You have spent years watching your period come and go unpredictably, and have tried medication or may have undergone fertility treatment. You have endured the questions from relatives and friends who couldn’t understand why pregnancy wasn’t happening. Then, finally, you see the two lines – you’re pregnant. For a moment, everything else seems to disappear, and that’s understandable. But here’s something you need to know: getting pregnant doesn’t mean your condition has gone away.
The condition, Polyendocrine Metabolic Ovarian Syndrome, or PMOS is significant because it reflects something doctors have long understood isn’t simply an ovarian or fertility problem. It can affect your hormones, metabolism, menstrual cycle, weight, blood sugar, cardiovascular health, mental health and reproductive health.
So while getting pregnant may have been your immediate goal, your PMOS health journey does not end with conception. It continues through pregnancy, after childbirth and into the years ahead. If you have PMOS, your pregnancy deserves the same careful attention as any other pregnancy, but your medical team should also know about your history.
This is important because pregnancy itself changes the way your body handles glucose and insulin. If you’ve already experienced insulin resistance or other metabolic problems associated with PMOS, your healthcare provider may want to pay particular attention to your individual risk factors. That doesn’t mean you’re destined to develop diabetes or have a complicated pregnancy. It means you shouldn’t assume that a positive pregnancy test has switched off the underlying condition. Tell your obstetrician that you have PMOS and make sure your medical history is clear. Don’t be afraid to ask what your pregnancy monitoring should include.
After childbirth, suddenly, your attention is everywhere except on yourself. You’re feeding the baby, changing nappies, trying to sleep whenever you can. If you’re breastfeeding, your body is working hard to nourish another human being. People ask how the baby is doing; few ask how you are doing.
The postpartum period is an important time to review your health and continue managing PMOS after pregnancy. Depending on your circumstances, your doctor may need to consider your blood pressure, blood glucose, weight, menstrual pattern and general wellbeing. Don’t assume that because the baby is healthy, your own health can now take a back seat.
What if your period doesn’t come back? This can be confusing, particularly if you’ve lived with irregular periods because of PMOS. After childbirth, your menstrual cycle doesn’t necessarily return immediately and if you’re breastfeeding, your periods may remain absent for some time because breastfeeding can suppress ovulation. Don’t panic the first time you realise your period hasn’t returned, but don’t ignore persistent irregularity either.
If your periods remain absent or become irregular after the normal postpartum period, talk to your doctor who will consider several things. You may also find yourself under pressure to lose your pregnancy weight, this can be particularly difficult if you’ve struggled with your weight before. You may have spent years hearing the same advice: Lose weight, but postpartum recovery isn’t the time for punishment.
You have just carried and delivered a baby. Your body needs time to recover. If you’re breastfeeding, you also have nutritional needs that shouldn’t be ignored in the rush to lose weight. With PMOS, weight management is best viewed as part of your overall health rather than as a measure of your worth.
PMOS can be associated with insulin resistance and an increased risk of type 2 diabetes. Pregnancy can also bring another issue into focus: gestational diabetes. If you developed gestational diabetes during pregnancy, don’t assume that the problem disappeared permanently when you gave birth and your blood sugar returned to normal.
Perhaps you spent years struggling with infertility before becoming pregnant. Maybe you experienced failed fertility treatment, miscarriages or the painful comments that often accompany childlessness. You may have told yourself that once you had your baby, all that pain would disappear. Sometimes it doesn’t.
Add sleepless nights, physical recovery, hormonal changes and the enormous responsibility of caring for a newborn, and you may find yourself overwhelmed. If you’re persistently sad, anxious, hopeless or unable to cope, speak to someone. Don’t allow anyone to tell you that you have no right to feel that way because you finally have the baby you wanted. You can be grateful for your child and still need help.
Your first pregnancy doesn’t necessarily guarantee that the next one will happen easily. This can be particularly confusing. You may think, I already had a baby. Why am I struggling to conceive again? PMOS may still be affecting your ovulation. That doesn’t mean PMOS is necessarily the reason you’re not getting pregnant again. Age, male fertility, fallopian tube problems, uterine conditions and other factors can affect fertility too. So don’t assume.
If you’re trying for another child and pregnancy isn’t happening, seek an appropriate fertility evaluation. The fact that you conceived once is reassuring, but it doesn’t mean every future pregnancy will follow exactly the same path, however don’t let PMOS become only a fertility diagnosis. You shouldn’t wait until another fertility problem appears before you pay attention to your health. Keep your medical appointments, ask questions, know your blood pressure and, where appropriate, your blood glucose status. Talk to your doctor about your menstrual pattern, tell your healthcare providers about your PMOS history. Don’t allow the demands of motherhood to make you invisible in your own healthcare.
Your baby is not the finish line. Once you give birth, your health doesn’t stop being important. If you have PMOS, the condition doesn’t disappear simply because you’ve become a mother. Your body has changed, your hormones will change again, your menstrual cycle will eventually return. Your metabolic health will continue to matter, you may want another pregnancy, or you may decide you don’t. Either way, you remain more than your reproductive history. The focus is no longer only on your ovaries; it’s on the whole you.
So when the congratulations have ended, when the visitors have gone home and everyone is asking about the baby, remember to ask one more question yourself: How am I doing? And make sure somebody answers it, because your baby may be the newest chapter of your life. PMOS isn’t the end of your health story.
