Polycystic Ovary Syndrome: Diet, Symptoms, and Fertility

Polycystic Ovary Syndrome (PCOS)

Hello, Doctor: My menstrual cycle is regular every month, and I am 158 cm tall and weigh 48 kg.
I am 32 years old and plan to start trying to conceive in the second half of this year (as I am currently undergoing treatment for Helicobacter pylori with several medications).
During a pelvic ultrasound last September, multiple follicles were found near my ovaries, and the doctor diagnosed me with polycystic ovary syndrome (PCOS).
The only related symptom I have is that I developed two fine hairs on my chin about two years ago, and I have not experienced any other abnormalities or discomfort.
However, since I want to get pregnant, I have been paying more attention to my diet after the examination, trying to minimize foods that cause blood sugar fluctuations.
Later, my health check-up at the end of last year showed normal ovaries (no follicles on the ultrasound), but I had slightly elevated glycated hemoglobin levels.
At that time, the hair on my chin had also stopped growing.
Currently, I still focus my diet on vegetables, proteins, and meats, while minimizing refined carbohydrates like rice and noodles; however, I have recently relaxed my diet a bit due to my sweet tooth, and I noticed that the hair on my chin has started to grow back.
I would like to ask: 1/ Given my physical condition, is my PCOS considered mild? 2/ Does dietary adjustment really provide substantial help for PCOS? 3/ If my PCOS is not severe but my glycated hemoglobin is slightly elevated, should I continue strict dietary management? It is very challenging for me to completely avoid carbohydrates and sugars.
4/ Even though I have regular menstrual cycles, is it still possible for follicles not to develop into eggs? Will I need ovulation medications or injections to conceive? Thank you, Doctor, for your answers.

Miss Wang, 30~39 year old female. Ask Date: 2023/03/15

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, based on the current situation, it should not be serious.
Just maintain a calm mindset and observe.
If there is no pregnancy after six months, then consult a gynecologist.
Wishing you good health.

Reply Date: 2023/03/15

More Info

Polycystic Ovary Syndrome (PCOS) is a common hormonal disorder that affects women of reproductive age. It is characterized by a combination of symptoms that can include irregular menstrual cycles, excess androgen levels (which can lead to symptoms such as hirsutism, acne, and scalp hair thinning), and polycystic ovaries as seen on ultrasound. Your situation, where you have been diagnosed with PCOS but have regular menstrual cycles and only mild symptoms, suggests that your condition may not be severe. However, it is essential to monitor your health closely, especially as you plan to conceive.

1. Severity of PCOS: Based on your description, it seems that your PCOS is relatively mild. The presence of multiple follicles on ultrasound does not necessarily indicate a severe condition, especially if you are not experiencing significant symptoms or irregularities in your menstrual cycle. Many women with PCOS can have regular cycles and still have polycystic ovaries. It's important to maintain regular check-ups with your healthcare provider to monitor any changes in your condition.

2. Dietary Adjustments: Diet plays a crucial role in managing PCOS. A balanced diet that focuses on whole foods, including plenty of vegetables, lean proteins, and healthy fats, while minimizing refined carbohydrates and sugars, can help regulate insulin levels and improve overall hormonal balance. Your efforts to reduce sugar intake and focus on nutrient-dense foods are beneficial. Research indicates that women with PCOS often have insulin resistance, which can lead to higher blood sugar levels and weight gain. By managing your diet, you can help mitigate these risks and potentially improve your symptoms.

3. Managing Elevated Glycated Hemoglobin: If your glycated hemoglobin (HbA1c) levels are slightly elevated, it is advisable to continue with a healthy diet. While it may be challenging to eliminate all sugars and carbohydrates, focusing on low glycemic index foods can help stabilize your blood sugar levels without the need for extreme dietary restrictions. Moderation is key; you can allow yourself occasional treats while maintaining a primarily healthy diet. Regular physical activity is also beneficial in managing blood sugar levels and improving insulin sensitivity.

4. Ovulation and Fertility: Even with regular menstrual cycles, it is possible to have anovulatory cycles (cycles where ovulation does not occur). This can happen in women with PCOS due to hormonal imbalances. If you are trying to conceive and are concerned about ovulation, it may be helpful to track your ovulation through methods such as ovulation predictor kits or basal body temperature charting. If you find that you are not ovulating regularly, medications such as Clomiphene Citrate may be prescribed to stimulate ovulation. In some cases, injectable medications may be necessary, but this should be discussed with your healthcare provider.

In summary, while your current state of PCOS appears manageable, it is essential to maintain a healthy lifestyle, monitor your symptoms, and consult with your healthcare provider as you prepare for pregnancy. Regular follow-ups can help ensure that any changes in your condition are addressed promptly, and they can provide guidance on fertility treatments if necessary. Remember, many women with PCOS successfully conceive and have healthy pregnancies with the right support and management.

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