Can you develop pcos after pregnancy

Polycystic ovary syndrome | Office on Women's Health

Polycystic ovary syndrome (PCOS) is a health problem that affects 1 in 10 women of childbearing age. Women with PCOS have a hormonal imbalance and metabolism problems that may affect their overall health and appearance. PCOS is also a common and treatable cause of infertility.

What is polycystic ovary syndrome (PCOS)?

Polycystic ovary syndrome (PCOS), also known as polycystic ovarian syndrome, is a common health problem caused by an imbalance of reproductive hormones. The hormonal imbalance creates problems in the ovaries. The ovaries make the egg that is released each month as part of a healthy menstrual cycle. With PCOS, the egg may not develop as it should or it may not be released during ovulation as it should be.

PCOS can cause missed or irregular menstrual periods. Irregular periods can lead to:

• Infertility (inability to get pregnant). In fact, PCOS is one of the most common causes of infertility in women.
• Development of cysts (small fluid-filled sacs) in the ovaries

Who gets PCOS?

Between 5% and 10% of women between 15 and 44, or during the years you can have children, have PCOS.¹ Most women find out they have PCOS in their 20s and 30s, when they have problems getting pregnant and see their doctor. But PCOS can happen at any age after puberty.²

Women of all races and ethnicities are at risk of PCOS. Your risk of PCOS may be higher if you have obesity or if you have a mother, sister, or aunt with PCOS.

What are the symptoms of PCOS?

Some of the symptoms of PCOS include:

• Irregular menstrual cycle. Women with PCOS may miss periods or have fewer periods (fewer than eight in a year). Or, their periods may come every 21 days or more often. Some women with PCOS stop having menstrual periods.
• Too much hair on the face, chin, or parts of the body where men usually have hair. This is called "hirsutism." Hirsutism affects up to 70% of women with PCOS.³
• Acne on the face, chest, and upper back
• Thinning hair or hair loss on the scalp; male-pattern baldness
• Weight gain or difficulty losing weight
• Darkening of skin, particularly along neck creases, in the groin, and underneath breasts
• Skin tags, which are small excess flaps of skin in the armpits or neck area

What causes PCOS?

The exact cause of PCOS is not known. Most experts think that several factors, including genetics, play a role:

• High levels of androgens. Androgens are sometimes called "male hormones," although all women make small amounts of androgens. Androgens control the development of male traits, such as male-pattern baldness. Women with PCOS have more androgens than normal. Higher than normal androgen levels in women can prevent the ovaries from releasing an egg (ovulation) during each menstrual cycle, and can cause extra hair growth and acne, two signs of PCOS.
• High levels of insulin. Insulin is a hormone that controls how the food you eat is changed into energy. Insulin resistance is when the body's cells do not respond normally to insulin. As a result, your insulin blood levels become higher than normal. Many women with PCOS have insulin resistance, especially those who have overweight or obesity, have unhealthy eating habits, do not get enough physical activity, and have a family history of diabetes (usually type 2 diabetes). Over time, insulin resistance can lead to type 2 diabetes.

Can I still get pregnant if I have PCOS?

Yes. Having PCOS does not mean you can't get pregnant. PCOS is one of the most common, but treatable, causes of infertility in women. In women with PCOS, the hormonal imbalance interferes with the growth and release of eggs from the ovaries (ovulation). If you don't ovulate, you can't get pregnant.

Your doctor can talk with you about ways to help you ovulate and to raise your chance of getting pregnant.  You can also use our Ovulation Calculator to see which days in your menstrual cycle you are most likely to be fertile.

Is PCOS linked to other health problems?

Yes, studies have found links between PCOS and other health problems, including:

• Diabetes. More than half of women with PCOS will have diabetes or prediabetes (glucose intolerance) before the age of 40.⁴ Learn more about diabetes on our Diabetes page.
• High blood pressure. Women with PCOS are at greater risk of having high blood pressure compared with women of the same age without PCOS. High blood pressure is a leading cause of heart disease and stroke. Learn more about heart disease and stroke.
• Unhealthy cholesterol. Women with PCOS often have higher levels of LDL (bad) cholesterol and low levels of HDL (good) cholesterol. High cholesterol raises your risk of heart disease and stroke.
• Sleep apnea. This is when momentary and repeated stops in breathing interrupt sleep. Many women with PCOS have overweight or obesity, which can cause sleep apnea. Sleep apnea raises your risk of heart disease and diabetes.
• Depression and anxiety. Depression and anxiety are common among women with PCOS.
• Endometrial cancer. Problems with ovulation, obesity, insulin resistance, and diabetes (all common in women with PCOS) increase the risk of developing cancer of the endometrium (lining of the uterus or womb).

