PCOS & Family

For most of us, PCOS is a lifelong chronic condition and symptoms can persist even after menopause. But even if we have PCOS for the duration of our lives, it’s important to understand that this condition does not necessarily impact us in the same ways throughout the years.

Just as life is not static, PCOS symptoms and triggers can morph over time. More importantly, our goals transform every time, and this has a large impact on how you may go about managing your symptoms.

You are reading this because you have indicated that you are in a parenthood phase of life. We’ll be focusing on how to manage PCOS while being a parent, but we will also touch on other elements of balancing PCOS with your life such as career and relationships.

In this article we’ll be focusing on questions like:

• How many PCOS impact my life as a parent?
• What are parent-friendly ways I can manage my PCOS with lifestyle modifications?
• How can I be most productive at work while having PCOS?
• How can I balance the lifestyle modification that comes along with managing a chronic condition with maintaining relationships?
• What are tips for opening up to friends and family about having PCOS?

PCOS and parenthood: What to look out for  

At this point, we all know the common symptoms of PCOS: irregular ovulation and periods, acne, hair loss, hirsutism, blood sugar imbalance and potential weight issues, mental health disturbances, and more. But which symptoms should you be most concerned about in terms of it impacting your role as a parent? We’ll be splitting this section into two main sections: mental health and energy levels.

Note: If you are trying to add to your family and having trouble conceiving, make sure to reach out to your care team and we can share our life stage article on PCOS and fertility.

Mental health

Mental health disturbances like anxiety and depression are common occurrences with PCOS. In fact, people with PCOS are 3 times more likely to experience anxiety and/or depression than people without PCOS and are more likely to report a higher severity of symptoms.

Although the exact reason for this association between conditions is unknown, many symptoms of PCOS such as hirsutism, infertility, body weight fluctuations, and a general lack of control over one’s health and body can be frustrating and anxiety-provoking. Some studies have suggested that insulin resistance or higher androgen levels could be a factor that predisposes people with PCOS to develop mental health conditions.

This is a key factor to be aware of as a parent. When you are raising children, centeredness, patience, empathy, and stability are key factors for cultivating a healthy environment and showing up for our families. And, if we are struggling with our mental health, it is difficult to provide such an environment.

Luckily, mental health struggles with PCOS is manageable. Below are potential treatment strategies:

• 1-1 therapy: If you can afford it, 1-1 talk therapy with a counselor is well-worth the time and monetary investment. You can explore a variety of treatment strategies used by different therapists such as cognitive behavior therapy (CBT). There are also many therapists such as LMFTs (licensed marriage and family therapists) who focus on helping clients with family and relationships. Let your care team know if you would like help finding an in-person or virtual therapist. We would love to help!
• Group therapy: If you cannot afford a personal counselor or think that you would benefit more from strong community support, group therapy may be a good option. Especially when it comes to being a parent and balancing family with life’s other responsibilities, learning from peers can be invaluable. Be sure to check out your Pollie support group and let your care team know if you would like a more counseling-focused group.
• Stress management techniques: Being a parent is no walk in the park, nor is having PCOS. Say hello to a perfect recipe for stress! Stress can catalyze or worsen a mental health problem, and having techniques in your pocket that help you relax and regain clarity is important. Journaling, exercising, going on walks, baking, taking baths, cuddling with your dog, and just getting out into nature are all ideas for managing stress.
• Medication: While Pollie cannot prescribe medication yet, finding a mental health professional who can is important if your mental health is impeding your ability to properly function as a person and parent. Selective serotonin reuptake inhibitors (SSRI), a major class of antidepressants, directly change our neurohormonal levels. Recent studies have found that hormone replacement therapies (in which estrogen and other hormones may be supplemented) can have a reciprocal relationship with antidepressants; people taking antidepressants may be missing an underlying endocrine condition, and people treated with hormonal replacement therapy feel the effects not only physiologically but mentally as well (1). Additional studies have reported antidepressants’ interactions with estrogen receptors (2). Androgen-blocking drugs are also commonly used to treat endocrinological conditions or as an oral contraceptive yet they also affect our neurohormonal levels and mental health (3). Since hormonal fluctuations of estrogen, testosterone, and other hormones act on your brain as well as the rest of your body, blocking our androgens for physiological changes affects your mental health too. It is important to talk with your healthcare provider about the ways in which your treatments for either mental or endocrine conditions interact.

Energy

Beyond emotional stability, another key part of being a parent is having enough energy to keep up with your children. Whether you are a full-time parent of one or juggling a career with three kids, raising a family is hard work. And children often have unlimited levels of energy!

But, PCOS can sometimes throw a wrench in being able to keep up with your children along with life’s other obligations. Fatigue, insomnia and other sleep disturbances, and brain fog are all common symptoms of PCOS. Consider the following facts about PCOS, our circadian rhythm, and sleep quality:

• Studies have suggested that people with PCOS have elevated serum melatonin levels in the middle of the night compared to the general population (melatonin levels should be highest before bedtime, and this pattern suggests poor sleep quality and a disturbed circadian rhythm). While the exact cause of this is unknown, a strong possibility is the higher levels of androgens generally seen with PCOS.
• Conversely, melatonin supplementation intended to regulate production of this hormone has been shown to decrease androgen levels and improve metabolic function for people with PCOS (4, 5).
• Many people with PCOS report daytime fatigue. In a study of 59 adolescent girls with PCOS, it was found that the aforementioned later melatonin offset is associated with circadian misalignment, which is associated with metabolic issues (6).
• Evidence suggests that people with PCOS have a heightened response to stress versus people without (7). Since there is a connection between sleep disturbance and heightened cortisol levels, it is possible that the tendency to have a more intense stress response impacts sleep quality at night (4).
• There is a strong relationship between sleep disturbances and insulin resistance, with evidence showing a causal relationship that can become a viscous cycle (4).

