One of the most common symptoms of polyendocrine metabolic ovarian syndrome (PMOS – Formerly known as polycystic ovary syndrome/PCOS) is irregular menstrual cycles. Though there’s a lot more to this condition than missing a period here and there, this is usually one of the first symptoms women with PMOS deal with. Many of us have been trying to regulate our cycles since puberty.
Of course, irregular, heavy, and sometimes painful periods are frustrating enough on their own. However, they can also leave you wondering whether getting pregnant will be more difficult when you’re ready to start a family. The good news? Many women with PMOS conceive naturally and have healthy pregnancies. Please don’t ever think motherhood is out of reach because of your diagnosis!
That said, I’d be lying if I told you PMOS doesn’t make things more challenging for many women. Research suggests that 70–80% of women with PMOS experience some degree of infertility or difficulty conceiving. There can also be additional challenges after conception. However, with the right lifestyle changes, proactive medical care, and close prenatal monitoring, you can improve your fertility, support a healthier pregnancy, and significantly increase your chances of bringing home a healthy baby.
Here’s what you need to know about PMOS and pregnancy:
PMOS and Pregnancy: What to Expect Before, During, and After
Women with PMOS deal with three major root issues driving symptoms: insulin resistance, inflammation, and hormonal imbalance. All three of those feed into one another and cause a long list of chronic symptoms. Think: excess hair growth on the face and body, acne, weight gain, fatigue, mood swings, and more. Of course, as something that’s predominantly hormonal, PMOS also has major impacts on menstrual cycles and pregnancy (which require lots of coordination between hormones).
Because of that, one of the most frequently asked questions I get as a PMOS dietitian is, “How will PMOS impact my fertility?” So, in this post, I’m going to talk about how PMOS can affect the reproductive system and how you can improve fertility and pregnancy outcomes naturally. As someone with PMOS who conceived naturally, I can tell you that your dreams of motherhood are absolutely not out of reach! Let’s talk about it.
Can You Get Pregnant With PMOS?
YES! I am living proof of that. Many women with PMOS conceive naturally, have normal pregnancies, and give birth to healthy babies. However, PMOS can make things more difficult, especially if your condition is unmanaged. (As in, you’re not currently taking any steps to fix the root issues leading to your symptoms.) The hormonal and metabolic dysregulation with PMOS can negatively impact conception, pregnancy, and birth outcomes. Here are some difficult stats on the subject:
- 70–80% of women with PMOS experience infertility or difficulty conceiving.
- PMOS is the leading cause of infertility due to lack of ovulation worldwide.
- Women with PMOS have about a 50% higher odds of miscarriage than women without the condition.
- Women with PMOS are over twice as likely to develop gestational diabetes, preeclampsia, and gestational hypertension.
I know those numbers can feel discouraging, but don’t give up! Even if a doctor told you that you can’t get pregnant with PMOS, you can. Of course you can! Now, if you talked to my OB years ago and told her I’d get pregnant on the first try, she might have kindly explained that it would probably take a while. At the time, my condition was totally out of control. My hair was falling out, I was gaining weight uncontrollably, I wasn’t ovulating, and I was insulin resistant. The situation was bleak!
But since learning how to reverse PMOS, I’ve gotten relief from all my symptoms, anovulation included. I’ve increased my insulin sensitivity, balanced my hormones, and kept inflammation at bay. If I can do it, you can do it, too! I’ll talk more about how below.
And all that said, even if you struggle to get pregnant on your own, there are a lot of fertility treatment options out there to help you reach your goals. Listen to me: You WILL be a mom!
How Does PMOS Affect Fertility?
Interferes with Follicle Development
One of the main hormonal imbalances people with PMOS face is elevated androgen levels. These are male sex hormones, and when they’re too high, the ovaries don’t receive the signals they need to fully mature an egg. Instead, many small follicles develop rather than a single dominant one. Often, these follicles stop growing too early, and no dominant, mature follicle forms at all.
Disrupts Regular Ovulation and Menstrual Cycles
Since there’s no healthy, mature follicle ready to go, the reproductive system doesn’t get the signal to ovulate. More specifically, when there’s no egg ready for fertilization, ovulation doesn’t happen. And since ovulation doesn’t happen, menstruation doesn’t happen either. The body patiently waits for a mature follicle, and you miss another period.