Researchers do not know if PCOS causes some of these problems, if these problems cause PCOS, or if there are other conditions that cause PCOS and other health problems.

Will my PCOS symptoms go away at menopause?

Yes and no. PCOS affects many systems in the body. Many women with PCOS find that their menstrual cycles become more regular as they get closer to menopause. However, their PCOS hormonal imbalance does not change with age, so they may continue to have symptoms of PCOS.

Also, the risks of PCOS-related health problems, such as diabetes, stroke, and heart attack, increase with age. These risks may be higher in women with PCOS than those without.

How is PCOS diagnosed?

There is no single test to diagnose PCOS. To help diagnose PCOS and rule out other causes of your symptoms, your doctor may talk to you about your medical history and do a physical exam and different tests:

• Physical exam. Your doctor will measure your blood pressure, body mass index (BMI), and waist size. They will also look at your skin for extra hair on your face, chest or back, acne, or skin discoloration. Your doctor may look for any hair loss or signs of other health conditions (such as an enlarged thyroid gland).
• Pelvic exam. Your doctor may do a pelvic exam for signs of extra male hormones (for example, an enlarged clitoris) and check to see if your ovaries are enlarged or swollen.
• Pelvic ultrasound (sonogram). This test uses sound waves to examine your ovaries for cysts and check the endometrium (lining of the uterus or womb).
• Blood tests. Blood tests check your androgen hormone levels, sometimes called "male hormones." Your doctor will also check for other hormones related to other common health problems that can be mistaken for PCOS, such as thyroid disease. Your doctor may also test your cholesterol levels and test you for diabetes.

Once other conditions are ruled out, you may be diagnosed with PCOS if you have at least two of the following symptoms:⁵

• Irregular periods, including periods that come too often, not often enough, or not at all
• Signs that you have high levels of androgens:
  • Extra hair growth on your face, chin, and body (hirsutism)
  • Acne
  • Thinning of scalp hair
• Higher than normal blood levels of androgens
• Multiple cysts on one or both ovaries

How is PCOS treated?

There is no cure for PCOS, but you can manage the symptoms of PCOS. You and your doctor will work on a treatment plan based on your symptoms, your plans for having children, and your risk of long-term health problems such as diabetes and heart disease. Many women will need a combination of treatments, including:

• Steps you can take at home to help relieve your symptoms
• Medicines

What steps can I take at home to improve my PCOS symptoms?

You can take steps at home to help your PCOS symptoms, including:

• Losing weight. Healthy eating habits and regular physical activity can help relieve PCOS-related symptoms. Losing weight may help to lower your blood glucose levels, improve the way your body uses insulin, and help your hormones reach normal levels. Even a 10% loss in body weight (for example, a 150-pound woman losing 15 pounds) can help make your menstrual cycle more regular and improve your chances of getting pregnant.³ Learn more about healthy weight.
• Removing hair. You can try facial hair removal creams, laser hair removal, or electrolysis to remove excess hair. You can find hair removal creams and products at drugstores. Procedures like laser hair removal or electrolysis must be done by a doctor and may not be covered by health insurance.
• Slowing hair growth. A prescription skin treatment (eflornithine HCl cream) can help slow down the growth rate of new hair in unwanted places.

What types of medicines treat PCOS?

The types of medicines that treat PCOS and its symptoms include:

• Hormonal birth control, including the pill, patch, shot, vaginal ring, and hormone intrauterine device (IUD). For women who don't want to get pregnant, hormonal birth control can:
  • Make your menstrual cycle more regular
  • Lower your risk of endometrial cancer
  • Help improve acne and reduce extra hair on the face and body (Ask your doctor about birth control with both estrogen and progesterone.)
• Anti-androgen medicines. These medicines block the effect of androgens and can help reduce scalp hair loss, facial and body hair growth, and acne. They are not approved by the Food and Drug Administration (FDA) to treat PCOS symptoms. These medicines can also cause problems during pregnancy.
• Metformin. Metformin is often used to treat type 2 diabetes and may help some women with PCOS symptoms. It is not approved by the FDA to treat PCOS symptoms. Metformin improves insulin's ability to lower your blood sugar and can lower both insulin and androgen levels. After a few months of use, metformin may help restart ovulation, but it usually has little effect on acne and extra hair on the face or body. Recent research shows that metformin may have other positive effects, including lowering body mass and improving cholesterol levels.

