Is Pregnancy Possible With PCOS?
Polycystic Ovary Syndrome, or PCOS, is a big name for a relatively common problem in people with ovaries. Dr. Adeeti Gupta explores PCOS and if pregnancy can still be possible if you struggle with PCOS.
Featured Speaker:
Adeeti Gupta, MD, FACOG
Dr. Adeeti Gupta has been a practicing OB/GYN in the NY area for over 15 years. She trained in India and the UK and graduated from Flushing Hospital in 2004. After graduation, she stayed on as faculty and Associate program director before turning on her entrepreneurial spirit to become the founder of the nation’s first-ever Walk-In Centers for Women’s health. She pioneered this concept and currently has five busy locations in NYC and surrounding boroughs. She also specializes in sexual health and Integrative Medicine. Caring for all women with compassion and women’s empowerment through preventative holistic health care are some of the core values that she promulgates. She is also actively involved in teaching residents, mentoring students, nurse practitioners, physician assistants and other providers to improve access and quality of women’s health by education one small step at a time. Additionally, Dr. Gupta is the Director of Performance Improvement and Quality Control. As part of her role, she conducts various PI projects to help improve outcomes in gynecologic care. Finally, Dr. Gupta is a Presidential Leadership Scholar who strives to change women’s health and build a better future for all. Transcription:
Is Pregnancy Possible With PCOS?
Caitlin Whyte (Host): Polycystic ovary syndrome or PCOS is a big name for a relatively common problem in people with ovaries. So, what does it mean? And can you get pregnant if you have PCOS? To help us answer these questions, we are joined by Dr. Adeeti Gupta, an OB GYN and the Director of Performance Improvement and Quality Control at Flushing Hospital.
This is Flushing Hospital Med Talk. I'm your host, Caitlin Whyte. Doctor, to start us off, can you just explain to our listeners what PCOS is?
Adeeti Gupta, MD, FACOG (Guest): That's a long question, but I will try to give it a, you know, in concise, cause I obviously see a lot of women dealing with this condition.
Host: Of course, yeah.
Dr. Gupta: The full form is polycystic ovarian syndrome. The key is to understand the difference between disease and syndrome. So, syndrome means it's just a compilation of various things that contribute towards a condition called PCOS. By definition, it means that you have irregular periods, which are spaced out, excessive hair growth in parts of the body where you don't want that hair growth, for example, you know, around your belly or on your face and polycystic ovaries on ultrasound. Which means that when you do an ultrasound on the ovaries, instead of seeing one egg every month, you see a whole bunch of eggs that are not ready for ovulation. So, that's the clinical definition.
Host: Gotcha. Okay. And do we know what causes PCOS at all?
Dr. Gupta: It's a chicken and egg situation. So, for years, researchers have been trying to find out what exactly causes it. At this point, it's related to insulin resistance, which is kind of what happens in diabetes as well. By insulin resistance, it means that you have glucose going, trying to get into the body, but the insulin doesn't allow the glucose to get into the cells. As a result, you develop symptoms, which are almost similar to how it would be in diabetes. So, you'll get overweight, you have increased waistline, you can get high blood pressure, and this is all called metabolic syndrome. So, the insulin resistance also causes hormonal imbalance between estrogen and progesterone.
So, that's why it's a chicken and egg situation because estrogen dominance or increase in estrogen leads to insulin resistance and insulin resistance leads in exchange to estrogen dominance. So, hence all the features of PCOS start showing in our body.
Host: Now, what are some symptoms that might tip someone off that they might be experiencing PCOS?
Dr. Gupta: It can start off as just excessive hair growth and acne sometimes. I don't know when people are going through puberty, obviously these are normal features, but if this keeps going on and it starts to get associated with irregular periods, meaning the periods start to get spaced out. And the girls start to gain a little bit of weight around the waistline then, yes PCOS could be starting.
Host: Okay. Are there any complications that are involved with PCOS?
Dr. Gupta: So, PSOS is a spectrum. It's, you know, I get a lot of women asking, oh gosh, I have PCOS now, what's going to happen. So it's a spectrum. It can start from nothing to being very severe and a very severe case would be no periods at all, extremely overweight, lots of hair growth. And the very early symptoms, as I said, could be just slight increase in hair growth and irregular periods. So, it can easily be that the pendulum can easily be swung from the severe condition to the very mild condition. So yes, there is treatment and it's mainly a lifestyle condition. So, if we detect it early, we can absolutely control it very easily with lifestyle and medication changes.
Host: Now talking about the reproductive system, is pregnancy possible with a condition like this?
