Aug 09, 2022 | By Heather Frame, BSN, RN
What You’ll Learn:
- PCOS has many different causes, you’ll need to get to the root to fix the issue.
- Some women with PCOS may have higher levels of LH or multiple LH peaks making it crucial to track ovulation consistently
- Women with PCOS tend to need to use ovulation tests for more days than regularly cycling women.
- Combine ovulation testing with a basal body temperature tracking to confirm your LH peak resulted in ovulation.
Nailing down ovulation day with PCOS (polycystic ovarian syndrome) can sometimes be difficult due to longer, irregular menstrual cycles – but it is absolutely possible!
Understanding hormones with PCOS
PCOS is driven by a hormonal imbalance. Let’s take a look at the hormones involved in PCOS:
- Luteinizing hormone (LH)
- Follicle-stimulating hormone (FSH)
- Dehydroepiandrosterone sulfate (DHEA-S)
LH and FSH are the hormones responsible for the maturation of the follicles and triggering ovulation. Women who do not have PCOS typically have equivalent levels LH and FSH in the beginning of their cycles; however, a woman with PCOS usually has higher baseline levels of LH equating to 3 times higher than their FSH level. This imbalance is enough to disrupt regular ovulation.
All women have some male hormones, also referred to as androgens, present in their body. With PCOS, the male-dominant hormones testosterone and DHEA-S are generally higher than in women who do not have PCOS. Estrogen and progesterone are the female-dominant hormones that promote a healthy menstrual cycle and regular ovulation. Many women with PCOS do have a normal level of estrogen, but due to increased androgens, the imbalance causes an alteration in regular menstrual cycles and ovulation. The absence or rarity of ovulation may also leave these women with lower progesterone levels.
In many cases of PCOS, insulin resistance can also disrupt hormones, meaning the body cannot efficiently regulate blood sugar levels. High levels of insulin can contribute to higher levels of androgens. Consistent blood sugar elevation can alter reproductive hormonal cycling which can also contribute to irregular ovulation.
Finding ovulation day with PCOS
Though finding your ovulation may prove more difficult, it can be achieved by doing the following with consistency:
- Utilize ovulation predictor kits (OPKs)
- Test LH daily after your period ends
- Observe fertile signs such as change in cervical mucus and cervical position
- Confirm ovulation with basal body temperature (BBT) shift
Tracking ovulation through the means of OPKs and cervical mucus is helpful through longer, irregular cycles. Ovulation tests detect LH (luteinizing hormone) levels in the urine. LH surges right before ovulation, so by testing daily you will be able to pinpoint when ovulation will most likely occur.
Due to higher baseline levels of LH, fluctuations encountered while testing are not uncommon, so don’t lose faith! Near ovulation, cervical mucus tends to become more thin, clear, and stretchy (like raw egg whites) making it the perfect consistency for traveling sperm. The cervix will also become soft, high, and open and is another indicator of fertility to observe while trying to conceive with PCOS.
Charting your BBT daily, in addition to LH testing, is so important for women with PCOS because it can confirm ovulation. To efficiently track BBT, you’ll need a basal body temperature thermometer.
After sleeping for at least 3 consecutive hours, check your temperature immediately upon waking before getting out of bed. Try to check at the same time each day to ensure accuracy and look for the spike in temperature that should occur after ovulation.
Getting pregnant with Premom when you have PCOS
Take some of the guesswork out of charting by logging your ovulation symptoms, LH tests, and BBT into your Premom app! It uses all of the information about your cycle to pinpoint your most fertile window in hopes of helping you achieve pregnancy faster.
Below is an in-app example of what cycle tracking looks like with PCOS:
Notice the LH fluctuations before reaching peak level on CD (cycle day) 25. Ovulation follows on CD 26 and is confirmed by increased BBTs afterward.
In addition to this chart overview, Premom also provides a physician designed cycle analysis report and cycle comparison report that can identify your unique cycle patterns for better ovulation prediction in future cycles.
When to seek help
If you are experiencing symptoms of PCOS, it’s always a good idea to reach out to your doctor. Due to its prevalence, – 10% of women carry this diagnosis equating to over 5 million women in the United States – it has been widely researched. Providers have a better understanding of PCOS now than in past years which aids in optimizing fertility!
Having a medical evaluation can not only be beneficial physically, but emotionally as well. Living with PCOS can feel isolating at times, but know you are supported and pregnancy is absolutely achievable! Keep in mind that you may need to test LH for longer periods of time due to irregular cycles, but in addition to observing the other fertility signs mentioned above, you will be able to find your ovulation day more easily.
Our medical team is also available for virtual consultations through the Premom app – please feel free to reach out to us if you are having trouble understanding how to track your cycles efficiently!
Heather Frame is a compassionate Women's Health nurse. She specializes in obstetrics, postpartum, newborn care, and lactation counseling. She is committed to providing women the support they need to achieve pregnancy and thereafter. As a personal user of Premom, she can attest to how important charting your cycles is in conjunction with achieving pregnancy. She would love to help you navigate your fertility journey. Schedule a consultation with Nurse Heather right through your Premom app!