My Partner Has PCOS—Should I Be Scared?

Common Concerns if Your Partner Has Polycystic Ovary Syndrome

Couple talking with therapist about how he can best support his wife with PCOS
Getty Images/simonkr

If your wife or partner has polycystic ovary syndrome (PCOS), she's not alone. At least one in ten women suffer from PCOS. But while it can be scary to hear that your partner has a medical condition, please know that she can live a full healthy life if her PCOS is well managed. 

There are changes that your partner will need to make to manage her condition, and she will need to follow up with her doctor on a regular basis. But PCOS is not a fatal nor inherently dangerous disease and the vast majority of women with the condition do just fine.

That said, we won't deny that there are challenges in living with a woman with PCOS. PCOS can cause annoying symptoms and management can be tedious. Having a loving partner who can work alongside her, however, can make a wonderful difference in how she manages these symptoms today and her long-term outlook.

Let's take a look at the common symptoms of PCOS, some of the ways in which it's managed, and the role that the condition may play in infertility for you and your partner.

Defining Polycystic Ovarian Syndrome (PCOS)

Polycystic ovarian syndrome, or PCOS, is a condition in which a woman's body secretes extra male hormones, called androgens. This excess in androgens can cause her ovaries to produce too many egg follicles each month, the "polycystic ovaries" responsible for the name of the condition. Excess androgens are also responsible for many of the other symptoms of the condition.

In a normal menstrual cycle, hormonal changes result in the maturation and release of an egg during each cycle. Due to the excess androgens, the follicles in a woman's ovary don't mature fully and aren't released, leading to the development of small ovarian cysts which can be seen on ultrasound. Since ovulation often fails to occur, the shedding of the uterine lining (the menstrual period) often fails to occur as well. This leads to the common symptoms of irregular periods, and often, infertility.

We aren't certain exactly what causes the excess androgens responsible for the clinical symptoms of PCOS. It appears there may be some genetic component, and it can run in families. Theories include an excess of insulin (due to insulin resistance) leading to an increased production of androgens, or low-grade inflammation in the ovaries also leading to an increased production of androgens. It's important as the partner of a woman with PCOS to realize that she did nothing wrong to cause her condition. Instead, she needs your support to cope with a condition that far too many women develop for unknown reasons.

Symptoms of PCOS

Women with PCOS tend to have symptoms related to the elevated androgen levels and the effect these hormones have on various tissues in the body. 

Common symptoms include:

  • Irregular periods (oligomenorrhea) or absent periods (amenorrhea)
  • Acne
  • Oily hair and skin
  • Abnormal hair growth (hirsutism)
  • Recurrent miscarriages
  • Obesity
  • Insulin resistance, with an increased risk of developing diabetes
  • High blood pressure
  • High cholesterol

Many women have only a few of these symptoms, which can create difficulty in making the diagnosis.

Diagnosis

Your partner may be frustrated if she's only recently been diagnosed with PCOS, and you may be wondering how this could happen. PCOS often goes undiagnosed until a woman is in her 20s or 30s. The reason behind this is that symptoms such as irregular periods and acne are common in the teen and early adulthood years. In addition, the use of birth control pills (one of the treatments used for PCOS) can conceal the symptoms as well.

There are several factors which are evaluated in order to make a diagnosis of PCOS. When a doctor takes a history and does a physical exam she may hear or see some of the signs. Lab tests to diagnose PCOS may reveal increased androgens as well as an increased level of luteinizing hormone (LH). The transvaginal ultrasound criteria for PCOS are also important in interpreting signs found on ultrasound.

Management of PCOS

The specific therapies used for PCOS will depend on a number of factors, such as the extent of symptoms and a woman's desire to either become pregnant or avoid pregnancy.

Maintaining a healthy weight through regular exercise and a healthy diet are essential, as are regular visits with her doctor. Part of her annual checkup should include blood glucose testing (for diabetes), blood pressure, and cholesterol levels. Early intervention is the key to treating and preventing these complications.

She also needs to see her gynecologist each year (or as suggested by her doctor) to make sure that she is getting a regular period (or at least 4 periods each year).