Reduces Endometrial Receptivity
Throughout your menstrual cycle, estrogen and progesterone work together to prepare your uterus for pregnancy. During the first half of your cycle, estrogen helps build up the uterine lining. After ovulation, progesterone transforms that lining into a nutrient-rich environment that’s ready for a fertilized egg to implant.
With PMOS, ovulation often doesn’t happen regularly. Without ovulation, your body doesn’t produce enough progesterone to properly prepare the uterine lining. Instead, estrogen continues stimulating the endometrium without progesterone to balance it. As a result, the lining gets way too thick. That means that even if an egg is fertilized, it’ll be much harder for it to successfully implant in the uterus. This is also why women with PMOS often have heavier, more painful periods. Shedding that thicker lining can be harder and less predictable, which can lead to longer or heavier bleeding when your period finally comes.
Here’s more on what periods are like with PMOS.
Reduces Egg Quality
Healthy eggs need a healthy environment to develop. In PMOS, high androgen levels disrupt the normal signaling between the brain and ovaries that regulates follicle development. As I already discussed, this impacts how the follicles grow.
At the same time, chronic inflammation within the ovarian tissue can damage the cells that support egg development, including the granulosa cells that nourish the egg. Over time, these hormonal and metabolic imbalances can interfere with egg development, making it less likely to be fertilized or to develop into a healthy embryo.
Alters Cervical Mucus
Around ovulation, your cervix normally produces a slippery, egg white-like mucus that helps sperm survive and swim through the reproductive tract to reach the egg. But because PMOS often disrupts ovulation and key hormones like estrogen and progesterone, many women don’t produce this fertile cervical mucus consistently.
Instead, cervical mucus may be thicker, stickier, or simply absent during the fertile window. Without that ideal consistency, sperm have a harder time reaching the egg, making conception less likely.
Increases Chronic Inflammation
Many women with PMOS experience chronic, low-grade inflammation throughout the body. This ongoing inflammation can place stress on the reproductive system. That can then affect the ovaries, developing eggs, and uterine environment.
It may also worsen insulin resistance and hormonal imbalances, creating a cycle that makes ovulation, fertilization, and implantation more difficult. While inflammation isn’t the direct cause of infertility, it can make many of the fertility challenges associated with PMOS worse.
Interested in learning more? Listen to my podcast episode, “Signs of Inflammation, PCOS Q&A, Mistakes to Avoid.”
How to Prepare for Pregnancy If You Have PMOS
When you decide to have a baby, it’s a really exciting time! You may just want to dive in and start trying right away. However, it’s a really good idea to address any underlying health issues first. That way, you create the healthiest environment possible for both you and your future baby.
Taking a few proactive steps before you conceive can improve your chances of getting pregnant, reduce the risk of miscarriage, support a healthier pregnancy, and give your baby the healthiest possible start in life.
And since the question comes up a lot, read my post on the best age to get pregnant with PMOS.
Get off hormonal birth control at least 3 months before you try.
If you’re on some type of hormonal birth control or have a birth control implant, try to be contraception-free for at least three months before trying to conceive. Since birth control suppresses ovulation, it may take a few weeks or months for your natural cycle to return. Plus, it allows you to identify any irregularities or masked symptoms that may need your attention first.
Haven’t researched this topic before? My post can be a helpful place to start! Check out: “What You Need to Know About the IUD and PMOS.”
Schedule a checkup and consider getting bloodwork done.
Go ahead and schedule an appointment with your OB-GYN to discuss your pregnancy plans. They can recommend supplements, lifestyle changes, and other strategies that will give you the best chance of conceiving and having a healthy pregnancy.
While you’re there, I also recommend asking for bloodwork to check your hormone levels. This can help identify any imbalances that may need to be addressed before trying to conceive. If your doctor isn’t willing to order these labs, you can always go through a private company instead. I like this PMOS lab kit from EquiLife.
Start tracking your ovulation and menstrual cycle.
In order to get pregnant, you have to know when it’s possible to conceive. Most women have a six-day fertile window: the five days leading up to ovulation and the day of ovulation itself. To determine when that window is, you’ll need to track your ovulation. There are a lot of ways to do this, including using ovulation predictor kits, taking your basal body temperature, or paying attention to your cervical mucus.
