Every day I meet healthy women who are ready to become mothers who share a similar story. Often they have used birth control pills for many years, starting as a teens, in order to regulate their menstrual periods. Now when ready to start a family, they have done all of the right things: started prenatal vitamins, consulted with their OB/Gyn doctors for pre-conception counseling, and stopped taking birth control pills. Then they patiently wait for their bodies to begin ovulating again. After stopping the pill, some are surprised to find that their cycles are very infrequent sometime stretching months before a menses will occur. Friends and family may keep saying “you’re young, it takes time'”… but without a menstrual cycle it seems as though all of the effort is futile. Even without any other symptoms or health problems, patients just know something is wrong.
Many of these patients with menstrual cycle irregularities have Polycystic Ovary Syndrome (PCOS). PCOS is caused by hormonal imbalances that prevent ovulation. It is estimated that 5 -10% of reproductive age women have PCOS and it is the most common cause of ovulatory dysfunction associated with infertility.
Some of the common symptoms associated with PCOS are span from heavy, irregular periods to not menstruating at all, acne, excessive hair growth on the face, obesity, and infertility.
While medical history and a pelvic exam can usually help your physician diagnosing whether you are suffering from PCOS, some other tests such as blood hormone levels, ultrasound and endometrial biopsy may be needed to confirm the diagnosis.
Treatment of PCOS will depend on your specific needs. Obesity may make the condition worse, so losing weight may help improve the hormonal imbalance. Other medications such as hormones or insulin metabolism medications can improve irregular or heavy periods. Early diagnosis and treatment can reduce the development of acne and facial hair. If your goal is to become pregnant, then your doctor may prescribe a medication to stimulate ovulation.
So many of the patients who share this history will tell me, “There were times when I thought maybe I just wasn't meant to get pregnant". Often they will hear that they must wait a full year before seeking help and are afraid to seek out a specialist. If you have irregular cycles and are trying to start a family and you don't think things are right, see someone, don't wait. The good news is that with treatment most patients with PCOS will go on to conceive and have healthy pregnancies.