How to Track Your Cycle with PCOS: A Practical Guide

Many women with PCOS I work with describe feeling lost when it comes to their cycles. “My app says I should be ovulating today, but I haven’t had a period in months.” Others share with me the frustration they have of never seeing a positive ovulation test, despite trying month after month. Unfortunately these experiences are not unusual. Tracking cycles in PCOS is complex, and often the tools designed for “average” cycles just don’t work.

In this blog, we will look at why tracking feels confusing in PCOS, what you can track more reliably, and how wearable and digital fertility trackers fit into the picture.

Why cycle tracking feels confusing with PCOS

Most fertility awareness methods and apps are designed around the assumption of a 28-day cycle, with ovulation on day 14. For women with PCOS, cycles are often longer, shorter, or unpredictable, and ovulation may happen later, less frequently, or not at all. This makes standard predictions inaccurate.

There are also unique challenges:

• Elevated luteinising hormone (LH): Ovulation predictor kits (OPKs) measure LH, which normally surges before ovulation. In PCOS, LH can already be high at baseline, leading to false positives.
• Anovulatory cycles: Some women experience monthly bleeding but without ovulation, making cycles appear “regular” when ovulation isn’t occurring.
• Unreliable signals: Changes in cervical mucus or basal body temperature may still occur, but they can be harder to interpret in PCOS. See below for further details.

This combination of irregular cycles, altered hormone levels, and inconsistent signals makes tracking with PCOS uniquely challenging — but not impossible.

How to track cervical mucus

Cervical mucus is one of the most useful signs of fertility. Rising oestrogen around ovulation makes mucus clearer, wetter, and more slippery. After ovulation, progesterone thickens mucus again. In PCOS, these patterns can be less predictable, but paying attention over time can still reveal valuable information.

• Check daily: Once a day, observe mucus either by wiping with toilet paper, collecting a small sample with clean fingers, or noting changes in your underwear.
• Look for changes: Record whether mucus is dry, sticky, creamy, watery, or stretchy. The “egg-white” type (clear and stretchy) is typically associated with higher fertility.
• Notice sensation: Pay attention to whether you feel dry, damp, or slippery.

Because hormone fluctuations in PCOS can produce mucus without actual ovulation, this method is not perfect, but it can still offer insight into your unique patterns.

How to track basal body temperature (BBT)

Basal body temperature can help confirm that ovulation has happened. Progesterone released after ovulation raises resting body temperature slightly.

• How to measure: Use a sensitive thermometer and take your temperature every morning immediately after waking, before getting out of bed or drinking anything. Try to do this at the same time each day.
• What to expect: If ovulation occurs, you may see a small but sustained temperature rise that lasts until your next period.
• Limitations: Poor sleep, illness, alcohol, or stress can all affect readings. In PCOS, the rise may be less clear or inconsistent.

BBT confirms ovulation after the fact but cannot predict it. It works best alongside other methods rather than on its own.

Journal your cycle

Keep a record of your cycle so you can find out what is happening for you. Consistency matters more than the format you choose. Options include:

• Paper journals or charts: A fertility notebook or calendar lets you write down daily observations of mucus, temperature, and symptoms.
• Digital logs: Some apps allow you to record data without relying on their predictions. This can be helpful if you prefer to store everything in one place.
• Spreadsheets: Customisable, and especially useful if you like visualising data over time.

The aim is to notice your patterns, not to fit your cycle into a textbook model.

Can new technologies help?

Wearable devices and fertility trackers are becoming increasingly popular. Many women use them already for sleep, fitness, or general wellbeing, but can they can also help with cycle tracking in PCOS?

Here is an overview of some of the options currently available. This is for information only (we are not affiliated with or endorsing any company, and this should not be taken as a product recommendation):

• Oura Ring: Measures temperature, heart rate variability, and sleep. Useful for spotting overall trends but designed for women with regular cycles. Predictions may be less reliable in PCOS.
• Tempdrop: A wearable thermometer worn on the arm overnight. It can make BBT tracking easier for women who struggle with consistent wake-up times. However, like all BBT devices, it confirms ovulation after it happens rather than predicting it.
• Ava Bracelet: Worn overnight, measuring multiple signals such as temperature, pulse rate, and breathing. Data may be less accurate in very irregular cycles.
• OvuSense: A vaginal sensor that measures core body temperature continuously. It claims to work better in irregular cycles but some women say it can feel invasive and is more expensive.
• kegg: A device that measures electrolyte changes in cervical mucus. Potentially useful, but relies on good mucus production, which may not always be the case in PCOS.
• Mira Fertility Tracker: Mira is a home urine test system that measures hormones including LH, oestrogen, and progesterone metabolites, giving numerical values rather than simple positives/negatives. This can be more useful for PCOS because it tracks multiple hormones, though interpretation may still be tricky with irregular cycles and consistently elevated LH.
• Natural Cycles: This app uses basal body temperature data (and in some cases Oura Ring integration) to predict fertile days. Again, its accuracy depends on regular cycles and consistent ovulation. In PCOS, where ovulation is unpredictable, the app may label long stretches of “red” (fertile) days, which can be frustrating and limiting.

