Polycystic ovary syndrome (PCOS) is a condition that throws off hormonal balance—especially key reproductive hormones like estrogen, testosterone, and progesterone. And guess what? There’s another major life event that impacts these same hormones in a big way: pregnancy!
Because both pregnancy and PCOS can throw hormones out of balance, they share a lot of the same symptoms—making it tricky to tell the difference! This can lead some Cysters to miss the early signs of pregnancy, which may delay prenatal care, increase the risk of complications, or postpone important lifestyle changes to support a healthy pregnancy.
So, today I want to walk you through the distinct and overlapping symptoms of PCOS and pregnancy. Hopefully, this will help you better understand what’s happening in your body. That way, you’ll know when it’s time to do some PCOS symptom management and when it’s time to take a pregnancy test.
PCOS And First Trimester Pregnancy Symptoms
When most women miss a period or experience some unusual pelvic pain, pregnancy is one of the first things they consider to be the cause! However, if you’ve been diagnosed with PCOS, irregular menstrual cycles and random cramping can just be a normal Tuesday. Because of this, it’s challenging for Cysters to recognize pregnancy in the first trimester!
Here’s more on why:
Can PCOS Mimic Pregnancy Symptoms?
Yes! Many of the common symptoms of PCOS mimic first-trimester pregnancy symptoms. PCOS hormonal imbalances of estrogen, testosterone, progesterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and insulin lead to symptoms like missed or irregular periods, fatigue, mood swings, bloating, constipation, headaches, pelvic pain, cramping, lower back pain, and weight gain. Of course, all these are also first-trimester pregnancy symptoms!
Because these symptoms are common for women with PCOS, they often don’t find out they’re pregnant until several weeks later than the average woman. Though it can be difficult, it’s a good idea to track your cycle, journal your symptoms, and be mindful of any symptom changes (even if they’re subtle). I also recommend keeping some pregnancy tests on hand to take a few days after your missed periods! That way, you can have extra confidence whether you’re dealing with PCOS or pregnancy.
Of course, if you ever experience changes in your symptoms, but your pregnancy test is negative, you can get a blood test for insight into what might be happening in your body! Here’s more on how PCOS affects pregnancy even beyond the first trimester.
What Are The Early Pregnancy Symptoms That Don’t Overlap with PCOS?
If you can’t rely on the standard tell-tale signs of pregnancy like missed periods, fatigue, mood swings, and weight gain, then how do you know when it’s time to take a pregnancy test? Luckily, not every symptom of pregnancy crossover to PCOS. So, below I’m going to break down other potential first-trimester symptoms to look out for!
Nausea and Vomiting
Here’s a common pregnancy symptom: morning sickness! This comes from the rapid increase of human chorionic gonadotropin (hCG), a hormone produced by the placenta that only happens during pregnancy. Other things that may contribute to nausea and vomiting are increased sensitivity to smells, changes in estrogen and progesterone, and blood sugar fluctuations.
Breast Tenderness
Pregnant women often experience breast tenderness as changes in estrogen, prolactin, and progesterone levels prompt the growth of milk ducts and glands! Plus, the increased blood flow to the breasts and fluid retention that comes with pregnancy can cause swollen and tender breasts.
Frequent Urination
Even though the fetus is very small in the first trimester, your uterus starts expanding right away. That means there’s less room for your bladder, and you’ll be making more trips to the bathroom! That spike in hCG will also increase blood flow to the pelvic area, stimulating the kidneys to produce more urine. Fluid retention plays a role, too!
New Food Cravings and Aversions
Intense cravings are super common with PCOS, especially for carbs and sweets, thanks to insulin resistance. But pregnancy cravings? They’re a whole different experience! While PCOS cravings are often tied to blood sugar imbalances, pregnancy cravings (and aversions) are triggered by hormonal shifts, increased nutritional needs, and heightened senses.
This means you might suddenly crave foods you never liked before, weird food combinations (pickles & ice cream, anyone?), or even non-food items like chalk or ice (a condition called pica, often linked to nutrient deficiencies). If you notice new and intense cravings that feel totally out of the ordinary, it could be a sign of pregnancy rather than just PCOS!
Dizziness or Lightheadedness
Increased blood volume, low blood sugar levels, chances in circulation, iron deficiencies, hormonal fluctuations, and even morning sickness during the first trimester of pregnancy can lead to feelings of dizziness or lightheadedness.
Spotting
A lot of changes are happening to the uterus during pregnancy, so even though you’re not experiencing periods, spotting isn’t uncommon. This can happen when the egg attaches to the uterine lining or due to increased sensitivity of your cervix.
Heightened Sense of Smell and Smell Aversions
No one knows exactly why pregnancy heightens your sense of smell, but many experts believe it’s an evolutionary defense mechanism—helping pregnant women instinctively avoid harmful foods and substances. Others suggest it’s linked to rising hCG levels in early pregnancy. Whatever the cause, heightened smell sensitivity is a super common first-trimester symptom and can even contribute to food aversions and nausea!
Increased Basal Body Temperature
Tracking changes in basal body temperature (BBT) is one of the most reliable ways to monitor your menstrual cycle with PCOS. Normally, BBT rises by about 0.5°F to 1.0°F (0.3°C to 0.6°C) after ovulation due to progesterone. If you notice a consistent rise in temperature lasting more than 18 days, it could be an early sign of pregnancy!
Changes in Cervical Mucus
The hormonal fluctuations that come with pregnancy can change cervical mucus. The mucus usually increases, becomes thick and stretchy, and has a milky white color. Seeing this change in cervical mucus could mean you’re pregnant.
Leg Cramps
Increased blood volume can slow circulation and increase swelling in the legs, causing cramps. Pregnant women often experience these at night! Additionally, pregnant women require more fluids and daily nutrients. If a woman with PCOS doesn’t realize she’s pregnant and fails to meet these needs, leg cramps could be even more likely.
Vivid Dreams
Here’s a strange one, but it’s super common with pregnancy! Changes in progesterone and estrogen can alter brain activity and influence the way dreams are processed and remembered, which could contribute to vivid, crazy dreams. Pregnant women also experience more Rapid Eye Movement (REM) sleep than non-pregnant women, and this is where dreams happen. This can contribute to those wild dreams, too!
Know your pregnancy as soon as possible by differentiating between PCOS and pregnancy symptoms!
When you have PCOS, your body can feel totally out of control. Knowing what’s going on inside your own skin can feel impossible, but it’s so important for your personal well-being to be aware of changes happening in your body. There are a lot of overlapping symptoms of PCOS and pregnancy, but understanding the distinct side effects of pregnancy can help you identify the early signs, so you know when it’s time to test!
Interested in how you can increase your chances of getting pregnant with PCOS and have a healthy PCOS pregnancy? Check out these other blog posts and podcast episodes:
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