Before my PCOS diagnosis, the longest stretch of time I remember going without a period was about six months. You can't ovulate if you don't menstruate, and you can't get pregnant if you don't ovulate. This simple, indisputable biology was something I had to repeat to many people over the course of my first year of marriage.
My husband and I were ready for a baby; my body wasn't.
For two or three years (it's hard to remember the exact time frame because I was doing everything in my power to disassociate from my reality at the time), my only diagnosis was "amenorrhea." The absence of menstruation. Periods don't just disappear, though. All of my lab work came back normal, but something was wrong. The only thing consistent about my weight was its fluctuation, I was tired all the time, and sex felt like I was being stabbed in the cervix. That's uh, not normal. At all. And I lived that way for a long time—too long.
I hated my body because I felt betrayed by it. The way it looked and the way it felt were so foreign to me, and I didn't know how to process it. So I just didn't. (Needless to say, this was not sustainable. Thanks, therapy!)
One new OBGYN (who sat with me in the exam room for nearly two hours as I poured my heart out) and one transvaginal ultrasound later, my diagnosis was confirmed: polycystic ovary syndrome (PCOS). To this day, I remember how my doctor described it: "It's like your ovaries are wearing a pearl necklace. Except instead of pearls, they're cysts."
Those "pearls" were the cause of my period disappearing faster than Carmen San Diego, why my clothes didn't fit, why I had no energy, and why I was in excruciating pain during what should otherwise be an extremely pleasurable activity!
For those who may have heard of PCOS (and you likely have, given that it's one of the most common causes of infertility) but may not know the details, here's the Cliff's Notes version: It's an insulin-resistant condition that causes a hormonal imbalance. When you have PCOS, your egg may not develop as it should, or it may not even be released at all during ovulation.
It's super common: The CDC estimates between 6-12% of menstruating people have this condition, of all ages, races, and ethnicities. While PCOS looks and feels different for everyone, the most common symptoms are irregular periods, extra body hair, thinning head hair, acne, weight gain, melasma, and skin tags. And despite being a common condition, PCOS is still widely underdiagnosed.
My most noticeable symptoms were the pain caused by the cysts and weight gain. Immediately after the ultrasound confirmed my diagnosis, my doctor started me on Metformin—an oral insulin-sensitizing agent typically used to manage type 2 diabetes. I do not have type 2 diabetes, but I do have insulin issues (aside from having PCOS, I was diagnosed with non-diabetic hypoglycemia at the age of 10). It's often effective in inducing ovulation in those who have PCOS. My doctor wanted to start conservatively in treating my PCOS (the next step would have been Clomid).
It worked. Within 33 days, I had my first period in months. Within 66 days, I had my first positive pregnancy test. (And because I know you're wondering—the act of conception was 100% pain-free. I became what I always used to make fun of: someone who cried after sex. I was just extremely relieved, OKAY??)
Instead of hating what my body couldn't do on its own, I felt relief that I had a doctor who knew and trusted the science behind diabetic medication and ovulation for women like me. I watched in wonder as my stomach grew and my entire body took on a different shape and size and never once cared about the number on the scale throughout my entire pregnancy. I was just so full of joy and gratitude that my health was in good hands and my body was working the way I always hoped it would.
That's not to say I don't struggle with body acceptance just because I learned how to accept that I have PCOS; I'm a human woman living in a society that expects me to perpetually look like I did when I was 17. I used to be a conventionally accepted size. Now I'm not. Taking Metformin (which I still do, despite the fact that I'm done having children) doesn't mean I somehow morphed back into a size six. Taking Metformin means I have a regular menstrual cycle and balanced blood sugar. That's more than enough for me.
Having PCOS means I'm always going to have it. So instead of succumbing to diet culture and not treating myself to things like new clothes simply because I am in a bigger body than I used to be, I know that I will never have my "old" body again. And that's okay! That body didn't have PCOS symptoms. This body does. That body didn't create and sustain the lives of two amazing children against the odds. This body did. That body was restricted. This body isn't. This body is free, because I don't have full control over it. Learning its limitations and how to navigate its obstacles taught me that I don't need to have full control over it.
Every body deserves to be loved, cared for, honored, and nourished—exactly for what it is.
Because there's so much more to this one brief, beautiful life than dwelling on what it isn't.