Polycystic Ovary Polycystic Ovary…Polycystic Ovary Syndrome
Polycystic Ovary Syndrome-PCOS It is one of the precious problems that are frequently encountered in our young girls and in the society in advancing ages.
As the name suggests, many millimetric small cysts are seen in the ovary. The egg, which should develop and crack every month, cannot fully develop due to hormonal internal stability disorder, and takes its place in the ovary as small cysts. Diagnosis by seeing these images only with ultrasound will lead to erroneous developments and results;
This appearance should not always be considered as a sign of disease. Since each individual will require different clinical signs, symptoms, and therefore a different approach and, if necessary, a different treatment arrangement, the diagnosis should be made after a detailed specialist evaluation, examinations and examination… Otherwise, long-term unnecessary treatments may be the subject of the word.
The disease may cause symptoms such as menstrual irregularity, acne, oily skin, increased hair growth, sometimes hair loss, infertility, and weight gain.
In recent years, valuable information has been obtained about the relationship between diabetes and its precursor, insulin resistance, and polycystic ovary syndrome.
In this case, which also has genetic origins, the diagnosis is usually made by ultrasonography, hormone analysis and evaluation of clinical findings, always together.
Various imbalances are detected when hormone measurements are made in the blood; especially LH and male hormones (testosterone, DHEAS…) have increased.
Some long-term medications -for those who are patient–are quite effective in women whose treatment has obvious complaints of menstrual irregularity and hair growth.
If there is a child request, the treatment to be used is ovulation-promoting drugs.
When drug treatment is not successful, laparoscopic surgery of the ovaries (ovarian drilling) can be applied in some patients with the selected feature.
What is polycystic ovary syndrome (PCOS)?
Polycystic ovary syndrome is a health problem that affects women’s menstrual cycles, their chances of getting pregnant, their hormonal stability, and their cardiovascular structures. Patients with PCOS typically have high androgen levels, irregular menstrual cycles, and many small cysts in the ovaries. However, different clinical findings may be present in different individuals.
What is the frequency of PCOS?
PCOS can be found in one out of every 10 women of childbearing age. There are 5 million patients diagnosed with PCOS in the United States, and the disease can be seen as early as 11 years old.
What is the cause of PCOS?
Although the cause of PCOS is unknown, experts state that many factors, including genetic predisposition, may cause this disease. Many mothers or sisters of PCOS patients also have PCOS.
The main factor underlying PCOS is an imbalance in hormones. More androgens than usual are produced in the ovaries of women with PCOS. Although androgen is known as the male hormone, women also produce androgens. High androgen can affect egg development and ovulation in women.
According to studies, insulin hormone also has a valuable place in PCOS. Insulin regulates sugar stability in the body. Many women with PCOS have problems with the use of insulin in metabolism, and in response to this, it is determined that the insulin measure is produced in excess. Excess insulin also increases andogen production. High andogeny can also cause…
– Acne,
– Increased hair growth,
– Weight gain,
– Ovulation issues.
What are the symptoms of PCOS?
The symptoms of PCOS can be different for every woman. Some of these symptoms are
– Infertility (failure to ovulate is the most common known cause of female-induced infertility, however, it can be corrected frequently and easily with today’s technology and drugs),
– Unsystematic menstruation,
– Hirsutism (in the face, chest, abdomen) and increased hair growth on the fingers),
– Cysts in the ovaries,
– Acne, oily skin, dandruff in the hair,
– Especially around the waist, increased weight, obesity,
– Male pattern baldness and thinning of the hair,
– Pain in the pelvic region,
– Anxiety and depression,
– Sleep apnea.
Why do patients with PCOS experience menstrual problems and infertility?
There are many fluid-filled follicles or sacs called cysts in the ovaries of women. With the growth of the egg in them, the amount of fluid inside these follicles increases. When the egg matures, the follicle ruptures and the free egg moves to the fallopian tubes and then to the uterus to be fertilized. This process is called ovulation.
In the ovaries of women with PCOS, the hormones that ensure the maturation of the egg cannot be secreted properly. The amount of fluid in the follicle may increase and the volume may increase, but cracking and ovulation do not occur. Instead, the follicles remain as tiny little cysts. Unless ovulation takes place, progesterone cannot be produced, and the lack of progesterone hormone causes menstrual irregularities. At the same time, androgens produced in the ovaries also cause ovulation.
Does PCOS go away with menopause?
