How to track and understand your cycle if you have PCOS
LAST UPDATED: Oct 11, 2021
6 MIN READ
HERE'S WHAT WE'LL COVER
Tracking your menstrual cycle is a powerful way to understand your body, and this is especially true if you have polycystic ovary syndrome (PCOS).
PCOS is a very common reproductive health condition that affects 1 in 10 people with ovaries. Not all people with PCOS experience the exact same set of symptoms, but experiencing irregular periods is one of the most common ones.
In this article, we’ll walk through the key things to know about how PCOS affects fertility, how tracking your cycle can help, and what the best cycle-tracking tools are. But first, here are your biggest takeaways:
PCOS is a leading cause of infertility because it can disrupt ovulation, which is a critical step in getting pregnant.
Cycle tracking can be an especially powerful tool for people with PCOS — whether or not you’re trying for kids. You can use recorded info about your cycle to talk to your healthcare provider about treatment plans.
Cycle-tracking apps, ovulation predictor kits (OPKs), cervical mucus monitoring, and basal body temperature (BBT) tracking can all help you get insight into your cycle (though some of these methods are more accurate than others).
Tracking ovulation when you have PCOS can be more challenging if you have irregular cycles. But experimenting with the various tools and methods available can help you find the right one for you.
A quick refresher on PCOS and menstrual cycles
PCOS is a hormonal disorder that's marked by high levels of “male” sex hormones (androgens like testosterone), multiple immature ovarian follicles (the fluid-filled sacs that house and develop eggs), and/or anovulatory (a lack of ovulation) menstrual cycles. But PCOS in one person doesn't always look or feel the same as it does in others.
In people who have PCOS, the intricate sequence of hormonal changes that prepares for an egg's release from an ovary (read: ovulation) doesn't always happen — making the condition one of the leading causes of infertility. When ovulation doesn't occur, getting pregnant isn't possible because there's no egg available to be fertilized by sperm. But if you have PCOS and want to start trying to conceive (aka TTC), medications like clomiphene citrate (aka Clomid) and even lifestyle changes (nutrition and exercise) can help ovulation become more regular.
If you have PCOS (and even if you don't), one thing that can help you get a better sense of your cycles and whether or not ovulation is happening regularly is cycle tracking.
What are the benefits of tracking your cycle if you have PCOS?
Before talking about benefits of cycle tracking when you have PCOS, it's important to make one thing clear: If you go three months without a period or have fewer than 10 periods per year, it's time to reach out to your healthcare provider. You don't need to track your cycle by doing anything more than jotting down when your period comes to have details for your provider, but using some of the methods we'll outline below might help you keep better tabs on that information.
All of that said, cycle tracking can help you better understand your body's patterns and give you a starting point for conversations with your doctor, among other benefits:
Get a clear record of your cycle so you can share it with your doc: Because PCOS can cause irregular cycles, keeping a record of them (using an app or other recording tool) is essential. You’ll be ahead of the curve on conversations with your doctor when you can show them the play-by-play of how your cycle's been going. They can use that info to help you better manage your symptoms or plan ahead for pregnancy.
Understand when you’re most likely ovulating: Ovulation can be tricky to pinpoint when your cycles are irregular. Tracking ovulation can give you a benchmark to help you understand where you may be in your cycle. You may even discover that you’re likely not ovulating at all, which is important to discuss with your healthcare provider. They can help you think through next steps and treatment options — like birth control pills if you're not TTC or ovulation-inducing medications if you are.
Know what’s normal for your cycle so you can identify changes. For all people who menstruate, having a baseline understanding of your cycle is important so you can identify if something changes suddenly. Shifts in the timing or symptoms that come with your cycle can indicate other health issues, so it’s important to bring these changes up with your healthcare provider.
Similar to the first bullet we included above, if you think you might have PCOS but haven’t been diagnosed yet, understanding your cycle can also be helpful when approaching your doctor to discuss your symptoms.
