The Polycystic ovarian syndrome (polycystic ovary syndrome) is a disorder of the female hormonal balance. This disorder leads to an increase in male hormones, the so-called androgens, which in addition to menstrual disorders can also lead to infertility. The polycystic ovary syndrome is also called Stein-Leventhal syndrome known.
What is polycystic ovary syndrome?
Polycystic Ovary Syndrome is one of the most common metabolic disorders in adult women. The causes are usually the increased androgen level (hyperandrogenism), menstrual disorders and infertility in women.The Polycystic ovary syndrome mostly occurs in women of reproductive age. Due to the increased production of male hormones (androgens), malfunctions occur in the ovaries (ovaries). Several criteria must be met in order for a diagnosis of PCO syndrome to be made.
Criterion No. 1: So-called polycystic ovaries must be present. This means that cysts are growing in the ovaries. At least 8 cysts must be detectable.
Criterion No. 2: Menstrual bleeding occurs very rarely or not at all. Ovulation occurs very rarely or at all.
Criterion No. 3: The concentration of male hormones is very high. PCO syndrome is relatively common. About 10 percent of all women between the ages of 15 and 25 suffer from polycystic ovarian syndrome (polycystic ovary syndrome).
causes
A primary cause for that Polycystic ovary syndrome has not been found until today. However, it was possible to define various factors that are present in many of those affected.
Many women have a family disposition. It is therefore assumed that there is a hereditary component, although the causative gene has not yet been clearly identified.
Furthermore, disorders in the brain are also possible. The pituitary gland produces an increased amount of the hormone LH (luteinizing) in PCO syndrome. The production of the hormone FSH (follicle-stimulating), however, is reduced. Because of this imbalance, the ovaries (ovaries) produce an increased amount of male sex hormones.
Disturbances in the pancreas are also possible causes. In polycystic ovary syndrome, an increased concentration of insulin in the blood has been found. The excess insulin stimulates the ovaries to produce more male hormones, which in turn stimulates the pituitary gland to release more LG.
Other possible causes of polycystic ovarian syndrome are puberty, hypothyroidism, stress and tumor diseases.
Symptoms, ailments & signs
The polycystic ovary syndrome is a multifaceted clinical picture that can be associated with various complaints. Menstrual cycle disorders are a common symptom. The patients have a prolonged cycle that lasts longer than 35 days and menstruate less often. Menstrual bleeding can also stop completely. In this case it is called amenorrhea.
During the cycle, there may be intermenstrual bleeding or even additional bleeding. The cycle disorders lead to reduced fertility or complete infertility. Due to the increased concentration of male sex hormones in the blood, women with polycystic ovarian syndrome have a male hair type (hirsutism).
The hair not only grows in the genital area, but also on the thighs or on the stomach and in the area of the upper lip. The patients also suffer from hair loss, oily skin and acne. They also tend to be overweight and have high blood sugar levels. True masculinization with a deepening voice and an enlargement of the clitoris is rare.
In principle, not all symptoms are equally pronounced in women with PCO syndrome. However, the majority of those affected suffer greatly from the symptoms. In particular, the lack of fertility or complete infertility can lead to severe depressive moods if the desire for children is not fulfilled.
Diagnosis & course
That is diagnosed Polycystic ovary syndrome by the gynecologist. In addition to a general anamnesis (medical history), a gynecological examination is carried out. If a polycystic ovary syndrome is suspected, imaging tests such as B. Ultrasound and MRI are used to visualize the ovaries. This will help identify cysts in the ovaries.
A blood test is also carried out to confirm the diagnosis. In addition to a general blood count, the various hormone levels in the blood are examined. In particular, the hormones LH and FSH are indicative values for a PCO syndrome.
If those affected want to have children, laparoscopy can also be performed. The ovaries in particular are carefully examined. If necessary, biopsies are also performed. Here, tissue is removed from the ovaries, which is examined histologically and cytologically.
