational diabetes.

PCOS and long term health

As PCOS is also associated with long term health implications for diseases including metabolic disorders (Type 2 diabetes etc.), high blood pressure, heart disease, psychological issues and reproductive organ cancers⁶ making changes to support a regular ovulatary cycle with your hormones in balance will help your health and wellbeing for life.

Managing PCOS

Fertility issues with PCOS are the most common condition that I work with. Because male hormones (androgens) produced in PCOS interfere with the delicate balance required for ovulation and then the support for potential embryos, I usually work with my clients for at least three months to make effective changes to their menstrual cycles. This helps to prepare the body for regular periods, ovulation and progesterone production which are necessary for an egg to be produced and an embryo to develop and then attach to the uterus lining.

If your body is working to produce eggs and the hormones required for successful implantation, your chances of pregnancy are higher with each cycle. Managing the hormones can also have an effect on whether a pregnancy can be sustained. This is because raised LH levels which are common in unmanaged PCOS can lead to an increased risk of miscarriage. What evidence is there to recommend reflexology for conception with PCOS? In a data collection study, the Association of Reproductive Reflexologists found the success rate for pregnancy with PCOS was 72% and the live birth rate was 57%.

Managing PCOS can be difficult unless you know what to focus on. When working with PCOS clients, I offer a range of support which is tailored to your needs. This includes dietary and lifestyle advice, healthy living, mindset and reproductive reflexology which helps to regularise hormones with specific routines for each part of your menstrual cycle, and helps to provide the optimal conditions for conception, pregnancy and wellbeing.

Combined in one package, you can benefit from my experience of supporting people with this condition to improve cycle regularity and balance hormones so they work effectively for you. In addition, you can feel better because your body is working in the way it’s designed to.

Your Next Steps

If you’re preparing for pregnancy and you have PCOS or, if you have a PCOS diagnosis and are struggling with the symptoms but aren’t getting ready for a baby, then book your free call with me today, let’s see what changes could be possible for you.

References:
1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6266413/
2. https://ae-society.org/patients/
3. Rosenfield, R.L. (2015) The Diagnosis of Polycystic Ovary Syndrome in Adolescents. Pediatrics 136(6), 1154-1165. [Free Full-text]
4. Balen, A.H. and Anderson, R.A. (2007) Impact of obesity on female reproductive health: British Fertility Society, Policy and Practice Guidelines. Human Fertility 10(4), 195-206. [Abstract]
5. Palomba, S., de Wilde, M.A. and Falbo, A. et al. (2015) Pregnancy complications in women with polycystic ovary syndrome. Human Reproduction Update 21(5), 575-592. [Free Full-text]
6. https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/background-information/complications/