How can you track your cycle if you have PCOS?
There are lots of ways to get insight into your cycle if you have PCOS. But because the symptoms and experiences of PCOS can vary a lot from person to person, some of the following methods might work better for your body than others. You can always experiment until you find the one that's right for you:
Cycle-tracking apps: Cycle-tracking apps are an easy way to establish a record of the length and timing of your cycle. Some apps can make predictions about when your next period or ovulation is likely to come — if you have irregular or very long cycles, though, an app might not be able to make predictions.
Ovulation predictor kits (OPKs): Ovulation predictor kits (OPKs), or ovulation tests, work by measuring the amount of luteinizing hormone (LH) in your urine. Since LH surges about 24-48 hours before ovulation, tracking LH is one of the best predictors for when you’re likely to ovulate.
Cervical mucus: Another way to clue you into your menstrual cycle is to keep tabs on your cervical mucus. At different times in your cycle, you might notice changes in the amount (and type) of mucus your cervix produces.
Basal body temperature (BBT) tracking: The idea behind tracking basal body temperature (BBT) is that your body temperature rises slightly during ovulation, so keeping an eye on your temp can help you understand if ovulation has occurred. BBT is a less accurate way to track ovulation than other methods because there are lots of things that can impact your body temp — including illness, sleep patterns, stress, and alcohol (to name a few!). And because temps rise after ovulation, it's a better predictor of whether or not you've already ovulated.
A note about birth control: Some forms of hormonal birth control work by preventing ovulation and affect the menstrual cycle. You can still track your cycle if you’re on birth control, but it's important to take your birth control into account when thinking through the cycle-tracking method that works best for you and your goals. Here's an example: The combination pill works by suppressing ovulation, so if you’re on this form of birth control, tracking LH or using a cycle-tracking app that logs LH levels won't be helpful because you won’t be ovulating.
What might make cycle tracking more challenging for people with PCOS?
Like we mentioned earlier, one of the hallmarks of PCOS is irregular or absent cycles. Depending on how irregular your cycle is, it might be harder for the cycle-tracking apps to provide predictions about your cycle and your most fertile days. Irregular cycles can also make using traditional threshold-based LH tests more difficult if your LH stays below the “typical” threshold of 25 mIU/mL — that means you might never get a positive result even if you are ovulating.
(Our clinical team recommends testing in the afternoons and twice a day during your fertile window, the five days leading up to and the day of ovulation, for better chances of catching your LH surge.)
All that said, it's important to understand that no LH test or app can tell you that you're definitely ovulating. According to Modern Fertility medical advisor and fertility specialist Dr. Temeka Zore, MD, FACOG, if your cycles generally last between 21-35 days, that’s a sign that you’re likely ovulating. If you’re getting your period more like every 2-4 months, it’s harder to predict if you're ovulating. If you’re having trouble pinpointing ovulation or think you might not be ovulating, it’s a good idea to talk to your healthcare provider.
What can you actually do with the information once you're tracking your cycle?
Once you’ve invested the time to get familiar with your cycle (using one or more of the options we’ve explored in this article), you’ll be a step ahead on bringing up any potential issues with your doctor. If PCOS is interfering with your ovulation, bringing a detailed record of your cycle to your next appointment can help inform treatment options and next steps.
Even if you’re not TTC, having a record of what’s normal for you can help you identify if something is off with your cycle. Changes to your menstrual cycle can indicate other health issues, so keeping tabs on it will help you advocate for yourself when talking with your healthcare provider.
The bottom line
If you have PCOS, tracking your cycle is a great way to gather intel about what’s going on in your body. Cycle tracking can help you understand if (and when) you’re ovulating, and there are a variety of cycle-tracking methods to choose from. Armed with a detailed record of your cycle, you’ll be better prepared to get the best care and medical advice from your healthcare provider.
This article was reviewed by Dr. Sharon Briggs, PhD, Modern Fertility's head of clinical product development.
If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.