Aunt Flo made her first visit when I was twelve and ever since then she has been an irregular guest. Back then I envied those girls (now women) who had nice, tidy 28 day cycles with ovulation and corresponding mittelschmertz exactly on day 14. That’s never been the situation for me. It’s been a guessing game of how long can you go without a flow.

When I was 16 I was diagnosed with Polycystic Ovarian Syndrome, PCOS, for those of us in the know. It’s primary symptom is menstrual irregularity but there are others silent symptoms like high triglycerides and cholesterol and insulin resistance issues.  If you have irregular cycles AND are a good sized girl you might have PCOS.

When I was diagnosed the Doctor prescribed birth control pills to regulate my cycle and said not to worry about PCOS until I wanted to have a baby. (Irregular cycles=irregular ovulation=hard to make a baby without medical intervention.) So I took my pills and didn’t worry.

Flashforward 16 more years and I’m 32 and ready to have a baby.  But what now?  Luckily, I’m a smooth talker- I was able to convince my primary care Doctor that because of my PCOS (and age) that I needed a referral for an infertility workup before my husband and I were technically declared infertile (our health insurance defined infertility as 1 year of unprotected sex in women under age 35 or 6 months in women over age 35 with no conception).

The workup showed my hormone levels were off and my ovaries were covered with the stereotypical string of pearls that PCOS is known for. But, I luckily got pregnant without intervention (and right after the Hysterosalpinogram -where they flush your fallopian tubes with dye to check for blockages but a nice side effect is then you have nice clean tubes for the egg to travel down).

Three years after delivering Baby #1  we wanted a second and that, dear friends, is where the trouble began. In the time between Baby #1 and attempts to conceive I had gotten older and gained weight. Both things that cause trouble for babymaking.  This time the fertility work up and corresponding HSG did nothing. The good news was that there had been advances in understanding PCOS. Someone somewhere had found the link between insulin resistance and PCOS.  Taking the popular diabetes drug Metformin was the  new course of action. (Of course, controlling sugar intake through diet and exercise would most likely have done the same thing but not as quickly.)

Metformin is tricky in that it SUCKS to start. It can cause significant digestive upset. Many start the drug only to dump it a few weeks later. It’s general yuckiness in the first few weeks is pretty legendary but, it really does help your body control the sugar which somehow magically allows hormones to go to normal levels so you ovulate regularly and on your own!  A big high five for Metformin. (Another new benefit of Metformin is that it seems to decrease the risk of miscarriage for women with PCOS. The risk of miscarriage is much higher for women with PCOS.)

I decided to help the Metformin work better by changing my diet to balance carbs and protein. I added lots of veggies and decreased he processed foods and sugar. It still took about a year and some medical intervention but I did get Baby #2.

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