Content Warning: weight loss, diet, exercise, pregnancy.
Those of you who follow me closely on insta or twitter will already know that I finally got a positive pregnancy test result back in May. It’s been a long journey, almost two years of trying, but it finally happened. When I got that result I didn’t really believe it until I had my first scan. I thought because it must have been a false positive, or a phantom pregnancy. I was waiting for a doctor to gently break the news to me that it is all in my head. I’m 14 weeks pregnant now, past the first trimester, with a bit of a bump beginning to show. I’ve had three scans, each one showing a live fetus, and it still doesn’t feel real to me. I’m hoping when I begin to feel it move inside me I’ll start to trust that it’s actually happening.
I have a lot I want to talk about regarding pregnancy, but I want this post to be a positive one. I thought it’d be nice for people who had been following my conception journey to get to hear the ending. I know there are so many people out there going through their own emotional rollercoaster, trying to navigate sex and their relationship and their emotions every time they get that negative test result. It is really difficult, and can be very isolating as most people don’t feel comfortable discussing their conception journey with friends and family. Know that you are not alone in this.
For the rest of this post I’m going to speculate on what I think helped me get pregnant. Some of these things I would (and did) really hate to receive as advice, and I have no evidence any of it was what actually helped. I’m going to discuss diet and exercise and weight loss, so if these topics are difficult for you, please don’t read this post. I’d hate to make someone feel worse. What I’ll begin by saying, is that everything took a really long time. Unfortunately, if you’ve got PCOS, I think you have to get used to the idea that there is no quick way to get pregnant (without fertility treatment).
My own brand of PCOS
PCOS, like many disorders that only affect people with ovaries, is poorly researched and under funded. Most of what you can read about is regarding fertility or weight loss. No one even seems to have a good idea of what the underlying processes are that cause the huge range of symptoms, or what causes PCOS in the first place. They think there is a genetic component, as it tends to run in families, but not always. There doesn’t seem to be any medications that are specific to PCOS, doctors just tend to “borrow” drugs from other better-researched areas, like metaformin (used to manage diabetes) or SSRIs (used to manage depression).
Although PCOS is a common disorder, no research body seems that bothered about funding research in to it, and it’s unlikely anyone with PCOS will get to see a medical expert on it. When I got my diagnosis, my GP even said to me that people with PCOS are generally left alone to get on with it, and to look for advice on the internet. So you really are on your own, unless you go back for help with very specific and narrow symptoms, such as if you develop type 2 diabetes, or you get PMDD (pre-menstrual depressive disorder) that never goes away because your period never starts, or if you get anaemic because you’ve been menstruating for over a month and it shows no sign of stopping.
Another problem with PCOS (and why it is so important that large-scale scientific research is conducted), is that it is a label used to categories a bunch of symptoms, that will not be the same for every person. This means that my PCOS is likely to be very different to someone else’s with the same diagnosis (so would probably need different treatment). To get a diagnosis of PCOS you only need to have 2 out of 3 of the following symptoms: irregular or absent periods, cystic ovaries, excessive hormone levels (which could be causing: male pattern baldness, excessive body hair, acne, excessive sweating). Before I begin talking about what I did to try to conceive, I thought it would be useful to discuss my PCOS symptoms as they were two years ago.
I was someone who hit the jackpot and had all three of symptoms necessary to get a diagnosis of PCOS. My periods were few and far between, with my cycles regularly reaching to 50 to 60 days long. When I went for a diagnostic ultra sound they found that both my ovaries were enlarged and had multiple “cysts” all over them (“cysts” is in quotations because they are not actually cysts; they are underdeveloped egg follicles that never got released. Using the word “cyst” is misleading, and there is a move in medical research community to change the name to something more accurate such as “metabolic hormonal disorder”). My hormone levels were unbalanced, and I have excessive and fast growing body hair, including on places seen as typically “male” such as my stomach, chest and face. I also had a BMI of over 30 (making me clinically obese), low energy, and PMDD. My body tends to “over react” to stress too, meaning I get sick a lot, which I’ve since found out is a PCOS thing (inappropriate adrenal response). This was my starting point when I began trying to get pregnant.
When I said I wanted to have children, a GP told me that NHS fertility services wouldn’t help me while my BMI was over 30 (this was before I was even thinking about fertility treatment, but I guess the doctor knew that many people with PCOS need medical help to conceive). She told me that I have insulin resistance, which puts me at a high risk of developing type 2 diabetes. Basically, one of the things PCOS does is mess with your insulin, meaning you don’t process sugars the way you should. Some people with PCOS control this by taking medication, but I was told to try controlling it with diet first.
I was told to cut out all high sugar and high carb foods. I took this very seriously and went cold turkey pretty much over night. I cut out all sugary treats, drinks and cereals, all bread, pasta, rice, potatoes and anything made with wheat flour. I cut out almost all alcohol, although this was more from necessarily; without all those carbs I found I would get intoxicated too quickly and have a headache the next day, so I just stopped drinking more than one glass socially.
This wasn’t easy, I had strong cravings and I found my diet was really limited. I’ve never eaten meat, and I wasn’t about to start now, which meant I had less options than meat-eaters who opt for a low-carb diet. When the craving for a particular food did get really bad, I’d just let myself eat it rather than waste my energy obsessing over it. I was in general eating a lot healthier, I’d have a boiled egg for breakfast, and natural unsweetened yogurt with fresh fruit for a snack, or some cooked vegetarian sausages. I’d eat more vegetables to make up for lack of a carb on my plate.