What are my treatment options for PCOS if I want to get pregnant?

You have several options to help your chances of getting pregnant if you have PCOS:

• Losing weight. If you have overweight or obesity, losing weight through healthy eating and regular physical activity can help make your menstrual cycle more regular and improve your fertility. Find a personalized healthy eating plan using the MyPlate Plan tool.
• Medicine. After ruling out other causes of infertility in you and your partner, your doctor might prescribe medicine to help you ovulate, such as clomiphene (Clomid).
• In vitro fertilization (IVF). IVF may be an option if medicine does not work. In IVF, your egg is fertilized with your partner's sperm in a laboratory and then placed in your uterus to implant and develop. Compared to medicine alone, IVF has higher pregnancy rates and better control over your risk of having twins and triplets (by allowing your doctor to transfer a single fertilized egg into your uterus).
• Surgery. Surgery is also an option, usually only if the other options do not work. The outer shell (called the cortex) of ovaries is thickened in women with PCOS and thought to play a role in preventing spontaneous ovulation. Ovarian drilling is a surgery in which the doctor makes a few holes in the surface of your ovary using lasers or a fine needle heated with electricity. Surgery usually restores ovulation, but only for 6 to 8 months.

Read more about treating infertility in PCOS.

How does PCOS affect pregnancy?

PCOS can cause problems during pregnancy for you and for your baby. Women with PCOS have higher rates of:⁶

• Miscarriage
• Gestational diabetes
• Preeclampsia
• Cesarean section (C-section)

Your baby also has a higher risk of being heavy (macrosomia) and of spending more time in a neonatal intensive care unit (NICU).

How can I prevent problems from PCOS during pregnancy?

You can lower your risk of problems during pregnancy by:

• Reaching a healthy weight before you get pregnant. Use this interactive tool to see your healthy weight before pregnancy and what to gain during pregnancy.
• Reaching healthy blood sugar levels before you get pregnant. You can do this through a combination of healthy eating habits, regular physical activity, weight loss, and medicines such as metformin.
• Taking folic acid. Talk to your doctor about how much folic acid you need.

What is the latest research on PCOS?

Researchers continue to search for new ways to treat PCOS. Some current studies focus on:

• Genetics and PCOS
• Environmental exposure and PCOS risk
• Ethnic and racial differences in PCOS symptoms
• Medicines and supplements to restart ovulation
• Obesity and its link to PCOS
• Health risks for children of women with PCOS

To learn more about current PCOS treatment studies, visit ClinicalTrials.gov.

Did we answer your question about PCOS?

For more information on PCOS, call the OWH Helpline at 1-800-994-9662 or contact the following organizations:

• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), NIH, HHS
  Phone Number: 1-800-370-2943
• American Association of Clinical Endocrinologists
  Phone Number: 904-353-7878
• American College of Obstetricians and Gynecologists
  Phone Number: 1-800-673-8444
• American Society for Reproductive Medicine
  Phone Number: 205-978-5000
• InterNational Council on Infertility Information Dissemination, Inc.
  Phone Number: 703-379-9178
• PCOS Foundation
  Phone Number: 713-487-7267
• PCOS Awareness Association
• PCOS Challenge

Sources

1. Trivax, B., & Azziz, R. (2007). Diagnosis of polycystic ovary syndrome. Clinical Obstetrics and Gynecology, 50(1), 168–177.
2. Bremer, A. A. (2010). Polycystic ovary syndrome in the pediatric population. Metabolic Syndrome and Related Disorders, 8(5), 375–394.
3. American College of Obstetricians and Gynecologists. (2015). Polycystic ovary syndrome.
4. Lorenz, L. B., & Wild, R. A. (2007). Polycystic ovarian syndrome: an evidence-based approach to evaluation and management of diabetes and cardiovascular risks for today's clinician. Clinical Obstetrics and Gynecology, 50, 226–243.
5. Goodman, N. F., Cobin, R. H., Futterweit, W., Glueck, J. S., Legro, R. S., & Carmina, E. (2015). American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society disease state clinical review: guide to the best practices in the evaluation and treatment of polycystic ovary syndrome - part 1. Endocrine Practice, 11, 1291–300.
6. Boomsma, C. M., Fauser, B. C., & Macklon, N.S. (2008). Pregnancy complications in women with polycystic ovary syndrome. Seminars in Reproductive Medicine, 26, 72–84.

