A hallmark sign of having the medical condition polycystic ovary syndrome (PCOS) is irregular or absent menstrual cycles. For the women with PCOS who are sexually active or trying to get pregnant, waiting until you get your period or not becomes a guessing game. It also makes it difficult to know when you should take a pregnancy test.

Menstrual Irregularity With PCOS

Menstrual irregularity is most often times due to an imbalance of hormones. Some women with PCOS can have a period that lasts an agonizing 3 weeks while others may not get a period for 3 months, never knowing when it will show up or not. Others may get no periods whatsoever. Only a small percentage of women with the syndrome will have a regular menstrual cycle.

A woman with PCOS who is trying to get pregnant could face the problem of not knowing if she was pregnant or not. She and her husband could attempt to conceive for months, trying to time intercourse to the most likely time of ovulation. Always dealing with an irregular menstrual cycle, it wouldn't be a surprise when a month would pass and she didn’t get her period. Not knowing if she was pregnant or not, she and her husband could find themselves resorting to spending a lot of money on home pregnancy kits only to get a negative result. This can be a frustrating, emotional, and expensive monthly ordeal.

In this scenario, a woman could—unsurprisingly—not get her period, take a pregnancy test, and have it be negative, followed by another month without getting her period. After another month, a new home pregnancy test could finally have a positive result, and perhaps a few more to ensure that it's true. At her first OBGYN appointment for her pregnancy, this woman and her husband may be surprised to learn that she was already 10 weeks pregnant, with the previous results having been what is called a false negative pregnancy test. Meaning, when taking that first home test, she really was pregnant but the test reader she used was unable to detect it at that time.

False Negative Pregnancy Tests

There are many factors that can cause a false negative pregnancy test. The most unlikely ones are that the at-home test malfunctioned or had expired. Most false negative results occur when levels of human chorionic gonadotropin (hCG) in the urine are too low for the test to detect pregnancy. This can happen if you take the pregnancy test too early, especially if you ovulated late in the month which can happen with women with PCOS. It can also happen if your levels of hCG become diluted by too much fluid intake before the test.

When to Take a Pregnancy Test

A pregnancy test should be taken whenever a woman suspects she may be pregnant. Since it can take up to a week for hCG levels to rise, it is best to wait a good 7 days or so after a missed period to take a home pregnancy test. Levels of hCG can also be measured by a blood test, but this is usually done in a physician’s office. If you get a negative result, you can recheck in a week or so with another at home test to be sure.

Take a pregnancy test seven days after your missed period. Recheck in another week if the test is negative.

Early Signs of Pregnancy

Not all women, especially first-time moms, can tell if they are pregnant or not in the early weeks of pregnancy. But usually, there are some telling signs and symptoms to look for that can indicate that a woman is pregnant.

Early signs and symptoms of pregnancy include:

Missed period
Increased fatigue
Sore or tender breasts
Food aversions
Mood swings
Abdominal bloating
Frequent urination
Nausea
High body temperature
Headaches
Lower back pain

Familiarizing yourself with these common signs and symptoms can help you understand if you are pregnant or not. While you are waiting for that definitive answer, it is advisable for you to avoid alcohol, smoking, and any drug use just in case.

How to Improve Menstrual Regularity

Increased stress along with significant diet and exercise changes, can affect your menstrual cycle. If you experience irregular periods and you have PCOS, chances are it is more due to the hormone imbalance.

The best ways to regulate your cycle if you have PCOS include:

Following a healthy diet that is rich in antioxidants and healthy fats and low in processed or sugary foods
Exercising regularly: In a study published in the journal of Hormone and Metabolic Research, sedentary women with PCOS who exercised moderately for 30 minutes, 3 days a week saw significant improvements in ovulation and menstrual regularity.
Taking supplements that have been shown to improve menstrual regularity and ovulation in women with PCOS. These include n-acetylcysteine, omega-3 fatty acids, vitamin D, and a combination of myo and d-chiro inositol.

When to Call Your Doctor

If your period is two weeks late, and you still are getting negative pregnancy tests, a visit to your gynecologist for a pregnancy exam and blood test is recommended. During the internal exam, your doctor may be able to feel if your uterus is enlarged, indicating you may pregnant.

If you have PCOS and your periods are commonly irregular and you’re not sure if you are in fact pregnant, talk to your doctor about when you should call them. Knowing the early warning signs of being pregnant will help you know if you are or not.

If you have a positive pregnancy test and severe abdominal or pelvic pain, especially if accompanied by nausea or vomiting, dizziness or fainting, contact your doctor immediately and/or go to the emergency room. You may have what’s called an ectopic pregnancy or other medical problem that requires immediate attention.

Always trust your gut instincts. The sooner you are evaluated for pregnancy, the sooner you can know if you are pregnant and receive proper treatment. Consulting with health professionals prior to pregnancy is advisable to prepare your body for a healthy pregnancy and to discuss ways to regulate an irregular menstrual cycle.