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PCOS, fertility & training - what worked for you?
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Hi Ladies!

I was recently diagnosed with lean PCOS and would like to start trying to get pregnant later this year. After coming off BCP in December and not having a period for a few months my doctor figured it was exercise induced (ironman in March and training for another this summer). She ran some bloodwork after having me do the progesterone challenge and she diagnosed me with PCOS. She is open to me starting metformin, but I'm hesitant to do anything before my next race, so I was planning on starting after. Then my plan would be to give myself a few months on that prior to starting to try. My body fat isn't super low, but I'm open to possibly needing to change my workouts to help.

Does anyone else have experiences with PCOS, metformin and getting pregnant while training? I won't be in ironman training mode after this next race, but will continue working out. Any thoughts would be greatly appreciated!
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Re: PCOS, fertility & training - what worked for you? [Five_year_plan] [ In reply to ]
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PCOS here, and on metformin for bouts of low blood glucose. The metformin works pretty well for me, but I'm pretty sure it only really helps stabilize blood sugar. I'm not sure it will do anything to help you ovulate if that's the issue. Some people get an upset stomach when first taking it, so either take it long before your race so you can get used to it, or wait until afterward to start.

Have you had an ultrasound of your ovaries as part of the diagnosis process? That will help tell if they're cystic and not releasing eggs like they should. It's not the most pleasant ultrasound to undergo, though.

Feel free to PM me if you don't want to share here.
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Re: PCOS, fertility & training - what worked for you? [Five_year_plan] [ In reply to ]
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I had similar issues as well. My OB always said not to stop taking birth control (or put me on meds to help get pregnant) until we were ready to actually be pregnant. After coming off BC I didn't get regular periods and then stopped getting them altogether, so my OB ended up giving me something to induce periods (can't remember the name, but PM me if you want me to look it up), then Letrizole to try to get me to ovulate when that wasn't happening. When that didn't work with my OB, I went to a specialist and she diagnosed me with PCOS and put me on a combo of pills (including Metformin) and had me take an Ovidrel shot. That worked and we got pregnant the first month :)

As far as training, my OB never made me cut back, so I did 3 half ironmans during that time. When she referred me to a specialist I was in the middle of training for a marathon (trying to qualify for Boston). The specialist said I could keep training through my marathon, but recommended I cut back my mileage afterward, as a precaution (fyi, i had been off BC for over a year at this point). I ended up finding out I was pregnant 4 days before my race and still hit my qualifying time of 3:32:36 :)

I personally would not worry about it or start taking meds until I was ready to be pregnant, but have a plan set up with my doctor for what we were going to do once I was ready.

Good luck and happy racing.
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Re: PCOS, fertility & training - what worked for you? [jl2732] [ In reply to ]
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Best of Luck.
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Re: PCOS, fertility & training - what worked for you? [Five_year_plan] [ In reply to ]
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I have skinny PCOS. When I was TTC and it became an issue, I was maybe 135 and 5'6". I never went on medication but was eventually able to get pregnant (twice) with the help of OPKs and time. Anyway, "skinny" or not, I found that keeping my weight down was critical for managing the PCOS. I was kind of a chubby 135 lb / 66", and had actually gained some weight thinking perhaps I was exercising too much, but with hindsight, I'm pretty sure I had the opposite problem. I've found that if I stay down around 125, I have fairly regular cycles, much more so than when I'm 10 or 15 pounds heavier. For me, more exercise was the answer, not less.

I never went on Metformin, so I can't comment on that.
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Re: PCOS, fertility & training - what worked for you? [Five_year_plan] [ In reply to ]
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PCOS is becoming a blanket term for women who have unexplained infertility and/or prone to skip periods, as athletes are prone to doing. I would undergo the ultrasound to confirm presence of ovarian cysts before hitting the drugs. Metformin really messes with your stomach and is linked to weight gain.
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Re: PCOS, fertility & training - what worked for you? [jocks] [ In reply to ]
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Thanks for your response. Since my post I decided to see an RE since I wasn't convinced I had PCOS. I have gone and he thinks my lack of ovulation is hypothalamic amenorrhea due to exercising. He isn't concerned about my weight, but thinks doing 2 Ironmans this year was the culprit. We are going to wait another month to see if I have a cycle and if not, we will start on ovulation meds.
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