Dr. Gupta: Absolutely. Just so, just to explain to people why the chances of pregnancy are low in PCOS, if it's severe, is, as I said, the hormone imbalance causes estrogen to just keep going up and up and up and the body doesn't have enough progesterone. So ovulation doesn't happen. But if we control the syndrome and, you know, swing the pendulum to the early side, then we can control it. And pregnancy can absolutely happen. Even small lifestyle changes like, you know, trying to reduce the weight and increasing your activity by just 15, 20 minutes every day can help in spontaneous ovolution, meaning without medication you can ovulate, or we have a lot of medications that we can give nowadays to ovulate. So we have a lot of things in our arsenal that can help women nowadays.
Host: So with all of this talk of signs and symptoms, when should a patient reach out to their doctor, if they suspect that they have PCOS?
Dr. Gupta: When they start to notice a change in their menstrual cycle, you know, even if it starts to get delayed by one or two days, they start to see an increase in hair growth, sometimes they even start to feel like more breast tenderness or increase in their abdominal circumference. They should start to seek out their doctor. And the doctors also should be more aware, you know, when women come for regular checkups or even just a missed cycle and stuff, they should definitely work up the women for PCOS right away, instead of, you know, waiting and just telling them, go check your, go wait for your cycles to come, ex cetera.
Host: Absolutely. And as we wrap up here, Doctor, what are some possible treatment options and the importance of timely treatment?
Dr. Gupta: Timely treatment is important because we don't want the pendulum to swing all the way to the extreme side, because then it's hard to bring the body back. Right? And the treatment options I like to go through the entire spectrum. One is, the first is lifestyle. My acronym is LAMP. So lifestyle condition is increasing your physical activity, monitoring your diet so that you consume a lot of green vegetables, at least three bowls of green vegetables every day. And then alternative therapies like natural supplements, like berberine inositol have now been shown to increase fertility and help with insulin resistance. Mental wellness is extremely important because if you're stressed and your body and the whole brain vagina axis does not work correctly. So estrogen progesterone balance is affected. Then physical wellness as we talked about exercise and then medications we can give for ovulation induction are metformin as well as clomiphene, but that should all be given under Doctor guidance. And social wellness is extremely important where women who are suffering from this condition, they all feel alone and they feel like it's the end of the world. So support is extremely important. So that's my LAMPS acronym to help women negotiate PCOS.
Host: I love that. Well, Doctor, is there anything else that we didn't discuss today that you'd want listeners to know about PCOS?
Dr. Gupta: I just want women to not feel alone, ask for help. There are a lot of resources out there and it is really an easy fix, but we just need to detect it and start early.
Host: Well, thank you for joining us today, Doctor. We so appreciate your time. For more information, or to make an appointment with an obstetrician or gynecologist at Flushing Hospital, please call 718-670-8992. That's 718-670-8992. This has been Flushing Hospital Med Talk. I'm your host, Caitlin Whyte. Be well.
Is Pregnancy Possible With PCOS?
Caitlin Whyte (Host): Polycystic ovary syndrome or PCOS is a big name for a relatively common problem in people with ovaries. So, what does it mean? And can you get pregnant if you have PCOS? To help us answer these questions, we are joined by Dr. Adeeti Gupta, an OB GYN and the Director of Performance Improvement and Quality Control at Flushing Hospital.
This is Flushing Hospital Med Talk. I'm your host, Caitlin Whyte. Doctor, to start us off, can you just explain to our listeners what PCOS is?
Adeeti Gupta, MD, FACOG (Guest): That's a long question, but I will try to give it a, you know, in concise, cause I obviously see a lot of women dealing with this condition.
Host: Of course, yeah.
Dr. Gupta: The full form is polycystic ovarian syndrome. The key is to understand the difference between disease and syndrome. So, syndrome means it's just a compilation of various things that contribute towards a condition called PCOS. By definition, it means that you have irregular periods, which are spaced out, excessive hair growth in parts of the body where you don't want that hair growth, for example, you know, around your belly or on your face and polycystic ovaries on ultrasound. Which means that when you do an ultrasound on the ovaries, instead of seeing one egg every month, you see a whole bunch of eggs that are not ready for ovulation. So, that's the clinical definition.
Host: Gotcha. Okay. And do we know what causes PCOS at all?