The point of the diet was to give me more energy, reduce my risk of developing type 2 diabetes, and get my BMI below 30. I did achieve all of that, although my energy levels remained low, they were slightly better than they have been. I lost 3 stone in about four months, which put my weight back in the “healthy” BMI range (I don’t agree that weight is any way related to health, so I dislike this categorisation). My weight then stayed relatively stable, dropping a few pounds here and there very gradually. After about 6 to 8 months of being a stable weight, I began to add carbs back in to my diet. Basically, I still avoided white rice, potatoes and anything made with white wheat flour, but I began to eat wholemeal products, such as wholemeal bread. I found wholemeal noodles and pasta made from milled peas. I really got into Besan pancakes (Indian spiced pancakes made from milled chickpeas). This gave some more diversity back in to my diet, along with the help of a few good cookbooks. I think I could have started off this way, choosing wholemeal carbs rather than cutting out all carb-based foods all together, as processing sugar is the main problem my body has.
I’m not sure if changing my diet improved my PCOS symptoms at all. I know my body hair was just as prevalent as ever. But my periods, in general (there was a few 50 + day cycle exceptions) began to occur more often, which suggested it was helping.
This is a topic that I find difficult to write about. My whole life people have been getting at me to do more exercise, and I hated it. Family members were using it as code for “loose weight”, and fitness fanatics just couldn’t comprehend that exercise could make me feel worse, not better. It’s true: I’d often get a real depressive low after a work out, rather than the endorphin rush everyone promises you will be there. I’d settled in to regular walks as a way to keep active, and avoided intense exercise all together.
However, I had read that regular intense exercise can help reduces PCOS symptoms, including improving fertility. After a year and a half of being on my low-sugar diet, and still with no positive pregnancy test, I sucked up all the negative feelings I had about exercise and got a gym membership. This was a tough decision, because I couldn’t really afford an extra expense, but I knew if I was going to actually stick to an exercise routine I needed to make it as convenient as possible. I couldn’t join a class because I knew if my fatigue or depression was bad I simply wouldn’t go to the class, whereas with a gym I could go whenever the mood took me.
It worked! I quickly started going three or four times a week. I spent about 45 mins on cardio machines like a cross trainer or bike, and about 20 mins doing upper body weights and floor exercises for core strength. I didn’t do leg weights because I have a problem with my knee joints. I could watch my favourite shows on netflix whilst I was doing cardio, and that really helped me stick at it. I don’t think it’s particularly important for anyone to follow a specific exercise routine, as long as you’re doing a mix of cardio and strengthening.
I wouldn’t say I enjoyed it, I could still feel really bad after, and would just go home and crash on the sofa for what was left of the day. But I was motivated, for the first time in my life, by the desire to have a baby, and to do all I could to increase my chances.
As with my diet, I did start to see improvements in my cycle. I wasn’t sure it was all that positive at first though. Basically, I started having menstrual bleeding far too often, as in my cycles were too short for me to be ovulating, rather than too long. I’m not sure why this happened; my body must have just been reacting to the changes the metabolic demands I was putting on it, creating a different hormonal balance. Perhaps if I had continued in the same routine for a year I would have seen my cycles settle in to some regularity. However, about 4 months in, I was finally pregnant!
Throughout all of these changes I was also tracking my fertility and trying to time sex for the most fertile days. I used a first in the morning before getting out of bed basal body temperature reading (oral), which I tracked using an app on my phone, and I used a resting heart rate monitor taken by a fitbit. If you want to know more about these methods, you can have a read of this post where I go in to detail about them.
Basically, all these methods do is try to predict your cycle. I found they were most useful to me to tell me if it was likely that I had ovulated, rather than predicting the actual day of ovulation in advance. The irregularity of my cycles just didn’t allow for accurate prediction. I still found it helpful to track my body changes, as I could see clear cycles in the data, although they differed in length.
I also took a pregnancy vitamin. It contained zinc, folic acid, vitamin D and iron, among other things. I didn’t spend a lot of money buying fertility vitamins, I just brought the standard supermarket brand pregnancy care multi vitamin. I was taking them daily for about a year and a half before I got pregnant, and continue to take them now. I’ve no idea if they helped at all, but I don’t think they hurt.
I can’t say for sure if any of the things I have mentioned actually did any good, or whether after 2 years of trying we finally just got lucky. PCOS is such a poorly understood disorder, due to lack of research and lack of funding, I don’t think there is any real consensus on what will help, and when you’ve been struggling with your symptoms or with fertility, that’s a really difficult thing to hear. I’d like to think in the future a team of doctors and scientists will get all the funding they need to do a lot of research in to it and finally create some solutions that are specific to PCOS that can improve the quality of life of people who have this disorder. For now though, in my experience, doctors will just leave you to it, and it’s up to you to do your own research. I’m hoping that by sharing my own experience I could help other people who are looking for help and advice.
I will also say that I did go to my doctor about infertility and was referred to the fertility clinic at my hospital. However, I wasn’t eligible for any NHS funded treatment due to my partner’s immigration status, and we simply couldn’t afford to fund the treatment ourselves. I know this is a useful option for a lot of people with PCOS though, and sometimes just a simple course of Clomid, a drug that helps people with PCOS to ovulate, is all they need to get pregnant.
When I started writing this post I was 14 weeks pregnant, and still very much anxious about miscarriage (people with PCOS have a higher rate of miscarriage than the general population, a saddening statistic given that most of them take a long time to get pregnant in the first place). As I finish writing it today, I am 25 weeks pregnant, and no longer so worried. I can feel my fetus moving inside me, reassuring me that they are okay, and in just 3 more weeks they would have an 80% survival rate if born that early. I am hopeful and I am happy.
If you’d like to help me out with the huge expense that is getting all you need to set up for a baby, you can gift me something off my baby amazon wishlist here or you can PayPal me a small amount here. I am very grateful for all contributions, I don’t have much money and I’m facing the daunting fact that I’ll have to live off even less whilst on maternity leave, whilst somehow finding the cash for the extra things a baby needs.