Emerging devices are also starting to measure saliva hormones or combine multiple parameters. While promising, most have not been thoroughly validated in women with PCOS.

The bottom line: Technology can be a helpful tool, but in PCOS it is best seen as an additional source of information rather than a standalone solution. Combining data from wearables with your own observations and professional support often provides the clearest picture.

When to seek professional support

If your tracking leaves you feeling more confused than informed, it may be time to seek support. In PCOS, ovulation is not always straightforward, and trying to decode apps or devices alone can feel overwhelming.

While cycle tracking can provide useful insights, it is not a diagnostic tool. If you have very infrequent periods (fewer than four per year), prolonged cycles (longer than 35–40 days), or symptoms that interfere significantly with your quality of life, medical assessment is important.  Your GP or specialist can rule out other causes, offer medical investigations, and discuss options for managing PCOS. Nutrition and lifestyle support can work alongside medical care, but they are not a substitute for it.

Working with a qualified practitioner can help you interpret your data and understand what it means in the bigger picture of your health. If you are trying to conceive, fertility specialists can also advise on medical options when needed. Don’t hesitate to book a call with us if you’d like to talk further.

For more detail on how nutrition and lifestyle support ovulation in PCOS, see our article: Understanding Ovulation and Fertility Challenges in PCOS.

Please note, we do not endorse or sell any products mentioned. Devices should be chosen with professional guidance.

Why is my ovulation all over the place?

Ovulation and Fertility Challenges in PCOS Explained

Often when I speak to women in the clinic for the first time, they come with feelings of having been dismissed. Many are told to “just lose weight” or are left with little explanation as to why their cycles are so unpredictable. And when it comes to fertility, the confusion and worry can be overwhelming. This blog takes a look at how PCOS affects ovulation and fertility, looking at the signs you may not be ovulating, and also evidence-based ways to support your body naturally. Whether you are looking to have a baby or not, regularly ovulating is super important for you health. Read on to find out why.

What is ovulation and why does it matter in PCOS?

Ovulation is the point in the menstrual cycle when an ovary releases a mature egg. In a typical cycle, this happens once a month, around the middle of the cycle. In PCOS, hormonal imbalances mean ovulation can often be irregular or absent entirely.

Ovulation matters not just for conception but for overall health. And this is key. Regular ovulation supports progesterone production, balances oestrogen, and plays a role in bone, heart, and uterine health. When ovulation is disrupted, many of these systems can be affected too.

How PCOS affects ovulation

PCOS is characterised by higher levels of insulin and androgens (male hormones like testosterone). Elevated insulin drives the ovaries to produce more androgens, which then interfere with normal follicle development. Instead of one follicle maturing and releasing an egg, several small follicles remain underdeveloped, which can lead to missed or irregular ovulation.

This is why cycles may be long, unpredictable, or sometimes appear regular but without ovulation actually taking place (anovulatory cycles).

Signs you may not be ovulating regularly

Are you wondering if this might be you? Clues that ovulation may be inconsistent include:

• Cycles that are longer than 35 days
• Periods that come unpredictably or are missed altogether
• Negative results on ovulation predictor kits (although these can often be unreliable in PCOS due to elevated LH)
• Lack of noticeable changes in cervical mucus or basal body temperature

Some women also bleed monthly without ovulation — highlighting just how confusing PCOS cycles can be without deeper investigation.

Fertility treatments vs lifestyle approaches

Medical options such as ovulation induction or assisted reproductive technology can be effective and are appropriate for many women with PCOS. Alongside these, nutrition and lifestyle changes are strongly recommended in the current guidelines as first-line therapy to support fertility. These are not quick fixes, but consistent approaches that create a better environment for ovulation to happen. And again – even if you’re not looking to have a baby right now (or ever!) regular ovulation should be considered a vital sign – it’s important for your health.