Dr. Gupta: It's a chicken and egg situation. So, for years, researchers have been trying to find out what exactly causes it. At this point, it's related to insulin resistance, which is kind of what happens in diabetes as well. By insulin resistance, it means that you have glucose going, trying to get into the body, but the insulin doesn't allow the glucose to get into the cells. As a result, you develop symptoms, which are almost similar to how it would be in diabetes. So, you'll get overweight, you have increased waistline, you can get high blood pressure, and this is all called metabolic syndrome. So, the insulin resistance also causes hormonal imbalance between estrogen and progesterone.
So, that's why it's a chicken and egg situation because estrogen dominance or increase in estrogen leads to insulin resistance and insulin resistance leads in exchange to estrogen dominance. So, hence all the features of PCOS start showing in our body.
Host: Now, what are some symptoms that might tip someone off that they might be experiencing PCOS?
Dr. Gupta: It can start off as just excessive hair growth and acne sometimes. I don't know when people are going through puberty, obviously these are normal features, but if this keeps going on and it starts to get associated with irregular periods, meaning the periods start to get spaced out. And the girls start to gain a little bit of weight around the waistline then, yes PCOS could be starting.
Host: Okay. Are there any complications that are involved with PCOS?
Dr. Gupta: So, PSOS is a spectrum. It's, you know, I get a lot of women asking, oh gosh, I have PCOS now, what's going to happen. So it's a spectrum. It can start from nothing to being very severe and a very severe case would be no periods at all, extremely overweight, lots of hair growth. And the very early symptoms, as I said, could be just slight increase in hair growth and irregular periods. So, it can easily be that the pendulum can easily be swung from the severe condition to the very mild condition. So yes, there is treatment and it's mainly a lifestyle condition. So, if we detect it early, we can absolutely control it very easily with lifestyle and medication changes.
Host: Now talking about the reproductive system, is pregnancy possible with a condition like this?
Dr. Gupta: Absolutely. Just so, just to explain to people why the chances of pregnancy are low in PCOS, if it's severe, is, as I said, the hormone imbalance causes estrogen to just keep going up and up and up and the body doesn't have enough progesterone. So ovulation doesn't happen. But if we control the syndrome and, you know, swing the pendulum to the early side, then we can control it. And pregnancy can absolutely happen. Even small lifestyle changes like, you know, trying to reduce the weight and increasing your activity by just 15, 20 minutes every day can help in spontaneous ovolution, meaning without medication you can ovulate, or we have a lot of medications that we can give nowadays to ovulate. So we have a lot of things in our arsenal that can help women nowadays.
Host: So with all of this talk of signs and symptoms, when should a patient reach out to their doctor, if they suspect that they have PCOS?
Dr. Gupta: When they start to notice a change in their menstrual cycle, you know, even if it starts to get delayed by one or two days, they start to see an increase in hair growth, sometimes they even start to feel like more breast tenderness or increase in their abdominal circumference. They should start to seek out their doctor. And the doctors also should be more aware, you know, when women come for regular checkups or even just a missed cycle and stuff, they should definitely work up the women for PCOS right away, instead of, you know, waiting and just telling them, go check your, go wait for your cycles to come, ex cetera.
Host: Absolutely. And as we wrap up here, Doctor, what are some possible treatment options and the importance of timely treatment?
Dr. Gupta: Timely treatment is important because we don't want the pendulum to swing all the way to the extreme side, because then it's hard to bring the body back. Right? And the treatment options I like to go through the entire spectrum. One is, the first is lifestyle. My acronym is LAMP. So lifestyle condition is increasing your physical activity, monitoring your diet so that you consume a lot of green vegetables, at least three bowls of green vegetables every day. And then alternative therapies like natural supplements, like berberine inositol have now been shown to increase fertility and help with insulin resistance. Mental wellness is extremely important because if you're stressed and your body and the whole brain vagina axis does not work correctly. So estrogen progesterone balance is affected. Then physical wellness as we talked about exercise and then medications we can give for ovulation induction are metformin as well as clomiphene, but that should all be given under Doctor guidance. And social wellness is extremely important where women who are suffering from this condition, they all feel alone and they feel like it's the end of the world. So support is extremely important. So that's my LAMPS acronym to help women negotiate PCOS.
Host: I love that. Well, Doctor, is there anything else that we didn't discuss today that you'd want listeners to know about PCOS?
Dr. Gupta: I just want women to not feel alone, ask for help. There are a lot of resources out there and it is really an easy fix, but we just need to detect it and start early.
Host: Well, thank you for joining us today, Doctor. We so appreciate your time. For more information, or to make an appointment with an obstetrician or gynecologist at Flushing Hospital, please call 718-670-8992. That's 718-670-8992. This has been Flushing Hospital Med Talk. I'm your host, Caitlin Whyte. Be well.