For those with PCOS, you are familiar with the challenges it can present before and during pregnancy. But what about postpartum? Let’s take a closer look.
Polycystic ovary syndrome (PCOS) is the leading cause of infertility and affects one in ten menstruating people. Despite what you may have heard, having a healthy and safe pregnancy is absolutely possible for those with PCOS.
However, your journey before, during, and after pregnancy may look a bit different due to existing hormone imbalances associated with PCOS.
When it comes to PCOS and having kids, there is a major emphasis on managing PCOS before and during pregnancy, but what about after pregnancy?
The postpartum period with PCOS is often a bit more nuanced, so we will focus on how you can nourish your body during this stage while your hormones are “resetting.”
This article will help you navigate your symptoms after pregnancy and how to better work with your body during this stage. Below are the topics that we will cover:
- How does PCOS affect fertility?
- How does PCOS influence postpartum recovery?
- How may PCOS impact breastfeeding?
- What can you do if you are having trouble breastfeeding with PCOS?
- How can you manage PCOS symptoms after pregnancy?
How does PCOS affect fertility?
Before diving into PCOS and postpartum, let’s talk a bit about the relationship between PCOS and fertility.
As mentioned, PCOS is the leading cause of infertility, and the main driver is the irregular (or even absent!) ovulation that is almost always associated with having PCOS.
When there is absent or irregular ovulation, insufficient progesterone is produced to allow for proper implantation.
Another potential cause of infertility is a blockage in egg release for fertilization due to the ovaries having too many fluid-filled follicles. For these reasons, conceiving can be quite challenging for those with PCOS.
Want more information on PCOS and fertility? Read more.
How does PCOS impact postpartum recovery?
PCOS increases the risk for some complications in menstruating people during the recovery postpartum period, so it is crucial to be aware of them to catch any signs and symptoms.
These include a higher risk for postpartum depression and cardiometabolic disorders, including postpartum preeclampsia or eclampsia, hypertensive heart disease, thrombotic disease, and congestive heart failure.
Advocating for proper screening and surveillance by your healthcare provider is necessary during this time. If something is off, proactively speak with your provider when you notice potential symptoms.
What is the relationship between PCOS and breastfeeding?
Not all mothers with PCOS will struggle with breastfeeding. However, challenges in this area are possible and can be frustrating. If you have complications with breastfeeding, do not blame yourself because that is not the case.
With PCOS, you may have lower progesterone levels, and low progesterone is linked to decreased milk supply and elevated androgens. Increased androgens interfere with prolactin (the main hormone driving milk production) receptors, causing a decrease in milk production.
Another potential major impact on milk supply is increased insulin levels. Females impacted by insulin resistance are likelier to have lower milk production.
And, as you likely know by now, at least 70% of people with PCOS experience insulin resistance.
Tips for breastfeeding with PCOS
- Maintain balanced blood sugar
- Remember, your nutrition matters
- Listen to hunger cues
- Try herbal teas
- Consider assessing hormone levels
- Reach out to a lactation consultant
So, what can you do if you have trouble breastfeeding with PCOS? Below are some tips to keep in mind that may help ease breastfeeding complications.
Maintain balanced blood sugar: Talk with your provider to see if they recommend you continue taking Metformin or inositol, as both can be safe while breastfeeding.
Remember, nutrition matters: Include protein, complex carbohydrates, fat, and colorful veggies for every meal. Eating enough when breastfeeding is important because our body requires extra energy to produce its milk supply during this time.
Listen to hunger cues: Speaking of eating enough, ensure you feed your body nourishing foods regularly throughout the day. Feeling hungrier is expected during this period, so ensure you eat every several hours and include balanced snacks throughout the day.
Try herbal teas: Different herbal teas have been shown to help with milk flow or production. Herbs like nettle, fenugreek, blessed thistle, stinging nettle, goat’s rue, moringa, and milk thistle may be helpful. As always, check with your provider before including these herbs in your diet.
Consider assessing hormone levels: Since PCOS increases the possibility of lower prolactin levels and higher testosterone levels, assessing hormone levels can determine what exactly is causing lower milk production.
Reach out to a lactation consultant: If it is accessible, a lactation consultant can teach you early breast massages, compression, and latching techniques. La Leche League also has great resources.
Don’t forget to breastfeed and/or pump regularly to keep supply and demand up.
How can you manage PCOS symptoms after pregnancy?
- Keep stress levels in check
- Find time to rest
- Nutrition and diet are key
- Exercise and movement will help
Keep stress levels in check
Being a new mother is exciting and fulfilling but not easy. With so many responsibilities, you may forget to take care of yourself. But, to have the energy to care for your baby, you must also be taken care of first.
Stress is often a catalyst for PCOS and can worsen symptoms, so finding moments to incorporate self-care is key. Your postpartum self-care routine may look slightly different but try to use nourishment as self-care as a start.
Use mindfulness to check in with yourself and take brief moments to do some breathwork throughout the day.
Find time to rest
In addition to finding effective stress management tools, rest and avoid taking on everything yourself. Sleep and recovery play a significant role in managing stress, which helps keep inflammation and PCOS symptoms at bay.
We know prioritizing rest isn’t always easy, but keep communication open with friends and family, and don’t be afraid to ask for help. You can also bring in a trusted source to give you and your partner a few hours of quiet time.
Nutrition and diet are key
We mentioned the importance of nutrition and balanced blood sugar for milk supply, but eating a nutrient-dense diet will also help build enough energy for you and your baby.
During stress, especially during pregnancy and postpartum, minerals can easily deplete. You can increase mineral intake through “mineral mocktails.”
Mix 6 oz coconut water, 3 oz orange juice, ¼ tsp cream of tartar, and a sprinkle of natural sea salt to replenish your minerals. You can also add collagen or whole-fat coconut milk if you are concerned about blood sugar.
Read next: The Best Collagen for Postpartum Recovery (And What to Avoid)
Be sure to also speak with your provider for additional ways to incorporate minerals into your diet and any multivitamins or supplements they recommend.
Exercise and movement will help
There is no need to jump back into exercise quickly, so go slow and find what works best for your body! Take note of your body needs and what movement feels good for you.
For many, working with a pelvic floor physical therapist is a good starting place to get back into movement. When your body feels ready, you can start with simple pelvic floor and core exercises to incorporate gentle movement into the day.
Other options can include taking the baby out for walks to get out of the house for some fresh air and sunlight.
Slowly work on strength and endurance before doing intense exercises, and stay open with your provider if you have new or heightened symptoms.
Does PCOS go away after pregnancy?
It is a common misconception that PCOS goes away after pregnancy. However, having a baby does not mean your condition disappears.
It’s important that you pay attention to any symptoms that may reemerge. Continue to assess lab markers and your PCOS management strategies (including nutrition, sleep, stress levels, and movement,) which may change after pregnancy.
Note that these changes are completely normal.
If you have any questions about managing your PCOS post-pregnancy, contact your care team or work with your provider to determine if specific medications or supplements are necessary.
Other articles you might find helpful
Pollie’s PCOS (polycystic ovary syndrome) app provides personalized, research-backed, and OBGYN-approved interventions to help you manage your hormones, metabolism, reproductive health, and emotional wellbeing across all life stages.