Balancing blood sugar

Insulin resistance is common in PCOS and disrupts ovulation by raising androgen levels. Stabilising blood sugar helps to reduce these effects. Research shows that balanced meals combining protein, healthy fats, and fibre-rich carbohydrates improve insulin sensitivity and ovulation frequency.

Some small changes you can include are:

• Always pairing carbohydrates with protein (e.g. apple with nut butter)
• Choosing pulses over refined carbs (e.g. swapping rice for lentils)
• Avoiding sugary drinks and choosing water or herbal teas instead
• Eating three good meals per day, and trying to avoid snackign

Key nutrients for ovulation

Certain nutrients have shown particular benefit in PCOS and fertility research:

• Myo-inositol: may improve insulin sensitivity and has been shown in trials to restore more regular ovulation.
• Vitamin D: often lower in women with PCOS; adequate levels are associated with better cycle regulation and fertility outcomes.
• Omega-3 fatty acids: support lower inflammation and may reduce androgen levels.
• Magnesium and zinc: both play important roles in insulin action, ovarian function, and egg development.

Food sources matter — oily fish, nuts, seeds, legumes, and green leafy vegetables all contribute these nutrients in a natural form.

Stress and fertility in PCOS

High stress levels can disrupt the delicate hormonal signalling needed for ovulation. Cortisol interferes with the hypothalamic–pituitary–ovarian axis and can also worsen insulin resistance and inflammation.

Mind–body approaches such as yoga, mindfulness, gentle walking, or breathwork have been shown to lower stress in women with PCOS and are linked with improved cycle regularity. Building daily practices to calm the nervous system is just as important as food and supplements.

Movement and exercise

Exercise improves insulin sensitivity, lowers androgens, and supports ovulation. Both aerobic activity (such as brisk walking or cycling) and resistance training (such as weights or bodyweight exercises) are effective.

Research shows that even modest increases in activity improve metabolic and reproductive outcomes in PCOS. Consistency matters more than intensity, and over-exercising can sometimes have the opposite effect. Aiming for regular, enjoyable movement is the best approach.

Sleep and circadian health

Poor sleep is increasingly recognised as a hidden driver of hormonal imbalance. And women with PCOS have been seen to have higher rates of sleep disturbance. Annoyingly, insufficient sleep worsens insulin resistance, inflammation, and stress hormones – so it’s a vicious cycle. 

Prioritising good sleep hygiene: a consistent bedtime, minimising screens in the evening, and creating a dark, cool sleep environment, can support more regular ovulation. Screening for sleep apnoea is also important where symptoms suggest it. Check with your GP or healthcare provider.

Gut health and inflammation

The gut microbiome is closely linked with both immune and hormonal health. Research shows women with PCOS often have less microbial diversity, which may contribute to inflammation and insulin resistance.

Supporting the gut through fibre diversity (vegetables, nuts, seeds, pulses), prebiotic foods (onion, garlic, asparagus), and fermented foods where tolerated may help reduce systemic inflammation and support ovulation.

Reducing endocrine disruptor exposure

Environmental chemicals such as BPA and phthalates can mimic or interfere with hormone signalling. Research suggests they may worsen symptoms in PCOS.

Practical steps include avoiding microwaving food in plastic, choosing glass or stainless-steel water bottles, and reducing use of fragranced personal care products where possible. These small changes may help reduce the overall hormonal burden.

Alcohol, smoking and ovulation

Both alcohol and smoking are linked with reduced fertility outcomes. Excess alcohol can disrupt cycles and ovulation, while smoking contributes to oxidative stress and poorer egg quality. Minimising or avoiding these is an important but often overlooked step for reproductive health in PCOS.

Anti-inflammatory dietary patterns

Low-grade inflammation is a recognised driver of PCOS symptoms. Diets rich in antioxidants and omega-3 fats, and lower in ultra-processed foods, support a more balanced inflammatory state.

The Mediterranean diet, with its emphasis on vegetables, legumes, fish, olive oil, and nuts, has been shown to reduce inflammation and improve metabolic and reproductive outcomes.

When to seek support

If you’ve been trying to conceive for over a year (or six months if you’re over 35), fertility investigations are recommended. But you don’t have to wait until then. If your cycles feel confusing, or if you’ve felt dismissed by healthcare professionals, getting evidence-based support sooner can make the process less overwhelming and give you practical steps forward.

Whether you’re hoping to conceive now or in the future, there are clear, evidence-backed ways to create better conditions for ovulation. And you don’t have to figure it out alone.  Why not get in touch and book a free call? We’d love to talk further with you.

