Tracking ovulation with PCOS (Polycystic Ovary Syndrome) takes more than watching the calendar. Because cycles are often irregular and LH levels can fluctuate or show multiple peaks, a single method rarely gives you the full picture.
Ovulation test strips measure the LH rise that typically occurs before ovulation. With PCOS, tracking LH patterns across several days tends to be more useful than reading any single result as a straightforward positive or negative. Pairing LH testing with BBT tracking adds another layer. After ovulation, progesterone causes a slight rise in resting temperature, usually 0.5 to 1.0°F, which may suggest ovulation has likely occurred. Cervical mucus is worth watching too. As ovulation approaches, it typically becomes clear, stretchy, and similar to raw egg whites, which can signal your fertile window is opening.
Because PCOS may involve higher baseline LH or multiple fluctuations, using a tracking tool like Premom PCOS Pro may help you interpret LH trends more clearly beyond just positive or negative results, so you can better understand your fertile window.
What You’ll Learn:
- PCOS has many different causes; you’ll need to get to the root of 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 regular cycling women.
- Combining ovulation testing with basal body temperature tracking to identify if your LH peak resulted in ovulation.
- 5 tips for trying to conceive with PCOS
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)
- Testosterone
- Dehydroepiandrosterone sulfate (DHEA-S)
- Estrogen
- Progesterone
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 of LH and FSH at 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 bodies. 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 changes in cervical mucus and cervical position
- Identify if ovulation was likely successful with a basal body temperature (BBT) shift
Tracking ovulation through the means of OPKs and cervical mucus is helpful for 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 thinner, clear, and stretchy (like raw egg whites), making it the perfect consistency for traveling sperm. The cervix will also become soft, high, and open, which 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 help identify if ovulation was likely successful. 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 shown by increased basal temperature 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.
Signs You May Be Ovulating
Your body shifts in measurable ways as ovulation approaches. With PCOS, those shifts can be harder to read on their own, which is why tracking multiple signs together over time gives you a clearer picture of your cycle. Premom helps you log and connect these signals so patterns start to emerge across cycles, not just day to day
Use an ovulation prediction kit
Ovulation tests can detect a rise in luteinizing hormone (LH), which typically surges before ovulation. This can help you identify your most fertile days. With PCOS, LH can fluctuate or show multiple peaks, making it difficult to identify your true LH peak. Pairing LH testing along with basal body temperature (BBT) may help indicate when ovulation has likely occurred.
Track your basal body temperature
After ovulation, progesterone causes a slight rise in your resting temperature, typically around 0.5 to 1.0°F. Taking your temperature each morning before getting out of bed, at the same time every day, lets you spot that shift. A sustained rise over several days may suggest ovulation has likely occurred.
Observe your cervical mucus
Cervical mucus changes throughout your cycle. As ovulation approaches, it often becomes clear, stretchy, and similar to raw egg whites. This could be a sign that your fertile window is near.
Notice changes in cervical position
Your cervix also shifts during your cycle. Around ovulation, it may feel higher, softer, and more open. At other times, it may sit lower, be more closed and feel firmer.
Here are 5 tips to help get pregnant with PCOS
Tip 1: Lifestyle modifications
Optimize your health and well-being! Multiple studies have shown us that the gold standard for helping the cycle become more regular is nutrition and lifestyle-based. Our goal at Premom is to help solve the root problem to help you conceive. The recommendation is a two-part approach.
Nutrient-Dense Diet
What exactly does this mean? It means you want to focus on consuming healthy, unprocessed foods like eggs (with the yolk!), vegetables (steamed, sautéed, raw, etc), fruit (2-3 servings a day), quality proteins like chicken, beef, bison and so on. You also want to pack the diet with healthy fats from foods such as avocados, nuts, and seeds and a serving of quality dairy. You want to avoid processed foods that contain canola oil or vegetable oil. These are inflammatory in your body and wreak havoc on your overall health. This means limiting foods like pasta, chips, cookies, crackers, protein bars, white bread, etc.
Exercise
Start slowly by trying to be active at least 4-5 days a week for at least 20 minutes a day. This can be a walk around your neighborhood, playing tag with a little one, riding an exercise bike or taking a class at the gym. As your body becomes more accustomed to working out, you can gently increase the intensity. There is no need to overdo it — just focus on a moderate intensity 4 days a week. This will help to regulate blood sugars and help stabilize hormones.
Tip 2: Track your ovulation
One of the hardest parts of PCOS is that cycles may not be predictable. It may be difficult to know exactly when your fertile window is, which makes timing intercourse challenging. If each month your cycle is different, you will want to use ovulation strips to help find your fertile window. Learn more about the difference between quantitative strips and regular ovulation strips here.