During a normal menstrual cycle, the endometrium is exposed to hormones, like estrogen, which cause the lining to proliferate and thicken. When ovulation does not occur (which is typical in PCOS), the lining is not shed and is exposed to much higher amounts of estrogen. In time, this can cause thickening of the endometrium and may predispose a woman to develop endometrial (uterine) cancer (see below).

Medications and Treatments for PCOS

There are several medications which may be used to control symptoms, such as birth control pills and other hormones. Glucophage (metformin) is a medication which is used to address insulin resistance but may help regulate menstrual cycles and help with weight control as well.  Inositol is a supplement which offers promise for women with PCOS.

Excess facial hair can be troublesome for women with PCOS. Different hair removal options may be tried, or the medication Proscar/Propecia (finasteride) may help to reduce unwanted hair growth.

Obesity can be a double edge sword as the condition may contribute to obesity while excess weight can worsen the condition. There has been considerable research done on weight loss and PCOS with a number of methods showing promise.

Infertility Related to PCOS

Unfortunately, infertility is a common issue associated with PCOS, simply because the disease causes irregular ovulation.

Without the release of an egg, there is nothing to join with the sperm and pregnancy cannot occur. Therefore, if your partner isn’t ovulating regularly, the two of you may have difficulty figuring out when to be intimate in order to conceive.

The good news is that pregnancy is not impossible with PCOS. While it can be a challenge, there are a number of treatments available. You may need to seek the assistance of a fertility expert or reproductive endocrinologist.

There are oral medications, injectable drugs, and IVF as options. While not the way most couples envision starting their family, these treatments are successful for the majority of couples.

Complications and Long-Term Concerns Related to PCOS

Women with this syndrome have a greater risk of developing diabetes, high blood pressure, high cholesterol, and heart disease (metabolic syndrome). All of these are treatable or preventable, but she will need to make certain lifestyle changes.

Women with PCOS do have a slightly higher chance for developing endometrial cancer than women without PCOS. The more irregular and fewer periods a woman has, the greater her risk becomes.

Sleep apnea is also a fairly common condition among women with PCOS, and partners are in an ideal position to recognize some of the symptoms.

Supporting Your Loved One With PCOS

There are many things that you can do to be supportive of your partner with PCOS.

First, make the lifestyle changes with her, instead of singling her out. It’s much easier to stick to with a healthy diet when your partner does as well. Instead of going out to dinner or a movie, go for a hike or bicycle ride together. Find ways to be active together.

Learn about the treatment options for PCOS so you can discuss her decisions and are aware of potential side effects. Most women appreciate a partner who not only accepts her as she is but takes a special interest in what she is going through. Consider going to appointments with her and practice being her advocate so that she gets the best care possible.

Practice patience. Having a chronic medical condition is difficult enough, but with PCOS, hormonal levels are affected as well and can compound the frustration. Some women with the condition have stated that it feels like having premenstrual syndrome all month long. If your partner is feeling irritable, try to separate out her behaviors from who she is as a person. 

Learn to "read between the lines." Sexual concerns can be a problem for couples living with PCOS. Yet in one study, acne was the leading cause of sexual dissatisfaction among women with PCOS. Partners might believe that a woman's lack of interest indicates a lack of interest in them, or instead get angry. In this case, however, the best approach to improve sexual intimacy may be talking with her doctor about better treatment options for PCOS-induced acne!

Be supportive and understanding if she is struggling with her self-esteem or mood. PCOS and depression can also go hand in hand.

If you are dealing with infertility make sure she understands it is not just her problem. Seeing a counselor or psychologist as a couple can be very helpful if you are facing these concerns.

Consider attending a PCOS symposium with her. These are great events for learning the latest information about PCOS while providing opportunities for support for women dealing with the symptoms. Many of these meetings actually have breakaways and meetings designed just for loved ones of those with PCOS.

Bottom Line for Partners of Women With PCOS

Your partner may be very discouraged if she has been diagnosed with PCOS, but with a supportive partner, the journey is much more manageable. As symptoms of the condition can be annoying and she will need you for support, make sure you have a support system in place to get the support you need. 

As much as you can, try to focus on the "silver linings" of your partner's condition. Coping with a chronic disease is a challenge, but can also lead partners to communicate at a deeper level than those who are not exposed to these challenges. With an understanding of some of the basics of PCOS discussed here, take a moment to think about how to talk to your partner about PCOS.

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