PCOS and Menopause

PCOS is often considered a long-term condition, and while symptoms can change over time, menopause does not necessarily make them disappear altogether.

In the UK, the average age of menopause — defined as 12 months without a period — is around 51. Research suggests that women with PCOS may experience menopause a little later, on average 2–4 years after women without PCOS. However, it can sometimes be harder to recognise perimenopause in women with PCOS, as irregular or missed cycles are already common.

How PCOS and menopause symptoms can overlap

Some of the changes associated with perimenopause can mirror PCOS symptoms, such as irregular cycles, weight gain around the middle, insulin resistance, or increased hair growth. Because oestrogen and progesterone naturally decline during perimenopause, women with PCOS — who may already have lower levels of these hormones — may find some symptoms feel more noticeable in the short term.

One potential positive is that androgen levels also tend to decline with age, and some women with PCOS may see improvements in acne, hirsutism, or even more regular cycles as they transition through perimenopause.

Research suggests hormone changes can bring about differences such as:

• Menstrual changes: Women with PCOS may notice their cycles becoming shorter and more regular, while those without PCOS may experience increasing irregularity.
• Hair and skin: Acne and hirsutism may improve, although thinning hair can still persist.
• Insulin sensitivity: Insulin resistance may continue into menopause, which can be linked with higher risk of type 2 diabetes and changes in weight.
• Cardiovascular health: Some studies suggest that women with PCOS have higher levels of inflammatory markers during and after menopause, which may be associated with an increased risk of cardiovascular disease and stroke.

The bigger picture

Menopause does not “cure” PCOS, but hormonal changes during this life stage can shift which symptoms are more prominent. While ovulation naturally comes to an end (which resolves cycle-related symptoms), other aspects of PCOS may persist or evolve.

Continuing to focus on nutrition, movement, stress management, and lifestyle habits that support hormone balance and overall health can be valuable at this stage of life. It’s also important to keep up with regular GP health checks.

If you’d like to explore how nutrition and lifestyle support may help during PCOS and menopause, you’re welcome to book a free call with us.

Please note: we do not diagnose or treat PCOS or menopause. Nutrition and lifestyle support can complement medical care, but diagnosis and treatment should always be discussed with your GP.

PCOS and Fertility

Polycystic Ovary Syndrome (PCOS) is one of the most common hormone-related conditions in women of reproductive age. In the UK, it is estimated to affect around 1 in 10 women. PCOS can be associated with irregular menstrual cycles and ovulation problems, which may make it more difficult to conceive.

The good news is that with appropriate medical support — and attention to lifestyle factors — many women with PCOS go on to conceive and have healthy pregnancies.

How PCOS may affect fertility

• Irregular ovulation: In PCOS, hormonal changes such as higher levels of androgens (e.g. testosterone) can sometimes disrupt the regular release of eggs (ovulation).
• Egg development: Hormonal imbalance may also influence how eggs mature, which can affect fertility.
• Conception challenges: The combination of less frequent ovulation and possible changes in egg development can make natural conception more difficult for some women.

Support options for PCOS and fertility

• Nutrition and lifestyle: Research suggests that dietary changes, regular movement, stress management, and supporting healthy inflammation responses may help improve overall wellbeing and support more regular cycles in some women with PCOS.
• Medical treatments: Ovulation induction medications are sometimes prescribed by doctors to encourage egg release.
• Assisted conception: If other approaches are not effective, treatments such as IVF may be recommended by fertility specialists.

Important considerations

• Early conversations: Raising fertility concerns with your GP or specialist early can help ensure the right investigations and support are in place.
• Individual approaches: PCOS presents differently from person to person. The most appropriate strategy will depend on personal health, symptoms, and medical guidance.

The positive news

Although PCOS is often considered a long-term condition, it can be managed, and many women with PCOS do have healthy pregnancies.

If you’d like to explore how nutrition and lifestyle support may fit into your wider fertility journey, you’re welcome to book a free call with us at PCOS Clinics.

Please note: we do not diagnose or treat PCOS or fertility issues. Nutrition and lifestyle approaches can complement medical care, but diagnosis and treatment should always be discussed with your GP or fertility specialist.

PCOS in Teens

Polycystic Ovary Syndrome (PCOS) is one of the most common hormone-related conditions in women of reproductive age. In the UK, it is estimated to affect around 1 in 10 women.

While symptoms can start in the teenage years, diagnosing PCOS in adolescents is slightly different from in adults. Current guidelines recommend that for those under 20, doctors look mainly at hormone levels and irregular or absent periods. Ultrasound is not usually advised at this stage, as it has not been found to be reliable in younger women.