Tip 3: Medication and supplements for PCOS
Medications
PCOS has a metabolic component that can impact the way your body uses sugar. This could cause problems with insulin resistance and increase your risk of diabetes and heart disease. Having a chat with your OB/GYN or Primary Care Provider about using a medication called Metformin can be a good idea. This medication can help with insulin sensitivity.
Supplements
You can also discuss a few supplements with your provider, including Ovasitol, vitamin D3, folic acid or folate, and choline, which can all be great for fertility. You should always talk to your doctor about adding supplements and making sure they are right for you.
Tip 4: Identify ovulation with basal body temperature
Having PCOS can make ovulation more irregular and challenging. Using a second form of testing after the preferred ovulation strips can be helpful. We suggest using BBT (basal body temperature) testing to look for a slight rise in body temperature that occurs shortly after ovulation (usually within a couple of days). Premom offers a BBT thermometer that wirelessly syncs all of your information right to the app.
Tip 5: 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!
How Premom helps you track PCOS
Tracking ovulation can be more challenging when cycles are irregular. Premom offers tools that can help you understand your cycle patterns more clearly over time.
Meet PCOS Pro
PCOS Pro is a 6-month access pass inside the Premom app, designed for people with irregular cycles, including those with PCOS. It unlocks additional tracking tools and educational resources to support better cycle awareness.
PCOS Pro is a one-time purchase, not a subscription. It does not auto-renew and is separate from Premom Premium. You can use it with or without a Premium membership.
What all PCOS Pro includes
Advanced tracking tools for complex or irregular cycles.
Daily health logs for sleep, nutrition, and stress.
Cycle pattern insights that build over time as you track your data.
Educational guides focused on PCOS and hormonal health.
Is PCOS Pro a subscription?
No. PCOS Pro is a one-time purchase that gives you 6-months of access. It does not auto-renew, and you can choose to buy another pass whenever you’re ready.
Take the next step
Want a deeper look into your cycle?
Get your PCOS Pro 6-month access pass today.. One-time purchase. No recurring fees.
Finding Your Ovulation Day with PCOS: Frequently Asked Questions (FAQ’s)
With PCOS, ovulation may not happen at the same time every cycle. The best way to understand your cycle is to track different fertility signs together. Using ovulation test strips to watch LH changes, tracking basal body temperature, and observing cervical mucus with a smart app like Premom may help. Looking at these patterns over time may help you recognize when ovulation is likely happening.
For tracking ovulation with PCOS, it is usually recommended to use more than one method. Ovulation test strips can help you see LH changes, while basal body temperature may show a temperature rise after ovulation. Observing cervical mucus changes can also give helpful clues about your fertile window. Tracking all these signs together may give you a clearer picture of your cycle.
Yes, ovulation tests can still be useful if you have PCOS. However, LH levels may fluctuate or rise more than once during the cycle. Because of this, testing for several days and watching the overall pattern can help you better understand your cycle along with adding in additional tracking tools like BBT, urinary PdG tests or monitoring cervical mucus changes.
The test itself is not different. What may be different is the hormone pattern. Women with PCOS may have higher baseline LH levels or multiple LH rises, making a standard positive or negative result harder to interpret.
A quantitative ovulation test like the Premom Quantitative LH Test, read through the Premom app, assigns a numeric value to your LH level so you can track how it trends across days rather than waiting for a single threshold result. For PCOS, that pattern matters more than any one reading.
Tracking alongside BBT and cervical mucus changes gives you the fullest picture of your fertile window.
Hormone levels can vary from cycle to cycle. Some women with PCOS may see lower LH readings at certain times, while others may see fluctuations or higher LH levels. Tracking LH from the next day when your period ends and adding BBT tracking and cervical mucus changes may give you an understanding of the time of ovulation.
With PCOS, ovulation may not follow a predictable cycle day. Instead of relying on calendar-based guesswork for predicting ovulation, it may be more helpful to track LH patterns, basal body temperature, and cervical mucus changes over time to understand when ovulation may occur.
References
- Sterling E. Hormone Levels and PCOS. Contemporary OB/GYN. Published November 8, 2011. Accessed March 31, 2026. https://www.contemporaryobgyn.net/view/hormone-levels-and-pcos
- Yousaf J, Khadija S, Arshad N, Amjad MR, Gulzar J, Ullah A. The chances of infertility in a patient presenting with PCOS in childbearing age. Saudi J Med. 2022;7(1):15-21. doi:10.36348/sjm.2022.v07i01.003
- Zehravi M, Maqbool M, Ara I. Polycystic ovary syndrome and infertility: an update. Int J Adolesc Med Health. 2022;34(2):1-9. doi:10.1515/ijamh-2021-0073