The Office on Women's Health is grateful for the medical review by:

• Violanda Grigorescu, M.D., M.S.P.H., Chief, Partnerships and Evaluation Branch, Division of Health Informatics and Surveillance, Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention
• Torie Comeaux Plowden, M.D., M.P.H., Fellow, Reproductive Endocrinology and Infertility, Eunice Kennedy Shriver National Institute of Child Health and Human Development
• Lubna Pal, M.B.B.S., M.R.C.O.G., M.S., F.A.C.O.G., Associate Professor, Director of the Polycystic Ovary Syndrome (PCOS) Program, Department of Obstetrics, Gynecology & Reproductive Sciences, Yale School of Medicine

All material contained on these pages are free of copyright restrictions and maybe copied, reproduced, or duplicated without permission of the Office on Women’s Health in the U. S. Department of Health and Human Services. Citation of the source is appreciated.

Page last updated: February 22, 2021

Polycystic Ovarian Syndrome (PCOS) and Pregnancy: Symptoms

Medically reviewed by Suzanne Falck, M.D., FACP — By Chaunie Brusie on November 1, 2016

Polycystic ovarian syndrome (PCOS) is a condition that affects between 6 and 15 percent of women of childbearing age. If you’re diagnosed with PCOS, it may be more difficult to become pregnant. And if you’re able to become pregnant, you’re at risk for more complications during pregnancy, labor, and delivery.

Women with PCOS are three times more likely to have a miscarriage, as compared to women who don’t have PCOS. They are also more likely to develop preeclampsia, gestational diabetes, and have a larger baby and premature delivery. This could lead to difficulty during delivery or a cesarean delivery.

Risks for moms-to-be with PCOS

Having PCOS might make it harder for you to get pregnant. Hormonal imbalances might be to blame.

Women with PCOS are more likely to be obese and to rely on reproductive technology to get pregnant. One study found that 60 percent of women with PCOS are obese. Almost 14 percent required reproductive technology to get pregnant.

Women with PCOS have an increased risk of developing several medical complications throughout life, including:

• insulin resistance
• type 2 diabetes
• high cholesterol
• high blood pressure
• heart disease
• stroke
• sleep apnea
• possibly an increased risk of endometrial cancer

For pregnant women, PCOS brings an increased risk of complications. This includes preeclampsia, a dangerous condition for both mother and baby-to-be. The recommended treatment to resolve symptoms is delivery of the baby and placenta. Your doctor will discuss the risks and benefits regarding timing of delivery based on the severity of your symptoms and your baby’s gestational age. If you develop preeclampsia during your pregnancy, you will have to be monitored extremely closely. Other concerns include pregnancy-induced hypertension (high blood pressure) and gestational diabetes.

Having gestational diabetes could lead to you having a larger-than-average baby. This could lead to problems during delivery. For example, larger babies are more at risk for shoulder dystocia (when the baby’s shoulder gets stuck during labor).

Most PCOS symptoms during pregnancy can be treated with careful monitoring. If you develop gestational diabetes, insulin may be required to keep your blood sugar levels stable.

Risks for baby

Unfortunately, having PCOS during pregnancy makes things a little more complicated. It will require more monitoring for both you and your baby.

The potential risks with PCOS for the baby include:

• premature birth
• large for gestational age
• imiscarriage
• lower Apgar score

If your baby is a girl, some studies have shown that there is up to a 50 percent chance that she will also have PCOS.

Women with PCOS are also more likely to deliver by cesarean because they tend to have larger-sized babies. Other complications may also come up during labor and delivery.

Getting pregnant with PCOS

Some women may not realize they have PCOS until they try to conceive. PCOS often goes unnoticed. But if you’ve been trying to conceive naturally for over a year, you should speak to your doctor about getting tested.

