Overview of PCOS and Pregnancy
If you wish to get pregnant with PCOS but were, at one point, told that you would struggle to conceive naturally — you are not alone.
Many women with PCOS who are trying to conceive often find it frustrating to know that PCOS might be slowing things down for them.
Regardless of what you might have been told, PCOS does not mean you’re infertile.
PCOS is a condition of subfertility.
This means that while it might take you longer to fall pregnant than your non-PCOS peers, it is definitely possible.
In fact, research shows that women with PCOS have approximately the same number of children as women without PCOS.
Researchers also suggest that most women with PCOS will have at least one natural pregnancy (i.e., no need for fertility treatments).
Additionally, since women with PCOS have a higher ovarian reserve, they also remain fertile for longer—meaning that you may even have a longer timeframe to have children compared to those without PCOS.
Part 1: Pre-Pregnancy and PCOS
Fertility Planning with PCOS
Getting pregnant with PCOS mainly involves three steps.
First, you need to find out your PCOS root cause to determine what is affecting your hormones, ovulation, and cycle length.
Next, work on reversing your root cause so you can start ovulating naturally again.
Then, learn how to chart your cycles and time intercourse to increase your chances of pregnancy.
Often, being able to identify when you're ovulating is the missing link in falling pregnant naturally with PCOS.
Because women with PCOS tend to ovulate irregularly, detecting ovulation can be tricky.
This doesn't equate to infertility; it only means we should pay closer attention to things like our cervical fluid so we know when our body is gearing up to release an egg.
Lifestyle Adjustments for Enhanced Fertility
Regular exercise is essential in PCOS management, whether or not you’re trying to get pregnant.
A sedentary lifestyle means your muscles aren’t using up the excess glucose in your blood.
As such, insulin levels typically rise to address the extra glucose — leading to insulin resistance and inflammation.
Moving intentionally throughout the day, as well as finding a sustainable workout plan, can do wonders for PCOS management.
Regular exercise can reduce inflammation levels, lower stress hormones, and prevent insulin resistance.
If you don’t know where to start, endurance-based cardio workouts like cycling, jogging, and high-intensity interval training (HIIT) are all very helpful in improving cardiovascular health, especially when you have PCOS.
HIIT, in particular, helps to increase muscle sensitivity to insulin. However, you can enjoy different types of movement when you have PCOS!
What’s really important is finding a workout that is fun and sustainable for you.
For the most part, doing three days of moderately intense activities like HIIT or strength training for 20 minutes daily, supplemented with 30 minutes of cycling or jogging on other days, is great for PCOS.
How Nutrition and Supplements Can Help
Proper nutrition and supplementation can vastly improve fertility.
Having a healthy diet is easier if you know what to eat when you have PCOS. These include foods like seafood, legumes, and olive oil.
Seafood is rich in omega-3 acids that can lower inflammation and improve fertility.
Legumes, on the other hand, are rich in protein, essential nutrients, and fiber.
They also promote better insulin sensitivity because of their low glycemic index.
Olive oil, especially extra virgin olive oil, has anti-inflammatory and antioxidant properties that can also reduce the risk of other diseases.
Additionally, limiting trigger foods when you have PCOS (like refined carbohydrates) can help you manage insulin resistance.
Refined carbohydrates include cakes, pastries, white bread, other sugary desserts, and basically anything made with flour.
Pasta made of semolina, durum wheat flour, or durum flour is also very high in carbohydrates but low in fiber.
You should instead opt for bean-based or lentil-based pasta.
Foods that contain dextrose, sucrose, and high fructose corn syrup should also be avoided when you have PCOS.
Additionally, inflammation-causing foods like fries, margarine, red meats, and other processed meats should be consumed sparingly.
Most importantly, proper supplementation is crucial for managing symptoms and improving fertility when you have PCOS.
Taking an androgen blocker, for example, can help you address PCOS symptoms like acne, hair loss, and hirsutism caused by androgens.
Additionally, minerals like zinc, selenium, chromium, and magnesium can also combat the negative effects of inflammatory and oxidative stress caused by PCOS.
