PCOS symptoms in pregnancy

Overview

PCOS (polycystic ovary syndrome) is a common hormone condition that affects how the ovaries work. It can cause irregular periods, extra androgen hormones, and small cysts on the ovaries. These changes do not stop when you become pregnant. Your body is already adjusting to pregnancy, so some PCOS symptoms may feel different, improve, or get worse.

Yes. PCOS is one of the most common hormone problems in people of reproductive age. It affects around 1 in 10 people who have ovaries.

PCOS mainly affects people with ovaries during their reproductive years. It is often diagnosed in the teens, twenties, or thirties, so it can be present during pregnancy.

Symptoms

Common symptoms

• Mild bloating or pressure in your belly
• Tiredness and fatigue
• Nausea or vomiting in early pregnancy
• Mood swings or feeling more emotional than usual
• Acne breakouts or extra hair growth on the face, chest, or belly
• Weight gain or difficulty managing pregnancy weight
• Occasional mild cramping (always check with your provider)

Symptoms in children

• Not applicable — PCOS is usually diagnosed after puberty, and this article focuses on PCOS during pregnancy.

Symptoms in older adults

• Not applicable — this article is about PCOS symptoms during pregnancy, which affects people of reproductive age.

Causes

Main causes

• Hormone imbalances, including higher levels of androgens (sometimes called 'male-type' hormones)
• Insulin resistance, meaning your body does not use insulin effectively, causing higher blood sugar levels
• Inflammation and genetic factors that can run in families

Risk factors

• Having a family history of PCOS
• Living with overweight or obesity
• Having insulin resistance or type 2 diabetes
• Being born with certain genetic or hormonal tendencies

When to see a doctor

See a doctor urgently if:

• If you have heavy bleeding, severe pain, or signs of pre-eclampsia (a serious pregnancy condition involving high blood pressure), get urgent medical help right away.
• If your baby's movement pattern changes or slows down after 28 weeks, contact your maternity team the same day.

Book a routine appointment if:

• Tell your healthcare team at your first pregnancy appointment that you have PCOS or suspected PCOS.
• Attend all scheduled prenatal checks, even if you feel fine.
• Ask about any new symptom, no matter how small it seems.

Diagnosis

PCOS is usually diagnosed before pregnancy based on your menstrual history, symptom review, blood tests, and an ultrasound scan of your ovaries. During pregnancy, ultrasound pictures of the baby can make the ovaries harder to see, so your provider may rely more on your medical history, symptoms, and blood tests.

Tests that may be done

• Blood tests to check hormone levels and blood sugar
• An ultrasound scan of your ovaries
• Blood pressure checks at every appointment
• Urine tests to check for protein or signs of infection
• A glucose test later in pregnancy to check for gestational diabetes

What to expect at your appointment

You will likely have more frequent prenatal appointments than people without PCOS. Your team will check your blood pressure, urine, blood sugar, and your baby's growth using ultrasound. These checks are routine — they are there to catch problems early and keep you and your baby safe.

Treatment

Treatment for PCOS during pregnancy focuses on keeping your blood sugar, blood pressure, and overall health as stable as possible. There is no single treatment plan because every pregnancy is different.

Self-care at home

• Eat regular meals and snacks to keep blood sugar steady
• Drink plenty of water and choose water instead of sugary drinks
• Get pregnancy-safe exercise after checking with your team
• Rest when you are tired and try to sleep on your side in late pregnancy
• Manage stress with slow breathing, gentle movement, or talking with someone you trust

Medical treatments

Your healthcare team may suggest treatments to manage blood sugar, blood pressure, nausea, or blood clot risk during pregnancy. Any medicine you take is chosen carefully and only when the benefit to you and your baby outweighs the risk. Always ask about why a medicine is recommended and what to watch for.

When is surgery considered?

Surgery is not used to treat PCOS during pregnancy. If a separate surgical emergency arises, your team will discuss the risks and benefits with you before deciding what is safest.

Living with this condition

Take each day as it comes. Some days you may feel full of energy; other days you may feel drained. Keep a small notebook of symptoms, questions, and baby movements so you feel more in control at appointments.

Lifestyle tips

• Keep a routine for meals, gentle movement, and rest
• Wear comfortable, loose clothing
• Ask for help with housework, childcare, or errands when you need it
• Stay in touch with people who make you feel safe
• Join a prenatal class or group so you can share experiences

Diet and exercise

Eat a balanced diet with vegetables, fruits, whole grains, lean protein, and healthy fats. Regular meals help keep blood sugar steady. For exercise, walking, swimming, and prenatal yoga are good options if your provider says they are safe for you. Aim for regular movement rather than intense workouts.

Mental health and emotional wellbeing

Pregnancy with PCOS can bring worry, low mood, or anxiety, especially if you have had fertility struggles before. These feelings are real and valid. Talk to your midwife or doctor about how you are feeling. If you ever have thoughts of hurting yourself or your baby, call your local emergency number or a crisis line right away.

Prevention

PCOS itself cannot be prevented, but pregnancy complications can be reduced. If you have PCOS and are planning pregnancy, ask for a pre-pregnancy health check. If you are already pregnant, the next best thing is to attend all appointments, follow your care plan, and let your team support you.

Vaccines

There is no vaccine for PCOS. Your healthcare provider may recommend routine vaccines that are safe in pregnancy to protect you and your baby. Ask your midwife or doctor which vaccines are right for you.

Screening programmes

There is no screening test for PCOS itself. During pregnancy, your team will routinely check your blood pressure, urine, blood sugar, and baby's growth. These checks help spot problems early, especially if you have PCOS.

Complications

If left untreated

• Pregnancy-related high blood pressure or pre-eclampsia
• Gestational diabetes
• Preterm birth or early labour
• Baby being born smaller or larger than expected
• Higher chance of needing a caesarean birth

Long-term outlook

With regular care, most people with PCOS have a healthy pregnancy and a healthy baby. You may need extra check-ups, but that is a sign of good care, not a reason to worry. Your healthcare team will walk through each step with you, and you are not alone.

Find support

External links open third-party websites. Ruqelo Health is not responsible for external content. Listing an organisation does not imply endorsement.