“How to get pregnant with PCOS quickly?”.
The most straightforward answer to that question is that it is possible to conceive with PCOS, but it takes time. With the right therapy, you can get pregnant and lead an everyday, healthy life.
Despite the name, females with Poly Cystic Ovary Syndrome do not have cysts in their ovaries. Instead, it is a hormonal imbalance in the body that hampers the release and maturation of eggs(ovulation). As a result, it’s difficult to pinpoint the exact reason behind PCOS. Still, it is thought to be due to a combination of two significant factors: Insulin resistance and Elevated levels of male hormones(androgens) in the body.
Insulin resistance is an impaired response of the body to insulin resulting in an elevated amount of glucose; this leads to further insulin release in the body. In addition, high levels of insulin cause the ovaries to release androgens. Elevated androgen levels prevent ovulation and are the reason behind some other symptoms of PCOS.
Normal Menstrual Cycle
Every woman is unique and has a different menstrual cycle. As a result, there’s no correct way to describe a normal cycle. According to Cleveland Clinic, the Menstrual cycle is the physiological sequence of events that occur within the female body as it prepares for the possibility of pregnancy each month.
A menstrual cycle is considered to begin on the first day of a period. On average, a normal cycle lasts 28 days, but some women can have cycles as short as 21 days or as long as 35 days. The circulating hormones in the body intricately regulate the menstrual cycle. Hormone secretion in the body consists of a set of endocrine glands and their receptors present in various tissues/organs in the body.
The master gland Hypothalamus(in the brain) and the Pituitary gland(in the brain) have either a stimulatory or inhibitory effect on the ovaries[via Follicle Stimulating Hormone(FSH) and Luteinising Hormone(LH)]. Therefore, based on the signal received, Ovaries either increase or decrease the secretion of hormones like oestrogen and progesterone.
Phases of a Menstrual Cycle:
A series of changes are seen in a woman’s body when it prepares to support a pregnancy. Four phases occur due to oestrogen and progesterone’s direct/indirect effect on them.
The Phase of Menses: DAY 1- DAY 5
A fertilized egg requires a well-nourished environment to grow fully till term. The inner lining of the uterus(endometrium) provides such an environment. If pregnancy has not occurred that month, the endometrium becomes unviable and sheds itself in the form of bleeding from the vagina. Usually, this phase lasts 3-5 days and can go up to 7 days.
Uterus Preparation Phase: DAY 6- DAY 14
Every month the endometrium prepares itself to provide a hospitable environment for a fertilized egg. The endometrium is full of glands which are richly supplied by blood vessels to provide nourishment for the developing fetus. In the follicular phase, these glands undergo hypertrophy (increase in size) to provide a rich environment for the fertilized egg.
Ovulation: DAY 14
On day 14 of the menstrual cycle, there is a sudden upsurge in the amount of LUTEINIZING HORMONE that causes the ovaries to release an egg.
Fertility Period: DAY 15- DAY 28
Once the egg has been released from the ovaries, it travels along the fallopian tube, which are two arm-like structures connecting the uterus to the ovaries. During its course along the fallopian tube, if the egg encounters a sperm, fertilizations may or may not occur.
If fertilizations occurs, the resulting zygote travels to the nutrient-rich endometrium, resulting in a successful pregnancy. However, if fertilization has not occurred, a change in oestrogen-progesterone levels will result in degeneration and eventual shedding of the endometrial lining on DAY 1 of the menstrual cycle.
PCOS and the Challenges it Poses
Women with PCOS have a disrupted hormonal balance. This is the main reason why women experience the symptoms that are commonly observed in PCOS, namely, menstrual irregularities, abnormal growth of hair on the face, chest and back(Hirsutism) and infertility.
Usually, the first symptom reported by women with PCOS is menstrual irregularities. It can include loss of regularity of periods, heavy bleeding, prolonged bleeding or a complete absence of bleeding. If you experience any of these symptoms, get in touch with your doctor immediately.
