Model and artist Anna Kuen opens up about her pregnancy, her struggle with painful femininity, and the challenges of having confidence in her pregnant body due to her medical conditions.
Polycystic ovary syndrome, abbreviated as PCO syndrome or PCOS, was my diagnosis approximately ten years ago when, in my early twenties, I sought help at an endocrinology day clinic. I was unsure of what to do, suffering immensely, and felt like no one believed me. After all, I was slim and conventionally attractive – what could possibly be wrong?
I never had a regular menstrual cycle. My periods came and went unpredictably. When they did arrive, the pain was excruciating, often confining me to bed for days or requiring strong painkillers just to function. In between, I experienced weeks of typical premenstrual symptoms, developed allergies to various substances, and struggled to get through each day. People would say it would all settle down; after all, I was still young. These were words I heard all too often.
But it didn't settle down; it got worse. Every day, I felt like I was at the mercy of a roulette wheel, facing unbearable physical and psychological challenges. With the diagnosis of PCOS, my journey took another painful turn, involving various hormone treatments, none of which I tolerated well. Without much explanation, I was told that getting pregnant would be difficult, and I should pretty much forget about having children.
In my early twenties, amidst pursuing an art degree, I felt far from well. I wasn't healthy, and it seemed like I would have to live with these issues indefinitely, perhaps until menopause. Ironically, I had already experienced some symptoms similar to menopause due to PCOS.
Polycystic ovary syndrome, often referred to as PCOS, affects five to ten percent of women of childbearing age. What exactly triggers this hormonal disorder remains unclear, whether it's inherited or due to a bodily malfunction. The specifics of how, what, and where in the body this disorder leads to the ovaries being covered with follicles, while ovulation and menstruation rarely occur, are complicated to explain. Around 70 percent of PCOS patients also suffer from insulin resistance, which, if left unmanaged, can lead to type 2 diabetes. Women with this diagnosis often experience symptoms of "masculinization," such as increased body hair, hair loss, acne, and obesity. In my case, few of these typical external signs applied to me. Doctors frequently dismissed my concerns. They seemed to think that my appearance meant I couldn't possibly be suffering as I claimed. The prevailing attitude was, "You look great, so you must be fine." It has been and continues to be difficult for me to understand and accept this dismissal, as though I needed to prove that I wasn't somehow deficient – looking fine on the outside but feeling bad on the inside.
The hormone treatments, meant to "restore balance to my system" as advised by doctors, were even more challenging than everything that came before. I experienced extreme side effects, both physically and mentally. If I hadn't delved into extensive research on PCOS out of desperation, I might never have discovered alternative approaches to managing my condition and making it more bearable.
I stumbled upon "Metformin," a diabetes medication that also regulates the menstrual cycle and has achieved success with PCOS patients in the United States. However, in Germany, Metformin is not officially approved for treating PCOS; it is prescribed "off-label," meaning outside the scope of approved use by authorities. I decided to stop taking the hormones and visited my gynecologist to discuss Metformin. Unfortunately, my gynecologist couldn't prescribe Metformin in Germany; only diabetologists had that authority. So, my next visit was to a diabetologist, where I felt once again that I was being judged. What could possibly be wrong with me? A glucose tolerance test was finally conducted to assess potential insulin resistance. As soon as the results were available, I received a call from the practice, informing me that I had narrowly avoided developing type 2 diabetes.
It was a profound shock, but it also brought some relief, finally confirming that I wasn't imagining my symptoms. Alongside PCOS, I received another diagnosis: insulin resistance. It was an unexpected diagnosis that significantly reduced my chances of natural pregnancy.
As time passed, I didn't dwell on the desire to have children. Other aspects of life took precedence, including my return to modeling, which happened more by chance than by design. With Metformin, I had discovered a treatment that genuinely improved my condition. With the right medication, I regained control over my life and my body. I completed my art degree and continued working on my art in the studio, all while traveling the world for modeling assignments. My mantra was simple: as long as I remained healthy, experienced reasonably regular periods, and received positive feedback during routine check-ups, I was content to carry on and see where life would lead me.
