This week, we’re helping to raise understanding about infertility by recognizing National Infertility Awareness Week. One in eight couples of childbearing age is diagnosed with infertility, and for women, polycystic ovary syndrome (PCOS) is a leading cause. It is a hormonal imbalance accompanied by two of three characteristics: overproduction of androgens (male hormones); irregular menstrual cycles; and an ultrasound that shows ovaries with tiny follicles that look like cysts but are not. PCOS affects six to eight percent of women of childbearing age.
The signs of PCOS vary greatly among women. Some have excessive hair growth in a male pattern, as well as weight gain, acne, and scalp hair loss. Others have insulin resistance that may lead to diabetes, with lipid disorders and high blood pressure. The good news is that women with PCOS can and do get pregnant, but conception often means an unpleasant ordeal of tests, procedures, cycle tracking, and medications, not to mention cost.
Lifestyle interventions (i.e. healthy eating and activity) that help control weight are a cornerstone of PCOS treatment. Having too much body fat and eating too many carbohydrates aggravates insulin resistance and hormonal imbalance. The diet for PCOS should have only the number of calories that it takes to maintain a healthy weight and carbohydrates should not contribute more than 40 to 50 percent of total calories.
To improve insulin sensitivity, it is best to space carbohydrates evenly throughout the day and to burn the glucose they produce to fuel physical activity. Carbohydrates should come from high fiber vegetables, beans and legumes, and whole grains. Foods containing added sugar, such as candy, sweets and soda, and excessive fruit and juice are discouraged. It is also a good idea to limit fatty animal foods because PCOS is linked to heart disease. Daily exercise for at least 30 minutes is necessary for weight control. A loss only five percent of excess weight can improve pregnancy rates.
When insulin resistance is present, the oral diabetes medication, metformin, is prescribed to reduce blood sugar levels. Metformin, used alone or with other fertility drugs, can restore ovulation and improve pregnancy rates. Herbal remedies are sold to improve insulin sensitivity; however, some herbal remedies may interfere with fertility treatments and so their use should be sanctioned by a doctor.
To learn more about infertility and PCOS, visit RESOLVE: The National Infertility Association website. April 24 and 25 are national Advocacy Days when we are encouraged to call our congressmen in support of the Family Act that creates a tax credit for the out-of-pocket costs associated with infertility treatment.