Girls in the Adolescent Age Group
PCOS is generally observed in girls of pubertal age or childbearing age. Young girls experiencing PCOS symptoms, for example, growth of facial hair, might be subjected to social rejection, forcing them to stay indoors. Lack of time spent outdoors, along with reduced physical activity, might cause such girls to put on weight; increased weight further aggravates insulin resistance, thus pushing these girls into a vicious cycle. As a parent/guardian, it is essential to provide support to the girl and help her get out of this vicious cycle. The first step is to seek medical attention. It is important to ensure emotional development at a young age.
Married/Women wanting to Start a Family.
Women who want to start a family are another age group who suffer from PCOS. Failure to conceive after repeated attempts may cause such women to feel isolated and helpless. However, it’s important to realize that there are remedies available.
The following section describes all the treatment options available for PCOS and its associated symptoms.
Management of PCOS
PCOS has no cure, but the associated symptoms can be controlled in women and women facing these issues can lead a smooth everyday life.
Natural Remedies for PCOS:
1. Salad
A healthy diet consisting of processed food, unhealthy food and alcohol is highly detrimental to the regularity of the menstrual cycle. An unhealthy diet may also cause a hormonal imbalance in the body that may lead to irregular periods and failure to ovulate. A diet rich in green vegetables, fruits, dry fruits, red meat and fish is ideal. A complete diet nourishes the body, providing it with the required nutrients and controlling the symptoms of PCOS.
2. Regular Exercise
Out of all the remedies on the list, exercising regularly is the most important component of a healthy lifestyle. Maintaining weight and regularizing hormonal cycles are a few notable benefits of exercising regularly. The majority of women with PCOS (38%-88%) are either overweight or obese and may benefit greatly by including exercise in their routine.
3. Ginger
Ginger has been used for multiple diseases, including menstrual abnormalities. The active component in ginger is GINGEROL which has an anti-inflammatory effect. Also, it augments uterine musculature contraction and normalizes hormonal imbalance. In addition, ginger tea on an empty stomach promotes metabolism.
4. Unripe Papaya
Unripe papaya is loaded with antioxidants like vitamin A, vitamin C, and vitamin E. It is also known to reduce the oxidation of cholesterol. Papaya has been routinely used in women with PCOS to remedy menstrual irregularities and reverse infertility. Carotene in papaya promotes estrogen production and increases uterine contractions, thus regulating the menstrual cycle.
5. Jaggery
Jaggery is another superfood that plays an active role in combatting menstrual irregularities. The sweet taste, along with tons of health benefits, makes jaggery an ideal addition to one’s daily routine.
6. Turmeric
Turmeric is probably a real-life Panacea; its magical healing properties can probably cure it all. In addition, its anti-inflammatory and anti-spasmodic properties are effective in treating menstrual irregularities.
7. Aloe Vera Juice
Aloe Vera juice enhances metabolism and helps keep the gut healthy. In addition, it also helps correct hormonal imbalances and treats menstrual irregularities.
8. Cinnamon
Cinnamon is yet another example of a superfood that is widely used to regulate insulin levels. This has a regulatory effect on menstrual cycles and helps regularize them. Cinnamon is also reported to reduce the pain associated with menstruation.
Pharmaceutical Therapy for PCOS
Women with a diagnosis of PCOS can have varied presentations. Some women may have few of the symptoms, with one more noticeable than the other. Others may have all or none of the symptoms (sub-clinical/asymptomatic). Consult your doctor for further guidance. Pharmaceutical therapy is widely used in females with menstrual irregularities associated with PCOS. These are as follows:
1. Therapy for Menstrual Abnormalities
Oral Contraceptive Pills (OCP) play a very crucial role in managing the symptoms of women with PCOS. OCPs act by decreasing hormonal levels of hormones like luteinizing hormone and reducing androgen production. It causes a correction of the hormonal imbalance, thus regularizing the menstrual cycle. Combined Oral Contraceptive Pills (COCP) contains both Oestrogen and Progesterone and are usually the first line of therapy against PCOS-induced menstrual irregularities. Recently newer low-dose formulations are being used to reduce the side effects. Lately, long-term injectable formulations like Depo Medroxyprogesterone Acetate(DMPA) are also being used. OCPs have a lot of additional benefits in addition to correcting menstrual irregularities like REDUCING ACNE, REVERSES HIRSUTISM and PROTECTION AGAINST UTERINE CANCER.