Try supplementing with saw palmetto prior trying to conceive to help manage your symptoms.
Saw palmetto reduces 5-alpha reductase, an enzyme that converts testosterone to DHT, a potent androgen.
Saw Palmetto also promotes estrogen balance, helping to lessen PCOS symptoms.
Spearmint tea is another supplement that can help you manage symptoms.
Among its benefits are its anti-androgen properties, an improved endocrine profile, testosterone reduction, increased estradiol, follicle-stimulating hormone, and luteinizing hormone.
Psychological and Emotional Considerations
Stress can adversely affect your health, especially if you have PCOS.
Try practicing mindfulness and meditation techniques to help your body reduce stress naturally and keep anxiety and depression at bay.
Reducing stress is crucial when you have PCOS, as it may be the key to managing some of your PCOS symptoms, too.
Yoga and relaxation are also great ways to ease stress, with a study showing that yoga, when done regularly, can also significantly lower testosterone levels in women with PCOS.
Lastly, breathing techniques such as box breathing can be done to calm oneself down.
You can do this by inhaling-holding and exhaling-holding the breath for 4 seconds each.
Part 2: Pregnancy Management with PCOS
Early Pregnancy Considerations
Women with PCOS who are trying to conceive may find taking prenatal vitamins beneficial as they have the added effect of helping to manage PCOS symptoms.
Because PCOS is a hormonal disorder that can also affect fertility, taking prenatal vitamins with vitamin D3 and folate can help manage PCOS symptoms while preparing the body for pregnancy.
Ideally, you should start taking daily prenatal vitamins 1 to 3 months before you wish to get pregnant or right when you’ve decided that you want to try conceiving.
Managing and Avoiding Health Risks
There are, unfortunately, some PCOS-related pregnancy complications that may arise in unmanaged PCOS cases, including miscarriage, preeclampsia, gestational diabetes, c-section delivery, preterm birth, and pregnancy-induced high blood pressure.
Proper symptom management and prenatal care are thus crucial in ensuring a healthy pregnancy.
Nutritional Needs and Dietary Adjustments
One of the most important vitamins you should take during pregnancy is folate, a B vitamin that can naturally be found in food.
Folic acid and methylated folate are two types of folate; however, they are received differently by the body.
Methylated folate is the better option, so look for prenatal vitamins that use it.
Unlike folic acid, methylated folate does not need conversion before it can be used by the body.
It’s bioavailable instantly and can be used for the baby’s development.
Other than folate, choline and inositol are also beneficial during pregnancy.
Both can be found in food, but prenatal vitamins provide much-needed supplementation during pregnancy.
Monitoring and Managing Insulin Resistance
Prenatal vitamins can also help to manage insulin levels.
A lot of women with PCOS have insulin resistance, a condition wherein cells become less responsive to insulin.
Nutrients like zinc in prenatal vitamins can help improve insulin sensitivity, making supplementation beneficial for PCOS women trying to conceive.
Safe Exercise Routines for Pregnancy with PCOS
You should always consult with your OB-GYN regarding your activity levels during pregnancy.
But, as a general rule, any exercise you’re used to before getting pregnant is still something you can enjoy at a lesser intensity during pregnancy.
So, if you’re used to lifting weights, consult your doctor about carrying on.
They may just set guidelines for how much you can lift.
You may also go on less intense runs or jogs and keep doing circuit exercises.
There are also gentle flow yoga routines you can follow along with, specifically for pregnancy.
Mind-body exercises are also very important when you’re pregnant with PCOS.
Studies have proven that women with PCOS have more intense bodily responses to stress, so exercises like Pilates, yoga, and tai chi can help burn calories and reduce stress levels at the same time.
Dealing with Anxiety and Stress During Pregnancy
As for stress and anxiety directly related to pregnancy, there are ways to manage and cope as you adjust to being pregnant.
First, acknowledge that while pregnancy may be uncomfortable, it is temporary and can be handled with the help of your healthcare provider.
Second, try to support your body as best you can with healthy food, good-quality sleep, and exercise.