However, the topic of having children frequently surfaced in my current relationship. I began researching alternatives to natural pregnancy, but none felt right for me personally. We had a loose plan to give it a try, with the understanding that if it didn't work out, we would explore other options.
Several factors converged – travel, work, stress – along with the joy of feeling in control of my body for the first time in years. I no longer felt dominated by my condition. Yet, a sense of mistrust lingered; my confidence in my body had never fully returned. What if my troubles resurfaced?
As a model, I served as a significant projection surface for others. It was easy for people to assume that everything was perfect, that my life was glamorous and exciting. The images portrayed me as a consistently happy, radiant, and photogenic woman. Who could imagine that anything was wrong? I rarely discussed the long and painful journey I had endured. My suffering was often dismissed, and not being believed made me incredibly frustrated. It angers me to think that between five to ten percent of women experience PCOS, meaning at least one woman in most circles likely understands that, apart from the physical and psychological challenges associated with PCOS, the desire to have children can also be a significant hurdle.
Therefore, it was quite a shock when, completely unprepared, I received a positive pregnancy test in January. We had expected many things, but becoming pregnant with PCOS wasn't one of them. I could hardly believe it and took two more tests immediately, all the while thinking, "It can't be true with PCOS!" I made an appointment with my gynecologist, who confirmed the pregnancy, even expressing astonishment. It probably seemed like a miracle to her as well. My partner and I were initially overwhelmed by this unexpected news, as the likelihood of pregnancy was close to zero. For me, it felt like a sudden revelation.
One of my biggest concerns was (and remains so every day) whether my body could handle it – pregnancy and nurturing new life. Could my body, which had never functioned properly, which had caused so much pain and despair, successfully carry a child? Would my child be healthy? What if my body failed, and something went wrong?
The feeling that I could actively address my situation, living in a body I had never fully trusted, became overwhelmingly powerful. I was scared and unsure, struggling to cope in the initial weeks. How could I learn to trust a body that had felt foreign for so long and didn't seem like my own?
During the first trimester, like many women, I felt quite unwell. Dizziness and nausea were constant companions. The psychological weight was paralyzing. Sleeping and taking walks were my only respite. Distraction was essential, as I couldn't afford to worry.
I had sleepless nights leading up to my first significant examination, almost like the exam anxiety I experienced in the past. Letting go, trusting, and following my intuition gradually returned in the subsequent weeks. I've been feeling much better recently. I'm happy, and I can feel the little person inside me kicking and growing. It's a bit like having a lively goldfish inside me, bringing me immense joy. The sensations, the tugging and pulling, as my body changes every day, amaze me. My fundamental confidence, something I never truly had, is growing stronger, providing one of the most empowering feelings I've ever experienced. I can't help but marvel at the incredible capabilities of women.
I'm also amazed that, despite my diagnoses, I'm capable of giving birth to a healthy new life. I'm acutely aware that my pregnancy borders on a small miracle, so much so that it occasionally feels abstract and intangible, as if some catch might reveal itself tomorrow. Yet, so far, there's been no catch. The little person is developing normally, and my body is undergoing entirely typical changes – more ordinary than anything else in my life. This perhaps explains why I occasionally find it so challenging to comprehend.
To women who suffer from PCOS, I wish they could feel as normal as I do now. Women like me, who constantly question themselves and feel their bodies are under scrutiny, deserve encouragement. I want to convey the message that help is available, that there are treatments, and that there are doctors who are willing to provide information and care, not only when the desire for children remains unfulfilled. After all, the first symptoms of PCOS often emerge during the teenage years. With better information and greater willingness to assist affected women, we could alleviate a lot of pain, suffering, and worry. We could also reduce the risk of early infertility.
"You are not alone in this. You are not wrong, and you are a wonderfully strong woman." I wish I had heard these words more often, and I hope to pass them on to every woman who reads my story and identifies with it.
I've never before spoken so openly about the story of my often painful femininity, about how challenging it is to acknowledge and embrace it. In the words of Emily Ratajkowski, "What a joy life can be in this body." She couldn't be more right!
