Polycystic ovary syndrome: What hurts every tenth woman
In the comments on topics related to gynecologyWe have been repeatedly asked to write about polycystic ovary syndrome. This is a really important topic: every tenth woman of reproductive age has polycystic ovary syndrome. In one study, it was found that almost 70% of women with this disease did not know about it. We understand how polycystic ovary syndrome arises, how it threatens, whether there is a treatment - and whether it is necessary to treat it at all.
How does it develop and who is at risk?
In the ovaries there are so-called follicles, or vesicles; each of them is an egg cell surrounded by several layers of other tissues. During each menstrual cycle, one of the follicles matures, and then breaks and releases the egg cell - this happens once a month and is called ovulation. If the follicle has matured, but has not participated in ovulation, a cyst can form - a cavity in which fluid accumulates. With polycystic ovary syndrome, such cysts form a lot - hence the name.
It is still not known exactly what causes polycystic ovary syndrome, and there are opinions about the role of both genetics and the environment. The risk group includes, first of all, those who have this disease in the family, and it does not matter, on the maternal or paternal line. Diabetes in relatives also increases the risk of this syndrome. In polycystic ovary syndrome, the balance between sex hormones is disturbed; in particular, it gets too many androgens (like testosterone).
How is he dangerous?
Polycystic ovary syndrome is a major cause of infertility. Logically: for the onset of pregnancy, an egg is needed, and with this disease the egg does not mature and does not come out of the follicle. If the pregnancy has occurred, the risk of complications remains high: for example, in women with polycystic ovary syndrome, the probability of miscarriage in the early period is three times higher. In addition, they have a higher chance of developing gestational (arising during pregnancy) diabetes mellitus, preeclampsia and eclampsia - a severe increase in blood pressure with impaired function of various organs. All these changes are dangerous both for the mother and the child, and therefore the likelihood of an emergency intervention — a cesarean section — is increased, so that the pregnancy is more likely to end.
Due to hormonal changes, weight gain, increased oily skin and acne, excessive hair growth become the companions of polycystic ovary syndrome. In addition, depression, anxiety disorders, and eating disorders are common among women with this syndrome. All this affects the quality of life in all its aspects.
In almost 70% of women with polycystic ovary syndrome, insulin sensitivity is impaired. Such resistance (reduced sensitivity) to insulin can lead to the development of type 2 diabetes. Women with polycystic ovary syndrome are more likely to have arterial hypertension (high blood pressure), which, in turn, increases the risk of stroke and cardiovascular complications. At the same time with this syndrome obesity, elevated levels of "bad" cholesterol in the blood and apnea (respiratory arrest) in sleep occur more often. These factors - polycystic ovary syndrome, insulin resistance, obesity, arterial hypertension - increase the risk of each other, and may also contribute to the development of endometrial cancer.
How to identify it?
The main symptoms of polycystic ovary syndrome are an irregular menstrual cycle, when menstruation occurs too rarely, too often, or disappears altogether. Often there is increased hair growth on the legs and in the lower abdomen - while the hair on the head becomes thinner and may fall out. Skin problems will include acne, oily skin and increased pigmentation, especially on the neck, groin and under the breasts. Symptoms such as rapid weight gain and high blood pressure also join. The problem with the diagnosis is that oily skin is often not perceived as a symptom of the disease, acne is considered age-related, and abundantly growing hair on the legs is attributed to bad luck. With excess weight and bad mood, and even worse - women are offered to "stop being lazy," "pull themselves together" and "get together."
The difficulty of diagnosis is also in the fact that in adolescence one cannot rely on the fact of an irregular menstrual cycle - even in a perfectly healthy person it can be established a couple of years after the first menstrual period. Unfortunately, there is no single test that immediately showed the presence of the disease. To make a diagnosis, the doctor must ask the patient in detail, including the regularity of the menstrual cycle and changes in body weight. On examination, the doctor will pay attention to hair growth and skin condition. In addition, the necessary gynecological examination, blood test for hormones, glucose, cholesterol and triglycerides. To assess the condition of the uterus and the size of the ovaries (due to cysts, they are usually enlarged), an ultrasound examination is performed. For those who want to understand whether to run to the doctor right now, there is a questionnaire on the symptoms of polycystic ovary syndrome.
How is it treated?
Unfortunately, polycystic ovary syndrome cannot be completely prevented - but its early diagnosis and treatment can help prevent dangerous complications. Treatment of PCOS is always complex and depends on the manifestations in a particular patient — for example, infertility, acne, or obesity. Often, treatment requires a change in lifestyle - talking about a healthy and varied diet with a reasonably calculated calorie and moderate physical exertion. For the treatment of the syndrome, it is important to reduce overweight: reducing it even by 5% can significantly improve the condition, increase the effectiveness of drugs and help with infertility. The main thing is to understand that the correction of nutrition and activity is not a temporary measure, and a new lifestyle will have to be adhered to in order to feel good.
Drug therapy can be aimed at normalizing the menstrual cycle (this is done primarily with the help of hormonal contraceptives - tablets, patches, vaginal ring). Another option is hormone therapy, aimed at ensuring that pregnancy begins soon. With the appointment of COCs most often normalized and hair growth, and skin condition. In severe cases, when hormone therapy does not help, surgical treatment is carried out - part of the ovary is removed or affected by current or laser.
Photo:Patricia - stock.adobe.com, Kateryna_Kon - stock.adobe.com (1, 2)
