PCOS & TTC: Your questions, answered

This PCOS Awareness Month, we kicked things off with a free PCOS & fertility webinar. You came with your questions, and our Lead Fertility Coach Sandy was on hand to answer. 

Then we thought, why stop there? Those that didn’t join the session or couldn’t make it deserve the same answers and insight, so here we are. We’ve put together a deepdive of the questions our community had about trying to get pregnant, whether they have been diagnosed with PCOS or suspect they might be dealing with the condition. Scroll on to find out more.  

Which supplements are good for PCOS?

There are really two supplements you should be looking for if you have PCOS: Myo-inositol, which has been shown to reduce insulin and testosterone levels, and can help with weight loss and improve ovulation for women with PCOS. Vitamin D can also help with insulin sensitivity and can improve ovulation. 

What is the most important piece of advice you would give to someone with PCOS?

This is a Sandy bugbear… when women are diagnosed with PCOS, they are often put on the contraceptive pill to regulate the menstrual cycle. In Sandy’s word’s, “The pill does not regulate your menstrual cycle!” Women with PCOS are often prescribed hormonal contraception in an attempt to regulate their periods (as a common feature of PCOS is irregular cycles – or very long cycles). It can be a good treatment option to help you manage symptoms – but it’s not the right solution for everyone. If the regularity of your menstrual cycle is an issue (most commonly when TTC, as predicting a fertile window is more needed here), then check out our PCOS guide. 

If I have just been diagnosed with PCOS, but am not yet TTC, what can I do to get ahead and prepare for when I do want to get pregnant?

• Make a plan. If you’re on oral contraception, make a plan for when to stop and learn what your menstrual cycle is like off the pill.
• Track your ovulation. Use urine ovulation tests to check if ovulation is happening. If you can’t accurately detect a surge in LH (luteinising hormone) you might need to implement some lifestyle changes to regulate your hormones, or get medical support in order to ovulate. 
• Make manageable nutrition and lifestyle changes. Some women with PCOS are instructed to lose weight to help improve chances of getting pregnant. This can actually be harder for women with PCOS, but making small changes sooner can help you get ahead and improve ovulation, improve chances of getting pregnant or shorten the time to get medical support if you need it. GPs will often limit access to fertility treatments based on BMI – whilst we believe this is pretty outrageous and downright unfair, it is unfortunately why weight loss is occasionally recommended before any testing is offered. If you can get ahead of this, and talk to your GP about the changes you’re already making with lifestyle, diet and nutrition, it may influence the conversation and their recommendations on next treatment steps. 

Why does PCOS make testing for ovulation so hard? How do you test for ovulation with PCOS? 

One of the symptoms of PCOS is insulin resistance, which leads to having elevated levels of luteinising hormone (LH). In a regular menstrual cycle, a surge in LH will often trigger ovulation, but elevated levels of LH throughout the menstrual cycle with PCOS can disrupt the function of the ovary and cause absent or irregular ovulation. If you consistently get results with “high” levels of LH but not “peak” - it most likely means your LH levels are consistently elevated and you might need to implement lifestyle changes or get medical support in order to ovulate.

Having PCOS is really getting me down – what can I do to feel less alone, and where can I go for support?

There are a lot of common symptoms in PCOS that aren’t related to your menstrual cycle, like anxiety, lack of concentration and fatigue. These symptoms can often make you feel worse about your diagnosis and leave you feeling isolated. Please know, you’re not alone! Verity is a great UK based PCOS charity that has a lot of resources and support. And so do we - join our monthly fertility sessions and chat with Sandy, Nicole and our brilliant care team. We’re right here to support in any way that we can, even if only to make things feel a little easier for you. 

I think I might have some of the PCOS symptoms but I’m not sure – what are the symptoms to look out for?

PCOS is a condition that manifests differently in women and has a range of symptoms. Common symptoms of PCOS include:

• Irregular or absent periods 
• Irregular or absent ovulation
• Heavy or very light bleeding when you have a period
• Excessive body or facial hair growth 
• Weight gain or difficulty losing weight
• Oily skin and acne
• Headaches
• Difficulty getting pregnant 
• Depression, anxiety

Yup that’s a long list. And often those symptoms can be hard to pin down or track regularly. What’s interesting (and awful) is that sometimes PCOS can be misdiagnosed as a mental health issue – particularly if your GP is not taking into account the menstrual cycle symptoms. 

How do I best prepare to get the most out of my GP appointment if I go to them about PCOS? 

GPs are getting better at female hormonal conditions, but the care can sometimes be a little inconsistent, so it can be a good idea to be as prepared as possible, to help them help you. It can be really helpful to prepare and provide a symptom diary, allowing your GP to see if there is a correlation of symptoms. Having symptoms mapped out over a few months can help your GP better identify triggers and the pattern of symptoms you are experiencing. Your symptom diary can include details of your recent menstrual cycles, your cycle length, any information on ovulation testing and other PCOS related symptoms (oily skin and acne, excessive facial hair or body hair and hair loss from the head). If you’ve noticed a change, write it down. Print out a little calendar and make a note every time you notice a symptom. It will help you feel confident asking for what you need when you sit down in front of your GP, and it will help your GP think through symptoms with you to figure out what’s going on.