The course of one Polycystic ovary syndrome depends on when the disease was discovered and how it was treated. Since obesity and increased insulin levels are often associated with this disease, this means an additional risk for the patent women, since these symptoms can cause not only cardiovascular diseases, but also diabetes mellitus and lipid metabolism disorders. With early and adequate treatment, the course of the polycystic ovary syndrome is good and can be cured without consequences. Inadequate treatment can lead to long-term effects such as infertility.
If polycystic ovary syndrome has been diagnosed, it is advisable to consult a specialist for treatment. Only gynecologists with the additional qualification of reproductive medicine have the necessary experience to successfully treat polycystic ovarian syndrome (PCO).
Complications
The PCO syndrome usually has a very negative effect on the quality of life of the woman concerned. In most cases, this increases the concentrations of male hormones, leading to androgenization of the woman. In most cases, many different psychological complaints develop and in some cases depression as well.
Those affected are often ashamed of the symptoms and sometimes suffer from inferiority complexes and a significantly reduced self-esteem. Social complaints can also occur due to the PCO syndrome. Especially at a young age, this syndrome can lead to teasing or bullying. Those affected continue to suffer from pimples and blemished skin. Overweight and hair loss can also occur as a result of PCO syndrome and have a very negative effect on the aesthetics of those affected.
Sometimes a woman's beard becomes apparent in the patients, and infertility can also be a symptom of the disease. As a rule, the desire to have children cannot be pursued. In severe cases, polycystic ovary syndrome can also lead to a miscarriage. The treatment of polycystic ovary syndrome is usually done with the help of medication. A healthy lifestyle can also have a very positive effect on the disease.
When should you go to the doctor?
PCO syndrome can only be diagnosed in sexually mature and reproductive young and adult women. If those affected have an unfulfilled desire to have children, a check-up visit with a doctor is recommended. If, despite all efforts and known methods of conception, no offspring could be conceived for several months, a visit to a doctor is advisable. Irregularities in the female menstrual cycle or a lack of menstrual bleeding should be presented to a doctor.
Intermenstrual bleeding or a very weak menstrual period often indicate a health problem. A doctor's visit is necessary so that research into the cause can be initiated. Obesity or problems with weight despite a low-calorie and balanced diet can be discussed with a doctor. Blemishes, acne or very oily skin are signs of a condition that needs treatment. If behavioral problems occur or a depressive mood occurs, a doctor should be consulted.
Changes in personality, a deep voice and irregularities in hair growth on the body are complaints that should be clarified by a doctor. It is advisable to talk to a doctor or therapist in the event of persistent or increasing dissatisfaction in your own life, a decrease in well-being or a reduced quality of life. In many cases, the emotional problems are based on physical inconsistencies that can be addressed.
Treatment & Therapy
Treating a Polycystic ovary syndrome includes several therapy goals. The acute symptoms are treated primarily. The long-term therapy goal, however, is the normalization of the metabolism and the prevention of possible secondary diseases such as diabetes mellitus and cardiovascular diseases.
Since polycystic ovarian syndrome is often associated with obesity, it is important to change your diet. Adequate physical activity in the form of sport is also important. Especially in the early stages of the polycystic ovary syndrome, these two measures can have a positive effect on both the menstrual cycle and ovulation.
When treating polycystic ovary syndrome, it must also be taken into account whether the women concerned want to have children. In women who do not want to have children, hormonal disorders are often treated with birth control pills. Through the composition of various female hormones such as estrogen and progestin, it is possible to slow down the release of male hormones, so that the consequences such as increased body hair and skin problems are reduced. However, this type of therapy is only intended for women who do not want to have children, as the “pill” has a preventive effect.
If women who want to have children suffer from polycystic ovary syndrome, the aforementioned therapy is not recommended. In these cases, low-dose cortisone preparations are often used. These act on the adrenal glands, where the male hormones are made. If ovulation does not set in despite treatment, medication that induces ovulation can be administered.