Clearly, quality sleep is difficult for people with PCOS. As though quality sleep was not difficult enough as a parent alone! There are a variety of things you can do to improve your sleep quality with the ultimate goal to maximize your energy during the day:

• Try to stick to a normal bedtime: We know, it’s hard, especially with kids. But when it comes to regulating your circadian rhythm, trying to get to bed at relatively the same time every night can help train your brain and body when it is supposed to be asleep and awake. Let your care team know if you need extra support here; we know this can be particularly challenging for nighttime or shift workers.
• Avoid screens before bed: Chances are you’ve already heard all about how the light from our computers, cell phones, and TVs can make it more difficult to fall asleep. This is because of something called “blue light,” which comes through in a higher concentration with electronic screens and can tell our brains it’s daytime. Experiment with going screen-free for an hour or two before bed to see if this helps, and consider buying blue light glasses as well.
• And speaking of electronics, try sleeping with your phone across the room. This can be a tough one, but many people find it helps them fully relax in preparation for bed. If you’re feeling like an overachiever you can try putting it in a different room entirely while you sleep. If you’re not sure about committing to the psychical distance, consider keeping it next to you but turning it off or putting it on airplane mode to start.
• Optimize your sleep environment. In general, it’s best to sleep in a cool, dark,  quiet room. Consider trying an eye mask or ear plugs if you live in a noisy area (and if you feel comfortable using ear plugs with your children!). We also recommend creating a peaceful environment in your bedroom: try to keep it clutter-free, change your sheets often, and use your bed for sleep and sex only.

PCOS and productivity

Working parents already have a lot on their plates. It is difficult to manage children and career for anyone, and if you are in the midst of bothersome PCOS symptoms, you may find that maintaining balance between work, your family, and health is difficult.

There are several common symptoms of PCOS that may take a toll on your productivity levels, for example:

• Brain fog
• Fatigue
• Anxiety and depression
• Insomnia

If you can’t think clearly or are too anxious or tired to find the motivation to actively participate in and excel at your job, it’s natural to feel frustrated. If this sounds like you, know you’re not alone: it can be helpful to even just recognize that your PCOS may be catalyzing these psychological issues at work. This awareness can be a helpful tool in and of itself.  

While reducing PCOS symptoms requires patience, in time you can manage the psychological symptoms that may be taking a hit on how you’re showing up to your job. If productivity is an issue for you, make sure to discuss this with your Pollie care team. There are a variety of lifestyle modifications your coach can help you with to tackle symptoms that are impeding your productivity. While Pollie does not currently prescribe pharmaceuticals, your care team can also help point you in the right direction if you are experiencing severe psychological symptoms that you think would benefit from medication.

It also may be worthwhile looking into career coaches or free online material to help manage difficulty concentrating or lack of motivation at work. This is also something your Pollie care team can help you find.

Managing your PCOS with social life

Relationships with both friends and romantic partners are a key part of life. Unfortunately, having children can complicate both of these types of interpersonal relationships, and PCOS can make things even murkier in terms of determining what balance means to you.

You may start to feel conflicted between giving your all to managing your PCOS and wanting to fully participate in your social life. For example:

• You know getting 8 hours of sleep per night is important for everyone, but especially people with PCOS. Regulating our circadian rhythm can help with re-balancing hormones, and wonky sleep schedules lend themselves to more hormonal disruption. But your group of friends likes to host dinner parties that go into the early hours of the morning, and you feel like you miss out on half the fun when you stick to your 10pm bedtime.
• Dairy aggravates your PCOS acne, and you recently learned that you are insulin-resistant and should stay away from starchy carbohydrates. This makes you a high maintenance participant at group dinners, and you find yourself saying “no” to social activities that don’t align with your dietary habits.

While in a perfect world, our friends and partners would magically change their behaviors and interests to suit our lifestyle needs, this is not realistic. Balancing social life with raising children is not easy, and adding a chronic condition to the mix further complicates things even more. Taking control of your PCOS in a sustainable way means finding treatment strategies that truly work for you now. Depending on your symptom severity’s impact on quality of life, your goals, and the monetary and time commitment that you can realistically dedicate to PCOS management, for some moms this may look like medication, while for others it could mean committing to more stringent lifestyle changes.

There is no denying it: it is difficult to manage trying to conceive with PCOS and simultaneously balance platonic and romantic relationships. But, it is possible with patience and experimentation.

Opening up to friends and family about PCOS

It is likely that you have heard of friends, family members, and colleagues who also have PCOS. With a condition that impacts 10% of the female population, this is an inevitability! Opening up to people who you may know already have a diagnosis can be a great place to start if you are not yet ready to share with others.  

We also recommend you share your experience with your Pollie support group. Opening up to people that you already know are struggling with the same condition can be a great first step to finding community support. If you are looking for more focused support around the infertility piece specifically, let your care team know. There are countless fertility communities that thousands of people have found strength and comfort in.