Guidelines also note that adolescents who have some features of PCOS, but do not meet the full criteria, may be considered at increased risk. Reassessment is recommended at or before full reproductive maturity (around eight years after starting their first period). This can include girls who had features of PCOS before starting the contraceptive pill, those with persisting symptoms, or those who have gained significant weight during adolescence.

Why early support matters

PCOS is often described as a long-term condition, and its symptoms — such as acne, excess hair growth, hair thinning, or weight changes — can be particularly difficult to cope with during the teenage years.

Although only a GP can make a diagnosis, starting conversations early about nutrition and lifestyle choices may help support overall health and wellbeing in teenagers showing features of PCOS. Parental and family support can also make a big difference in helping young people build positive long-term habits.

The mental health impact

Living with PCOS can sometimes affect mental wellbeing. Research suggests that anxiety, low mood, and depression may be more common in women with PCOS. For teenagers, who are already navigating a time of big changes and pressures, this additional emotional impact may be especially challenging. Supporting both physical and emotional health is therefore important.

Next steps

If you’d like to chat further, we have teen specialists here at our clinic, and we’d be happy to talk with you. Just book a call here.

Please note: we do not diagnose or treat PCOS. Anyone under the age of 16 must have a parent or guardian book and attend the call. Medical advice and diagnosis should always be sought from your GP.

PCOS Symptoms

Polycystic Ovary Syndrome (PCOS) affects an estimated 1 in 10 women in the UK, making it one of the most common hormone-related conditions in women of reproductive age. Worldwide, it is thought to affect more than 100 million women.

The name “PCOS” can be misleading, as not everyone with PCOS has cysts on their ovaries. In fact, around 20% of women without PCOS have cysts, while about 30% of women with PCOS do not.

So, what is it?
PCOS is often described as a complex endocrine condition involving hormonal and inflammatory factors that may disrupt the development of ovarian follicles. This can affect ovulation and menstrual cycles, and may be linked with changes in weight, skin health, fertility, and mood.

Research also suggests that women with PCOS may have a higher risk of developing metabolic complications, such as insulin resistance, type 2 diabetes, altered cholesterol, and cardiovascular risk factors.

Some of the more common symptoms of PCOS include:

Irregular or absent periods
PCOS can disrupt ovulation, sometimes leading to irregular, infrequent, or absent periods. Hormonal changes, particularly higher androgen levels, may contribute to this.

Heavy or painful periods
When ovulation is irregular or absent, the endometrial lining may build up over time. This can result in heavier bleeding when periods do occur. Hormonal imbalances, such as altered oestrogen and androgen levels, may also contribute.

“Cysts” on the ovaries
In PCOS, hormone signalling that supports egg release (ovulation) can be disrupted. Follicles may remain underdeveloped, which can appear as “cysts” on an ultrasound. These are not true cysts but immature follicles.

Acne or oily skin
Higher androgen levels can increase sebum (oil) production in the skin, sometimes leading to clogged pores and acne. PCOS-related acne often appears on androgen-sensitive areas such as the jawline, chest, or back.

Hirsutism (unwanted hair growth)
Androgens can stimulate hair follicles, leading to thicker, darker hair in areas such as the face, chest, or abdomen.

Hair thinning or loss
Some women with PCOS experience hair loss from the scalp, often in a pattern similar to male hair loss. This is linked to follicle sensitivity to dihydrotestosterone (DHT), a potent form of testosterone.

Weight changes
Insulin resistance, common in PCOS, can make it harder for cells to respond to insulin effectively. This may lead to higher circulating insulin levels, which can increase appetite, promote fat storage, and make weight loss more difficult.

Mood changes
Low mood, anxiety, and irritability are commonly reported in PCOS. Hormonal influences, inflammation, and insulin resistance may all play a role, alongside the psychological impact of other symptoms such as acne, hirsutism, or fertility challenges.

Long-term health risks
Research indicates that women with PCOS may have an increased risk of developing type 2 diabetes, cardiovascular concerns, and stroke. This is thought to be linked to factors such as insulin resistance, inflammation, and weight.

The positive news

While PCOS can feel overwhelming, research suggests that nutrition and lifestyle approaches may support symptom management and overall wellbeing.

If you’d like to explore how nutrition and lifestyle changes could support you, you’re welcome to book a free call.

Please note: we do not diagnose or treat PCOS. Nutrition and lifestyle support can complement medical care, but diagnosis and treatment should always be discussed with your GP.