2. Therapy for Infertility Associated with PCOS
If you’re experiencing infertility due to PCOS and need some help with how to ovulate, your doctor might start you on a drug called CLOMIPHENE CITRATE. It is a drug that acts by modifying the estrogen receptors present in the body. Usually, this drug is started early in the cycle; the couple is recommended to have regular intercourse to maximize their chances of getting pregnant.
An alternative option available is RECOMBINANT GONADOTROPINS. The only limitation to this option is the high cost. It is recommended to get a thorough examination to exclude other causes of infertility like tubal blockage. Your Doctor can help you choose which option is best for you.
3. Other Options Available for PCOS
In Vitro Fertilizations Technique:
IVF is an option available for couples who, after exhausting all the options mentioned above, still fail to conceive. This involves isolating an egg(female gamete) and sperm(male gamete) from the female and male, respectively. The isolated gametes undergo fertilizations under artificial conditions and, if successful, form a zygote. The zygote undergoes further development outside the female body. Once the zygote matures enough, it is transplanted into the female body for implantation. If successful implantation occurs, a viable pregnancy can be carried to term.
Laparoscopic Ovarian Diathermy
Resistance to clomiphene is observed in a small percentage of women. Therefore, laparoscopic diathermy of the ovaries with electrocautery may be attempted.
FAQs
1. Is Polycystic Ovarian Disease cancer?
No. Although polycystic ovarian disease is not cancerous, it is a condition that occurs due to hormonal imbalance in failing to ovulate.
2. How is PCOS diagnosed?
There is no specific test for PCOS; instead, it is a clinical diagnosis based on a detailed history taken by your doctor. Blood tests to check for hormone levels and USG might aid the diagnosis.
3. What other conditions are associated with PCOS?
PCOS has been associated with many other systemic disorders like Diabetes, Hypertension, Heart diseases, and Infertility, amongst others.
4. Will I be able to conceive if I have PCOS?
Yes, it is possible to conceive with PCOS. Please consult your doctor for a therapeutic plan that’s appropriate for you.
5. Will losing weight increase my chances of getting pregnant?
Yes, weight gain is associated with insulin resistance which is one of the reasons for PCOS. However, losing weight reduces insulin resistance, thereby increasing your chances of getting pregnant, and it is also protective against many other diseases like Diabetes Mellitus, Hypertension, etc.
REFERENCES:
1. Barber, Thomas M et al. “Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies.” Clinical medicine insights. Reproductive health vol. 13 1179558119874042. 9 Sep. 2019, doi:10.1177/1179558119874042
2. Mashhadi NS, Ghiasvand R, Askari G, Hariri M, Darvishi L, Mofid MR. Anti-oxidative and anti-inflammatory effects of ginger in health and physical activity: review of current evidence. Int J Prev Med. 2013;4(Suppl 1):S36-S42.
3. Shah D, Patil M; National PCOS Working Group. Consensus Statement on the Use of Oral Contraceptive Pills in Polycystic Ovarian Syndrome Women in India. J Hum Reprod Sci. 2018;11(2):96-118. doi:10.4103/jhrs.JHRS_72_18
4. Jensen JT, Speroff L. Health benefits of oral contraceptives. Obstet Gynecol Clin North Am. 2000;27(4):705-721. doi:10.1016/s0889-8545(05)70169-8
Written by Dr Nachiket Brahmankar
Dr Nachiket is a fully registered MMC Doctor, practising as a general physician at Apollo Clinics. In his free time, he loves to explore new hiking trails and read books.
Reviewed by Dr Manavi Raj
Dr Manavi is a healthcare professional with a Bachelor of Dental Surgery from Rajiv Gandhi University of Health Sciences, Bangalore. She has a diverse history of working in healthcare, writing and social media marketing. Outside of work, she enjoys dabbling with paints and loves the outdoors.