Both yes and no. Since PCOS affects many systems in the body, some of these effects continue after menopause, although ovulation has ended. Unwanted hair growth and male pattern baldness are some of the symptoms that continue after menopause. In addition to these, complications of PCOS such as heart disease, stroke and diabetes become more important as age progresses.
How do I know if I have PCOS?
There is no single test to diagnose PCOS. In addition to your complaints such as menstrual irregularity, weight gain, unwanted hair growth, your doctor can diagnose you by looking at your physical examination, pelvic examination, blood analysis and genital ultrasound.
How is PCOS Treated?
There is no definitive cure for PCOS that fixes everything with a one-time treatment. Treatment is symptom-oriented and aimed at preventing complications. That’s why they are long-term, controlled treatments. Some of these treatment ways are:
– Healthy Eating and Training: Weight control, avoiding processed and sugary foods, consuming high-fiber foods and whole grain foods especially help to reduce insulin levels. Even a 10 percent weight loss makes menstrual periods more systematic.
– Birth Control Pills: In patients who do not want to become pregnant, birth control pills have a great role in regulating menstruation, reducing androgen and treating acne. Although drugs containing only progesterone regulate menstruation, they are ineffective in the treatment of unwanted hair and acne.
– Treatment for Diabetes: In the treatment of type 2 diabetes, drugs containing the active ingredient metformin can also be used for the treatment of the symptoms of PCOS. Metformin reduces both insulin production and androgen secretion. After a few months of use, a decrease in unwanted hair, normalization of ovulation and a decrease in weight are expected. Metformin does not cause diabetes in a patient without diabetes
– Infertility Treatment: There are many alternatives in its treatment and often satisfactory results are obtained. Clomiphene citrate is the first choice drug to stimulate ovulation. Metformin can also be added in necessary cases. If this does not work, gonadotropin can be used. As another option, IVF treatment is the most helpful formula for pregnancy in patients with PCOS, and the risk of multiple pregnancy can be reduced in contrast to other procedures.
– Surgery: Surgery may be attempted as a last resort in patients who do not respond to other treatments.
– Treatment for Unwanted Hair: Laser epilation provides permanent and pleasing results for hair follicles. Spironolactone, which has antiandrogen effects and is mainly used in the treatment of high blood pressure, can be used to reduce unwanted hair and to treat male pattern baldness.
– Other Treatments: According to some studies, obesity surgery can be used in the treatment of PCOS if you are overweight and have a very high BMI.
How Does PCOS Affect Pregnant Women?
Patients with PCOS have a higher risk of miscarriage, gestational diabetes, preeclampsia (high blood pressure during pregnancy), premature birth. The delay time spent by the babies of pregnant women with PCOS in the neonatal intensive care, and the death rates during and after delivery are higher, and these possibilities increase, especially with multiple pregnancies. Many studies currently being conducted are investigating the effect of metformin on reducing complications experienced during and after pregnancy. No congenital anomaly known to be caused by metformin was found. You can consult your doctor for information on this matter.
Does PCOS cause other health problems?
PCOS is affected by the formation of many health problems, some of which are life-threatening. In the most recent studies, women with PCOS;
– More than 50 percent of them have diabetes or insulin resistance before the age of 40,
– The risk of heart attack is 4-7 times higher than women of the same age who do not have PCOS,
– Probability of having high blood pressure
– Many have high LDL, low HDL in cholesterol values,
– More likely to have sleep apnea.
Anxiety and depression are also more common in patients with PCOS. In addition, the absence of unsystematic menstruation and ovulation causes the production of progesterone despite the increase in estrogen hormone in women. In the absence of progesterone, the endometrial tissue cannot be excreted with menstruation and continues to thicken, which manifests itself with heavy and unsystematic bleeding. The risk of developing cancer in the thickened endometrium increases over time.
I have PCOS. What should I do to avoid complications?
If you have PCOS, the most valuable thing you can do to prevent complications like diabetes and heart disease from developing is to start treatment at an early age. Instead of focusing only on the treatment of a finite aspect of PCOS, such as infertility, you should talk to your physician about all your symptoms and go for a systematic checkup for diabetes. You can also protect yourself from possible complications of PCOS by eating healthy, exercising and not smoking.
How can I cope with my emotional problems caused by PCOS?
PCOS is not an easy disease to have. It can make you ashamed of your appearance, terrified of not being able to get pregnant, and feeling depressed. PCOS treatment can help relieve your worries while treating your symptoms.
