Polycystic ovary syndrome


Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders of young women. It is characterised by a group of symptoms including infrequent or irregular menses (<8 cycles per year), heavy or prolonged menstrual cycles, an excess of androgen (male hormones) and polycystic ovaries (ovaries containing many partially mature follicles). It is thought to be familial.


Androgen excess may result in acne, excess facial and body hair and reproductive dysfunction. Gestational diabetes, diabetes, obesity, cardio-vascular disease and endometrial cancer are also associated with PCOS.¹ 


Diagnosis in breastfeeding women:
Approximately 30% of PCOS women have insufficient milk²
Depression and anxiety may be present³
Reduced glandular breast tissue
Limited breast size increment during pregnancy
Limited changes in colour of areola during pregnancy
Limited changes in Montgomery glands during pregnancy
Low progesterone levels
Insulin resistance and hyperinsulinemia
Gestational diabetes
Increased risk of type II diabetes

Treatment:
Weight loss, particularly prior to conception
Progesterone, to enhance lobuloalveolar development
Monitor closely for gestational diabetes
Control of maternal blood glucose levels for better milk production
Metformin, to improve insulin resistance⁴
Express and store from 37 weeks gestation

Birth plan:
Choose a normal birth if possible
Avoid Pethidine during labour
Avoid all analgesia apart from Nitrous Oxide if possible
Skin to skin at birth and often in the following days
Breastfeed often
Express after feeds to increase prolactin receptors and stimulate production
Use a supply line for supplementation with expressed milk
Galactagogues (e.g. Domperidone) if not a diabetic
Metformin
Progesterone
Monitor baby’s output and weight gain carefully


Photo: https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
1. https://www.dralexpolyakov.com.au/polycystic-ovaries-or-pcos-whats-the-difference/
2. Marasco Lisa http://www.mobimotherhood.org/polycystic-ovary-syndrome-pcos-and-breastfeeding.html
3. https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443
4. https://www.advancedfertility.com/metformin-pcos-pregnancy.htm

​​



Call Me !

0411 603 401

Breastfeeding for Beginners

Experienced Lactation Consultant  (IBCLC)  & Midwife 

providing breastfeeding support in North Brisbane ​​