These things can keep your mind and body in good condition, helping you to deal with anxiety and stress as a result.
Lastly, don’t be afraid to ask for help. Seek out your partner, family, and friends, and don’t try to do everything alone.
Also, find a community that can support you during this time, as conversing with like-minded people can help take a load off one’s shoulders and reduce stress.
Childbirth education classes can be an excellent way to find your peers.
Part 3: Post-Pregnancy and PCOS
What to Expect After Giving Birth
After-birth recovery is relatively similar among PCOS and non-PCOS women, especially if one has managed PCOS symptoms prior.
However, close monitoring is still essential, especially given certain risks that may still arise.
Studies show that women with PCOS are more likely to experience cardiometabolic and psychiatric complications after birth, including postpartum preeclampsia, postpartum depression, and congestive heart failure.
These are not common occurrences, but it’s still important to keep all bases covered and listen to your doctor for a customized recovery program after giving birth.
Postpartum Hormonal Changes and Their Impact
Because hormone imbalances are common among women with PCOS, and pregnancy increases hormones even more, you might find that your hormones are more out of balance postpartum.
After you give birth, your high hormone levels will begin to plummet over the next few days.
Levels of estrogen and progesterone will also decrease soon after delivery, followed by a surge in oxytocin to compensate for the drop in estrogen and progesterone.
This might feel like an emotional roller coaster for you over the next few weeks after giving birth.
Additionally, sleep deprivation and adjusting to a new routine may also exacerbate the stress of childbirth.
Your hormone levels should begin to stabilize after three months postpartum, but it may take longer for those with PCOS as we already struggle with a baseline of hormonal imbalances to begin with.
This makes PCOS management extremely important.
Postpartum Weight Management and PCOS
A lot of women with PCOS often have issues with weight management.
Weight management may be challenging after giving birth, but you can get back on track with a proper diet, exercise, and supplementation.
It's crucial to maintain a healthy diet during your pregnancy so that you stay at a healthy weight even postpartum.
Don’t be too hard on yourself, as with or without PCOS, losing weight after delivery is challenging.
Postpartum Depression
Unfortunately, women with PCOS are at a higher risk for postpartum depression.
Because a woman's mind and body go through a lot during pregnancy, the changes don’t stop even after delivery as the body and hormone levels adjust.
You may feel emotionless, sad, or even empty postpartum.
Don’t be ashamed to seek help from your healthcare provider and mental health support to help you get back on your feet.
Breastfeeding with PCOS
The hormonal imbalances from PCOS can reportedly affect milk production, making breastfeeding more difficult.
However, there are natural ways to remedy this and to help your body produce milk.
Start by consulting with your provider, as well as supporting your body with food and supplements that encourage milk production.
Free 3 min Quiz
PCOS? Which Type Do You Have?
Frequently Asked Questions
Is there a best age to get pregnant with PCOS?
Research shows that while biologically, younger women with managed PCOS symptoms (25-29 years) may find it easier to get pregnant, those in older age groups tend to have much higher success rates because they've already mastered how to manage their PCOS symptoms.
So, really, the "best age" is once you've gotten a handle on your PCOS symptoms!
What are the first steps to take when planning for pregnancy with PCOS?
Take a prenatal vitamin right away, track your ovulation, and keep working on managing your PCOS root cause!
Can I get pregnant naturally with PCOS, or will I need fertility treatments?
Yes, you can.
Studies show that women with PCOS have at least one successful pregnancy without needing fertility treatments!
Are there specific prenatal vitamins or supplements recommended for PCOS and pregnancy?
The Nourished Natural Health Nourished Mama Prenatal vitamins contain a supportive blend of essential vitamins and nutrients, including methylated folate, choline, and inositol, to support a healthy mama before, during, and after pregnancy.
How can I manage insulin resistance during pregnancy with PCOS?
Regular exercise approved by your doctor is the best way to ensure that excess glucose in your blood is being used up by your muscles.
Additionally, maintaining a healthy diet with minimal refined carbohydrates will help keep cravings at bay.
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