If an excessively high insulin level was diagnosed as the cause, it is primarily important to lower it. The hormone FSH is often injected here as the drug of choice. However, the patient must be informed that with this form of therapy, the subsequent probability of a multiple pregnancy is very high.
In exceptional cases - especially in women who want to have children - it may be indicated that the polycystic ovary syndrome must be treated with an operation. The cysts in the ovaries are destroyed with a laser during a laparoscopy (laparoscopy).
You can find your medication here
➔ Medicines for menstrual crampsOutlook & forecast
The prognosis for the presence of polycystic ovary syndrome, also known as polycystic ovarian syndrome, is not very good. In addition to physical symptoms that are stressful, female fertility is also limited. Both can lead to emotional stress and social withdrawal. Therefore, polycystic ovarian syndrome not only leads to increased miscarriages, but also to mental disorders or depression that requires treatment.
PCO syndrome can lead to increased body hair, a missed menstruation and infertility. Even if it is still possible in principle to have children, this is made much more difficult. Pregnancies in women with polycystic ovary syndrome are more at risk. Those affected are more stressed by gestational diabetes, miscarriages or multiple pregnancies. In addition, complications are more common during pregnancy.
As a result, women with polycystic ovary syndrome develop an increased risk of suffering from cardiovascular diseases. Drug treatments and diet changes can increase the prospect of a better quality of life. Regular gynecological examinations are recommended. PCO symptoms can improve during the menopause. But they can also get worse. Why this is so is still being researched.
The existing symptomatic treatment approaches are inadequate. If there is no desire to have children, the increasing masculinization, or accompanying acne, can be counteracted with ovulation inhibitors. The prognosis is worse if you want to have children. The polycystic ovary syndrome that hits young women particularly hard.
prevention
To date, there are no direct preventive measures against that polycystic ovarian syndrome known. Since obesity is an important factor in polycystic ovary syndrome, you should change your diet and exercise enough. Furthermore, the annual gynecological check-up should be used. If polycystic ovary syndrome has been diagnosed, adequate therapy should be started as early as possible. This is the only way to positively influence the course and avoid long-term effects.
Aftercare
In most cases, follow-up care for polycystic ovary syndrome proves to be relatively difficult, so that direct follow-up measures for this disease are relatively limited.For this reason, those affected should consult a doctor at an early stage so that there are no other complications or complaints that could reduce the quality of life of the person concerned.
The polycystic ovary syndrome cannot heal itself, so that the patient is always dependent on treatment by a doctor. First and foremost, drugs that promote the symptoms must be stopped. However, you should only discontinue the medication with the consent of your doctor. Regular check-ups by a doctor are also very important during treatment in order to detect and treat further damage to the body at an early stage.
Most of those affected, however, are also dependent on an operation. Thereafter, strict bed rest should be observed, whereby those affected should rest and take it easy. The support and care of one's own family or partner is also very important, as this can also prevent depression and other psychological upsets.
You can do that yourself
In addition to drug treatment, those affected can also take active action against the symptoms of PCO syndrome themselves. In most cases a change in lifestyle is necessary.
In overweight patients, a reduction in body weight and a change in diet usually lead to a significant improvement. Abdominal fat in particular should be reduced. Physical activity such as light abdominal muscle exercises, jogging or Nordic walking can help. Regardless of the body weight of the person concerned, high-calorie foods should generally be avoided. The consumption of sugary foods and white flour products should be avoided. Instead, it is advisable to consume plenty of vegetables, filling protein, whole grains and oils with omega-3 fatty acids. Excessive alcohol consumption and smoking should be avoided. During pregnancy, greater attention should be paid to a healthy lifestyle and diet, as there are certain risks such as miscarriage or gestational diabetes with existing PCO syndrome.
If you have a lot of body hair, professional permanent hair removal can help. If affected women suffer from severe acne, laser treatment is possible. For many of those affected, the disease is primarily a psychological burden. In these cases psychotherapeutic help can also be used. There are also a number of self-help groups and internet forums in which those affected can exchange ideas.