Your doctor can help you develop a plan for getting pregnant. Some strategies, such as losing weight, healthy eating, and in certain cases, medications, can increase your chances for getting pregnant.

PCOS and breast-feeding

If you’re diagnosed with PCOS, you may need to continue to manage symptoms even after pregnancy. But symptoms and severity can vary. Sometimes the hormonal fluctuations after pregnancy and breast-feeding can change the symptoms, so it may be awhile before you settle into your new “normal.”

It’s safe to breast-feed with PCOS, even if you’re on insulin medication to help control your blood sugar. Women who have gestational diabetes are at risk for developing type 2 diabetes later in life, but breast-feeding can help lower that risk.

Breast-feeding has many benefits for both you and your baby, so if it fits your family, be sure to explore the options and available resources so you can have a successful breast-feeding experience.

What is PCOS?

PCOS, also known as Stein-Leventhal syndrome, is a hormonal imbalance that affects women. It’s characterized by the production of too many androgens, or “male” hormones.

PCOS can cause women to develop excessive hair and acne. It can also cause cysts on the ovaries and interrupt normal menstrual cycles.

It’s a tricky condition because there’s not one single test to diagnose it. Instead, doctors look at the clues of what’s going on in your body. Excessive hair growth or irregular periods might be signs. Doctors can then piece together a picture of PCOS.

PCOS symptoms

PCOS often gets missed in women because of the difficulty of making a diagnosis. The symptoms can vary and occur in many different types of women.

Obesity or weight gain, for example, can be a frequent occurrence with PCOS. But it’s not a given. Many women with PCOS have lean body shapes.

Unfortunately, up to 50 percent of women who have PCOS never actually get diagnosed. Because of this, PCOS is sometimes called the silent killer.

Some of the more common symptoms of PCOS include:

• “string of pearl” cysts on the ovaries
• insulin resistance
• high testosterone causing excessive hair growth, male pattern baldness, and acne
• suppressed ovulation
• excessive weight gain
• weight gain on the waistline
• dark, thick patches of skin on the neck, arms, breasts, or thighs
• skin tags in the armpits or neck area
• pelvic pain
• anxiety or depression
• sleep apnea

Treatment

There’s currently no cure for PCOS. But it’s possible to manage symptoms.

Options to help manage symptoms include:

• birth control pills
• weight loss
• spironolactone
• other androgen blockers

Along with other fertility drugs, metformin, which helps to control blood sugar, is commonly prescribed to help induce ovulation.

Note: You’ll need to stop taking some of these medications if you become pregnant. Work with your doctor to develop a plan that fits your needs.

Next steps

The most important thing to know about PCOS and pregnancy is that complications are very real. That’s why it’s more important than ever to take steps to have a healthy pregnancy.

Talk to your doctor, follow a pregnancy-safe exercise and diet program, and take medication as directed. These are all recommended regimens for controlling PCOS during pregnancy.

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Last medically reviewed on November 2, 2016

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How we vetted this article:

Healthline has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical associations. We avoid using tertiary references. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

• Does PCOS affect pregnancy? (2013, May)
  nichd.nih.gov/health/topics/PCOS/conditioninfo/Pages/pregnancy.aspx
• Mayo Clinic Staff. (2014, September 3). Polycystic ovary syndrome (PCOS)
  mayoclinic.org/diseases-conditions/pcos/basics/treatment/con-20028841
• PCOS pregnancy and delivery complications. (2016)
  pcosaa.org/pcos-pregnancy-and-delivery-complications
• Polycystic ovary syndrome (PCOS) fact sheet. (2014, December)
  
• Roos, N. (2011, October 13).Risk of adverse pregnancy outcomes in women with polycystic ovary syndrome: population based cohort study. British Medical Journal, 343. Retrieved from
  bmj.com/content/343/bmj.d6309
• Trikudanathan, S. (2015, January). Polycystic ovarian syndrome. Medical Clinics of North America, 99(1), 221–235
  ncbi.nlm.nih.gov/pubmed/25456652
• What is polycystic ovary syndrome? (2015)
  pcosfoundation. org/what-is-pcos

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Nov 2, 2016

By

Chaunie Brusie

Edited By

Nizam Khan (TechSpace)

Medically Reviewed By

Suzanne Falck, MD

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Medically reviewed by Suzanne Falck, M.D., FACP — By Chaunie Brusie on November 1, 2016

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