Polycystic Ovary Syndrome (PCOS) is a hormonal disorder that affects women of reproductive age, typically between the ages of 15 and 49.

It is characterized by the presence of many small cysts on the ovaries, which disrupt normal menstrual cycles and make it difficult for women to conceive. Women with PCOS have higher levels of androgens (male hormones), which can cause a range of symptoms, including irregular periods, acne, weight gain, and excessive hair growth.

PCOS affects up to 10% of women of childbearing age worldwide, making it one of the most common reproductive disorders among women.

Women with PCOS who become pregnant may experience a range of unique challenges and considerations related to their condition. In this article, we’ll explore some of the key issues to be aware of when managing PCOS during pregnancy.

Diagnosing PCOS during Pregnancy

PCOS is typically diagnosed through a combination of physical examinations, blood tests, and ultrasounds.

However, diagnosis during pregnancy can be challenging, as many of the symptoms of PCOS (such as irregular periods) may be masked by the hormonal changes of pregnancy. Additionally, the presence of cysts on the ovaries is not always a reliable indicator of PCOS during pregnancy, as ovarian cysts are common in healthy pregnancies.

In some cases, women who are not aware that they have PCOS may experience complications during pregnancy that prompt further investigation and diagnosis.

These complications may include gestational diabetes, preeclampsia (a potentially life-threatening condition that causes high blood pressure and organ damage), or premature birth.

Managing PCOS during Pregnancy

Women with PCOS who become pregnant should work closely with their doctors to manage their condition and ensure the health and wellbeing of both mother and baby.

Some of the key considerations and strategies for managing PCOS during pregnancy may include:.

Monitoring Blood Sugar Levels

Women with PCOS are at increased risk of gestational diabetes (a form of diabetes that develops during pregnancy), which can cause a range of complications for both mother and baby.

To reduce this risk, doctors may recommend regular blood sugar testing and monitoring, as well as dietary changes to regulate blood sugar levels. Women who develop gestational diabetes may need to take insulin injections, although this is relatively rare.

Managing Weight Gain

Women with PCOS may be more likely to gain excess weight during pregnancy, which can increase the risk of complications such as pre-eclampsia, gestational diabetes, and premature birth.

To manage weight gain during pregnancy, doctors may recommend a balanced diet and regular exercise. However, some women with PCOS may find it difficult to manage their weight even with lifestyle changes, and may require additional interventions such as medication or bariatric surgery.

Monitoring Hormone Levels

As noted above, women with PCOS have higher levels of androgens (male hormones) than women without the condition.

During pregnancy, these hormone levels may fluctuate further, which can cause symptoms such as acne, hirsutism (excessive hair growth), and mood swings. Doctors may recommend regular blood tests to monitor hormone levels and adjust treatment as necessary.

Managing Ovarian Cysts

The presence of ovarian cysts is common in pregnancy, even in women without PCOS. However, women with PCOS may be more likely to experience cysts that are larger or more numerous than usual.

In rare cases, these cysts may rupture or twist, which can cause severe pain and require emergency medical attention. Doctors may recommend regular ultrasounds to monitor the size and number of ovarian cysts and intervene as necessary.

Considering Medications

Many of the medications used to manage PCOS (such as metformin, clomiphene citrate, and letrozole) are not recommended during pregnancy, as they may cause harm to the developing fetus.

However, some women with PCOS may require medication to manage their condition during pregnancy. In these cases, doctors will carefully evaluate the potential risks and benefits of different medications and adjust treatment as necessary.

Monitoring Fetal Growth and Development

Women with PCOS may be at increased risk of complications such as premature birth, low birth weight, and fetal distress.

Doctors will carefully monitor fetal growth and development throughout pregnancy to identify any potential issues and intervene as necessary. This may involve regular ultrasounds, non-stress tests (which monitor fetal heart rate in response to movement), or other tests.

The Bottom Line

PCOS is a common hormonal disorder that can make it difficult for women to conceive and experience unique challenges during pregnancy.

Women with PCOS who become pregnant should work closely with their doctors to manage their condition, monitor their health, and ensure the health and wellbeing of their baby.

By carefully monitoring blood sugar levels, managing weight gain, monitoring hormone levels, managing ovarian cysts, considering medication, and monitoring fetal growth and development, women with PCOS can increase their chances of a healthy, successful pregnancy.