September is PCOS Awareness Month. PCOS, or Polycystic Ovary Syndrome, is a condition that affects 1 of every 20 women (some estimates put it at 1 in 10!). This month, we wanted to shed some light on the condition and why some women with PCOS may want to chart their cycle. One big reason: it removes a lot of the confusion around getting pregnant with PCOS and gives women a fertility window even with longer and more unpredictable cycles.
Contrary to its name, PCOS is more strongly linked to androgen excess than the presence of polycystic ovaries. It's diagnosed with a combination of excess androgens (hormones) and irregular or abnormal cycles. The root causes of PCOS vary from individual to individual, as do the symptoms.
In our last post I focused on ways in which PCOS can be managed by charting your cycles and using FAM. In this post I am focusing on one struggle of PCOS: fertility. One of the main fears that women with a PCOS diagnosis might have are issues surrounding getting pregnant. Before we dive into what to focus on if you're interested in getting pregnant with PCOS, it’s important to understand why fertility can be an issue when it comes to PCOS.
Getting Pregnant with PCOS: We Still Need to Ovulate to Get Pregnant
In my work as a fertility awareness educator, empowerment through education is key. In instances like PCOS, when we understand how our hormones work we can become better advocates for our health. With PCOS, the root cause of fertility is not just “infertility.” There is a reason that folks with PCOS may have trouble getting pregnant, and understanding why this is can help you overcome any struggles you may have conceiving.
There are some important pieces to understand when it comes to conceiving, and certain conditions that need to be met. Contrary to what we may have been told, we can’t get pregnant at any time. Each cycle, if we are not on hormonal birth control or breastfeeding, our ovaries will release an egg. This egg lives for only 12-24 hours.
In order for sperm to make the journey to the egg in time, the conditions of the vagina need to be favorable for sperm. This means there needs to be cervical mucus present to nourish sperm and speed up their journey to the egg. This, combined with the length of time the egg lives, is a window of about 5-7 days.
Most women will not be able to pinpoint this window of fertility if they are not tracking their cycle. If there is an underlying condition such as PCOS, it can add another challenge to conceive if we’re not sure when we’re actually ovulating. The reason that there may be fertility issues associated with PCOS is because ovulation may not be happening regularly or it may be delayed, giving you a long and drawn out cycle.
Learn to Chart Your Cycle
There is a way that we can pinpoint ovulation and take some of the mystery out of when the fertile window actually is. When we chart our cervical mucus and basal body temperature, we can have some sense of when ovulation is about to happen, and be sure that it has happened.
Tracking your cycle with either an app or on paper, and making notes about your cervical mucus and basal body temperature will give you an ideal time to conceive. You will want to time intercourse on peak day, the day of the most fertile, egg-white, clear, stretchy cervical mucus. This may happen before you actually ovulate, but it is the type of cervical mucus that will keep sperm alive and nourished.
Tracking your basal body thermometer with Tempdrop won’t tell you ahead of time that ovulation will occur (no app or device can predict ovulation), but it will tell you after the fact that ovulation has indeed occurred.
With PCOS you may have delayed ovulation, or cycles where ovulation does not happen. By tracking your fertility signs with FAM, you can have some sense of when ovulation will happen, even with irregular cycles. Just because you have PCOS doesn’t mean that you can’t conceive, if you have some sense of where you are in your cycle, you can time intercourse at ovulation.
Address the Root Cause
Most mainstream approaches to PCOS do not address the root cause of the condition. Educating yourself so you can advocate for your own health and ask for what you need from your practitioner is key. It is possible to manage PCOS symptoms and restore normal cycles with lifestyle and diet changes.
Reducing stress, eating foods that lower insulin resistance and maintain blood sugar balance are key in managing PCOS. The root cause of PCOS has to be addressed first, and it might mean adopting some new habits. Finding yourself some support either virtually or in person, in the form of a mentor or a women’s health-minded practitioner is key. Ask your practitioner about their approach to treating the root cause of PCOS, and remember that you have options. You’re not alone in this journey!
Nathalie Daudet is a social worker and FEMM instructor based in the centre of Winnipeg, Canada. She discovered fertility awareness after searching high and low for a non-hormonal method of birth control. After learning the magic of fertility awareness and the gift of body literacy, she decided to pursue formal fertility awareness training and share the knowledge of fertility awareness with women looking for a natural birth control option. Fertility Awareness Project is the hub for Nathalie’s FEMM classes in both group and individual formats, online and in person in Winnipeg, Manitoba. She can be reached at fertilityawarenessproject.ca. If you love this post and would like to thank Nathalie, shop Tempdrop with Nathalie's unique referral link.