At first, this may feel difficult if your cycles are really irregular. But that’s okay! The goal is to gradually rebalance your hormones and get your cycles back on track. Over time, your cycles may become more regular, making ovulation easier to predict. That’s often a good sign that your fertility and overall health are improving.
For more on this, here’s how to track ovulation with irregular cycles.
Talk to your doctor about prenatal vitamins and a supplement routine.
Supplements are one of the best ways to support your fertility with PMOS, especially when you combine them with the other lifestyle changes on this list. The right supplements can fill nutritional gaps, support healthy hormone balance, improve insulin sensitivity, and create a healthier environment for conception.
Some supplements, such as prenatal vitamins with folic acid, have even been shown to improve pregnancy outcomes! They reduce the risk of neural tube defects, support healthy fetal development, and help meet the increased nutritional demands of pregnancy.
Talk to your doctor before starting anything new. But here are the supplements I recommend women with PMOS consider taking to boost fertility:
- Prenatal Vitamin with Folic Acid: Provides essential vitamins and minerals for a healthy pregnancy while helping reduce the risk of neural tube defects during your baby’s early development
- Inositol Complete 40:1: Supports healthy insulin sensitivity, promotes regular ovulation, and helps improve hormone balance and fertility in women with PMOS
- CoQ10: Improves egg quality, increases chances of conception, and supports early embryo development
- Omega-3 Fatty Acids: Help reduce inflammation, support hormone balance, and promote healthy brain and eye development during pregnancy
Here are some more PMOS supplements to boost fertility.
Establish daily, strategic exercise habits.
Exercise is one of the best ways to improve fertility with PMOS, but the type of exercise you do matters. Cut the high-intensity workouts that put a lot of stress on your body and won’t be sustainable once you get pregnant.
Instead, prioritize slow-weighted strength training. Building lean muscle improves insulin sensitivity. This can help lower androgen levels, encourage more regular ovulation, and create a healthier hormonal environment for conception. Aim to strength train a few times each week, and compliment it with lower-impact movements like walking or yoga!
Adopt a gluten & dairy-free anti-inflammatory diet.
Few things will have a bigger impact on fertility and overall PMOS symptoms than changing the way you eat. We all know the foods we eat affect the way we feel, but that’s even more true when you have PMOS. The wrong foods and eating habits can worsen hormone imbalances, insulin resistance, and chronic inflammation. And all that can intensify PMOS symptoms and create a less supportive environment for conception and a healthy pregnancy.
So, what should you do? I recommend trying a gluten- and dairy-free anti-inflammatory diet. This way of eating isn’t restrictive. Instead, it prioritizes whole foods, lean protein, healthy fats, high-fiber carbohydrates, and plenty of colorful fruits and vegetables. On top of what you eat, make sure you’re not skipping meals and you’re practicing mindful eating.
These nutrition habits can support both a healthy pregnancy and your long-term health. For PMOS-friendly recipes and workout routines that follow these recommendations, download The Cysterhood app.
Stay hydrated and drink herbal teas.
Hydration plays a bigger role in fertility than many people realize. Every cell in your body depends on water to function properly, including the cells involved in hormone production and reproduction. Try to sip water consistently throughout the day, and consider swapping sugary drinks for soothing herbal teas.
There’s a lot of research that shows certain herbs can help support your body like a supplement! One of the best ways to get a bunch of research-backed herbs in one cup is to drink Ovafit’s Testosterone Relief Tea. It’s a strategic PMOS tea blend full of hormone-balancing herbs. It’s perfect for prepping your body for pregnancy!
Prioritize stress management and improve sleep hygiene.
Chronic stress and poor sleep can increase our body’s cortisol levels (AKA the stress hormone). These elevated levels not only make you feel anxious and wired but also throw other hormones out of balance and worsen insulin resistance.
To give your body the right support, aim for seven to nine hours of quality sleep each night and improve your sleep hygiene. You also need to find effective ways to manage stress! Think self-care, walking, journaling, reading, or spending time outdoors. Taking care of your mental health is just as important as taking care of your physical health when you’re preparing for pregnancy.
Know when it’s time to talk to a fertility specialist.
