PCOS, Missing Periods, and an Unexpected Positive Pregnancy Test
Written by Dr. Christina Massinople, MD
Board-certified physician, 25 years in medicine. Functional medicine for women, licensed in Alabama, Texas and Florida.
When this woman in her early 30s first came to see me, she had been struggling with symptoms associated with PCOS for years.
Her periods were extremely irregular and sometimes absent altogether. She had unwanted facial hair, persistent acne, gas and bloating, and concerns about fertility.
Her history suggested that these problems hadn’t suddenly appeared with her PCOS diagnosis. She had experienced irregular periods and acne since high school and had been treated over the years with multiple rounds of antibiotics, two courses of Accutane, and birth control pills.
After formally being diagnosed with PCOS, she had been placed on and off birth control to help manage her symptoms. Whenever she stopped the pill, her acne typically became significantly worse and her cycles remained unpredictable.
She had also experienced a previous pregnancy that ended in miscarriage at eight weeks and had been unable to become pregnant again.
By the time we began working together, she had stopped birth control and wanted to approach her health differently.
Her initial Medical Symptoms Questionnaire (MSQ) score was 26.
Looking beyond the PCOS label
Rather than focusing exclusively on controlling her periods and acne, we stepped back and looked at the larger picture.
Her history of repeated antibiotic exposure, gas and bloating, skin problems, hormonal symptoms and PCOS gave us several areas worth exploring.
Gut health became an important part of our initial strategy.
We worked on supporting her digestive health and addressing findings from her gut evaluation while also focusing on nutrition and the foundational habits that support metabolic and hormonal health.
As we worked through her gut treatment, we adjusted along the way. When she initially experienced increased symptoms after starting the protocol, we backed down on the supplements, allowed things to settle, and then gradually worked back toward the intended dose.
This wasn’t about throwing everything at her at once. It was about paying attention to how her body responded and adjusting accordingly.
Early progress
Within a little over two months, her overall symptom burden had changed considerably.
Her MSQ decreased from 26 to 8.
Her acne, which historically became significantly worse whenever she stopped birth control, was under much better control. She was feeling well overall, although her menstrual cycles remained long and irregular.
And then, two months later, I received some unexpected news.
She was pregnant.
Because of her previous miscarriage, she was understandably cautiously optimistic. She had been tracking her basal body temperature and had noticed a sustained temperature rise approximately two weeks before taking the pregnancy test, despite believing she had “skipped” another period because her cycle had been so long.
Once she learned she was pregnant, we appropriately discontinued the supplements from her gut protocol and shifted our focus to supporting her during pregnancy.
The transformation
Her story is not about claiming that one supplement, diet or gut protocol fixed PCOS or caused a pregnancy.
It’s about what can happen when we stop focusing only on suppressing individual symptoms and start looking at the health of the whole person.
Symptom questionnaire score
Lower is better. The Medical Symptoms Questionnaire is a standard measure of overall symptom burden.
Over the course of our work together
- Acne: significantly better controlled despite being off birth control
- Overall symptoms: markedly improved
- Pregnancy: conceived several months into our work together, after a previous miscarriage and difficulty becoming pregnant
- A healthy pregnancy and delivery, and a nine month old baby boy
Her PCOS diagnosis didn’t disappear simply because she felt better or became pregnant. But her health story changed.
The real win
When she first came to me, much of her previous care had understandably focused on managing the visible manifestations of PCOS, irregular periods and acne, with birth control.
We took a broader view.
We looked at her digestive health, her history, her nutrition, her symptoms, and the factors we could actually influence.
And as those pieces began to improve, so did the way she felt.
The positive pregnancy test was an incredibly meaningful moment in her journey, but the transformation had already begun before that test ever turned positive.
She was feeling better, her symptom burden had fallen dramatically, and she was beginning to see her health as something we could support from multiple directions rather than simply a diagnosis she had to manage.
Individual results vary. This case reflects one patient’s experience and is not a guarantee of similar outcomes. No fertility outcome can be guaranteed, and pregnancy requires individualised medical care.
Where to next
Ready to work on your own terrain?
If this is sounding familiar, there are two ways to go further. Private one to one care with Dr. Massinople, or the R.E.N.E.W. Elevated Foundations membership.
