PCOS Awareness Month: Top 10 PCOS pearls I wish everyone knew for better pregnancy health and beyond
By Alison Cowan, M.D.
Head of Medical Affairs, Mirvie
My patients often come in with preconceptions about PCOS that leave me thinking, “if only they had known earlier!”
Occupation: NICU nurse
Diagnosed: Week 36
Many people have never heard of PCOS, but it affects 5-10% of women and is the most common endocrine disorder for women of reproductive age.1 Affecting women across the entire lifespan, it causes hormonal imbalances, increases the risk for heart disease, diabetes, and infertility, and can also increase the risk of complications in pregnancy.2 The good news is that there is so much we can do to positively impact this disease, to improve fertility, pregnancy health, and overall health for women with this condition.
With that in mind, today I want to share my top 10 tips I wish everyone knew about PCOS for better pregnancy health and beyond. Whether you have it, wonder if you might have it, or know someone who has it (and I guarantee you’re in one of those three groups!), I hope this will provide a helpful guide for conversations with your healthcare provider or your loved one.
- Despite its name, women with PCOS are not at any increased risk of getting ovarian cysts. While the name ‘polycystic ovarian syndrome’ sounds like it will likely cause you to have ovarian cysts, this is not the case. The term ‘polycystic ovaries’ refers to a classic appearance of the ovaries on ultrasound associated with PCOS, but this involves having numerous follicles, not cysts.
- PCOS is the most common cause of infertility but is highly treatable. Many of my patients have had anxiety caused by thinking that they will never be able to get pregnant, and it is so crucial for women to know that there is help. While some women need assistance to achieve a pregnancy, this is fortunately a highly treatable form of infertility.
- Some women with PCOS are fertile without medical help. I’ve had many patients have an unanticipated pregnancy because they thought their PCOS made them infertile when this is not necessarily the case! Women with PCOS should still use contraception if they are not currently planning a pregnancy.
- If you have PCOS and are not having a period every month (outside of pregnancy), you need to talk to your doctor about treatment. One of the hallmarks of PCOS is it can cause a lack of a period or very few periods each year. This reflects underlying hormonal imbalances that when untreated can increase the risk of endometrial (uterine) cancer. Women with PCOS have a chance of endometrial cancer that is 2-6x as higher than average.2 The good news is this risk is preventable with proper treatment. If you don’t have a regular monthly cycle (and are not on any treatments to suppress your cycle safely), please discuss this with your healthcare provider at your next visit.
- For women who are overweight, even a modest decrease in your weight can pay off in significant health improvements. Most (though not all) women impacted by PCOS are also overweight. Reducing weight by just 5-10% can significantly improve health, reduce PCOS symptoms and improve natural fertility.3 You don’t need to feel pressure to get to an ‘ideal’ weight – small changes can pack a big punch.
- Exercise is a key component of optimizing health with PCOS. We know exercise is good for overall health, weight maintenance, and diabetes prevention. For adults with PCOS, it’s recommended to do 150 minutes per week of moderate exercise or 75 minutes per week of vigorous activity (or a combination of these), including muscle strengthening on two non-consecutive days of the week as an optimal regimen.2
- If you’re contemplating a pregnancy, schedule a pre-conception visit with your doctor to review your personalized recommendations. This is important for all women, but particularly for women with PCOS. It can be so helpful to plan with your doctor before you become pregnant. There are many ways to optimize health before pregnancy so that you are in the best position possible to carry a healthy pregnancy.
- Depression and anxiety are more common among women with PCOS, and there are tools that can help. We know depression, anxiety and other psychosocial issues can be more common among women impacted by PCOS. This is not surprising, as PCOS impacts quality of life significantly for many women.2 In addition to managing the physical symptoms of PCOS, it is important to bring up any emotional concerns you may be feeling.
- Women with PCOS need to have regular blood pressure, cholesterol, and diabetes screens over their lifetime. Because PCOS is associated with an increased risk of heart disease and diabetes, it’s essential to monitor closely for these conditions over your lifetime. Everyone with PCOS should have their blood pressure checked annually, have screening for diabetes every 1-3 years, and depending on age and other circumstances, should have their cholesterol checked.2
- PCOS can impact pregnancy health, so it is important to discuss this with your doctor or midwife during pregnancy. We know that women are at an increased risk of certain pregnancy complications, including high blood pressure disorders in pregnancy, preeclampsia, and preterm birth.4 Reviewing your personalized risk early in pregnancy can help ensure you are doing everything you can to keep yourself and your baby healthy during pregnancy.
I hope these tips left you with a broader understanding of PCOS. If it affects you personally, I hope you found something here to improve your personal health journey. At Mirvie, we believe that every patient deserves personalized care, because there truly is no one-size-fits-all when it comes to human beings. Knowing about our individual health conditions such as PCOS and how that can impact fertility, pregnancy health, and beyond can help us all to live our best, healthiest, and happiest lives.
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1. Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod. 2016 Dec;31(12):2841-2855. doi: 10.1093/humrep/dew218. Epub 2016 Sep 22. PMID: 27664216.
2. Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, Piltonen T, Norman RJ; International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018 Sep 1;33(9):1602-1618. doi: 10.1093/humrep/dey256. Erratum in: Hum Reprod. 2019 Feb 1;34(2):388. PMID: 30052961; PMCID: PMC6112576.
3. Lie Fong S, Douma A, Verhaeghe J. Implementing the international evidence-based guideline of assessment and management of polycystic ovary syndrome (PCOS): how to achieve weight loss in overweight and obese women with PCOS? J Gynecol Obstet Hum Reprod. 2021 Jun;50(6):101894. doi: 10.1016/j.jogoh.2020.101894. Epub 2020 Aug 16. PMID: 32814159.
4. Qin JZ, Pang LH, Li MJ, Fan XJ, Huang RD, Chen HY. Obstetric complications in women with polycystic ovary syndrome: a systematic review and meta-analysis. Reprod Biol Endocrinol. 2013 Jun 26;11:56. doi: 10.1186/1477-7827-11-56. PMID: 23800002; PMCID: PMC3737012.