The truth is, even when you’re doing everything right, sometimes we need extra support. There’s no shame in that! If you struggle to get pregnant even after implementing lifestyle changes, tracking your cycle, and taking the right supplements, don’t beat yourself up. This isn’t your fault, and you didn’t do anything to cause it.
If you’re under 35 and haven’t conceived after a year of trying, or you’re 35 or older and have been trying for six months, consider seeing a fertility specialist. Many women with PMOS have had success with treatments like intrauterine insemination (IUI) and in vitro fertilization (IVF). Needing fertility treatment doesn’t mean you’ve failed. It simply means your body needs a little extra help getting to the finish line.
How to Manage PMOS During Pregnancy
Once you get pregnant with PMOS, the race isn’t over! You shouldn’t stress about “doing everything right” and worry about all the “what-ifs” that come with having a baby. However, it’s a good idea to continue making choices that support a healthy pregnancy.
Here are some simple ways you can care for both yourself and your baby throughout pregnancy:
Attend all your prenatal checkups.
This one might seem obvious, but it’s so important to go to every prenatal checkup and participate in every test offered. This is especially true for glucose testing, since women with PMOS are at a much higher risk of gestational diabetes and preeclampsia.
Try to continue a PMOS-friendly, blood-sugar balancing diet.
Try to continue the gluten- and dairy-free anti-inflammatory diet I mentioned earlier. It’ll help you keep your blood sugar in check, maintain energy levels, fight pregnancy cravings, and, most importantly, fuel your body for the journey ahead.
Stay active with pregnancy-safe exercise.
There are a lot of benefits to staying active during pregnancy! With a doctor’s approval, continue doing slow-weighted workouts, light cardio, and meditative exercises. These help with blood sugar management, circulation, pain and discomfort, sleep, and more!
Continue a doctor-approved supplement routine.
Talk to your doctor about continuing your PMOS-supplement routine. Normally, it’s recommended that you continue taking at least your prenatal vitamins with folic acid, iron, and omega-3. They may also recommend a dedicated choline, calcium, and/or magnesium supplement depending on your needs.
Focus on managing stress and worry.
This one is hard when you’re pregnant with PMOS. It can feel like the statistics are stacked against you having a healthy pregnancy. But don’t let the numbers steal your joy. Statistics describe large groups of people; they don’t predict what will happen to you.
Every healthy meal, walk, good night’s sleep, and prenatal appointment is a step toward giving your baby the best possible start. Focus on what you can control, practice stress management, and remember that so many women like me have perfectly healthy babies with PMOS.
Prioritize hydration all day long.
Growing a baby requires a lot from your body, and staying hydrated helps support every part of the process. Aim to drink water consistently throughout the day to support healthy circulation, amniotic fluid levels, digestion, and energy. If you’re struggling with nausea or vomiting, talk to your doctor about the best ways to stay hydrated.
Allow yourself to get extra sleep.
Listen to me: pregnancy is EXHAUSTING. Your body is working around the clock to grow a healthy baby while you have to maintain all your daily responsibilities. Don’t feel guilty about getting extra sleep or taking a nap when you need one. Quality rest helps support hormone balance, blood sugar regulation, and your overall well-being during pregnancy.
Keep an eye on your blood pressure.
Women with PMOS have a higher risk of developing high blood pressure and preeclampsia during pregnancy. Pay attention to any unusual swelling, severe headaches, vision changes, or persistent upper abdominal pain. Of course, contact your healthcare provider right away if you notice these symptoms! Catching problems early can make a big difference for both you and your baby.
Build a strong support system.
Pregnancy isn’t something you have to navigate alone. Surround yourself with people who encourage you, support your health goals, and remind you that you’re doing a great job. Whether that’s your partner, family, friends, your healthcare team, or other women with PMOS, having people to lean on can make your pregnancy feel a whole lot less overwhelming.
It’s totally possible to conceive and have a healthy pregnancy with PMOS.
PMOS may make the road to motherhood a little more complicated. However, it doesn’t have to stop you from getting there. By addressing the root causes of your symptoms, taking care of your body, and working closely with your healthcare team, you can give yourself and your future baby the best possible start.
Remember, every journey looks a little different. Some women conceive naturally, others need fertility treatments, and both paths are equally valid. Don’t lose hope. With the right support and a proactive plan, a healthy pregnancy and a healthy baby are absolutely possible with PMOS.