Polycystic ovary syndrome is a syndrome that affects genetic, hormonal, metabolic and reproductive systems. It is a syndrome seen in 10% of women in the world, and even in 1 out of every 5 women according to some sources. It is the most common cause of infertility in women of childbearing age.
Every woman between the ages of 14-44 can experience polycystic ovary syndrome. In general, most women are diagnosed between the ages of 20-30.
Many symptoms may develop in people due to hormonal imbalances. There are also many disease complications and risks. I will talk about them in turn below.
The most common picture in polycystic ovary is insulin resistance. But there is no rule that every polycystic ovarian patient will have insulin resistance. You will see this in detail below. Therefore, while approaching polycystic ovary syndrome, approaches such as insulin resistance, let’s focus only on it, are very simple approaches.
Also, not every polycystic ovary appearance means polycystic ovary syndrome. Studies show that 25% of women in the world have the appearance of polycystic ovary and only 5-10% of them have polycystic ovary syndrome.
Excess of androgen hormones is another underlying cause and one of the main problems in polycystic ovary syndrome. The androgen hormones that cause this picture are mainly testosterone – androstenedione, as well as dihydrotestosterone, DHEA and DHEA-S. Although the ovaries have always been blamed for the excess of these androgen hormones in the past, the ADRENAL Glands are responsible for this androgen excess in 20-30% of patients with polycytic ovary syndrome. The adrenal glands produce all of the DHEA-S and 80% of the DHEA in the body. It produces 25% of circulating testosterone and 50% of andrestenedione. Therefore, adrenal system problems cause polycystic ovary syndrome, and the definition of adrenal polycystic ovary syndrome has just begun to enter the scientific literature.
While insulin resistance increases the production of testosterone by the ovaries, HPA (hypothalamic-pituitary-adrenal) axis disorders cause the release of DHEA, DHEA-S and androstenedione from the adrenal system. Hormones released from this adrenal system can be converted to testosterone in the surrounding tissues. This picture originating from the adrenal system occurs independently of insulin resistance and ovaries.
Cortisol is also secreted under chronic stress (cortisone and progesterone are both produced from pregnenolone). In case of stress, cortisol will be produced too much and progesterone production will decrease. This will cause estrogen dominance, which we call estrogen dominance. Most of the symptoms seen in polycystic ovary syndrome are caused by estrogen dominance.
AS I STATED ABOVE, INSULIN RESISTANCE IS NOT THE ONLY CAUSE OF POLYCYSTIC OVARY SYNDROME, IT IS JUST ONE OF THE CAUSES THAT MAY BE.
In this syndrome, which manifests itself most frequently as menstrual irregularity, each symptom can give us information and guide us about the systems that are broken.
Polycystic ovary syndrome is an all-encompassing syndrome in the form of problems that may arise from the LIVER-THYROID-ADRENAL-INCENTS-OVERLAR-LYMPHATIC SYSTEM. Contrary to what many people think, the problem is not your ovaries. Your ovaries change in response to hormones that are malfunctioning in the system. And it is necessary to focus on the main underlying causes of polycystic ovary syndrome. One of the most important of these is chronic toxicity, sedentary life, chronic stress.
Causes;
Chronic Toxicity
Insulin Resistance
Chronic Inflammation
Genetics
Androgen Excess
HPA Axis Disorders
Chronic Stress
Intestinal Flora Problems
Liver Detoxification Mechanism Problems
Lymphatic System Problems
Thyroid Metabolism Problems
This Disorders in the mechanisms of problems often progress like dominoes. When one system fails, other systems are also affected. Therefore, the holistic view of medicine aims to treat the patient, not the disease.
In general, polycystic ovary syndrome begins to show and manifest itself when puberty enters, but it may take years for the patient to develop a complete syndrome and realize it.
Every polycystic ovarian syndrome patient is individual. A very different set of symptoms can be seen in each. If we look at the symptoms that may occur:
1- Menstrual irregularities -absence of menstruation (the most common)
2-Acne
3- Hair growth (on the jaw-face-body-legs)
4-Hair loss (male type)
5-Acanthosis nigricans = darkening of the skin (especially neck, inner leg, under the breast, between the fingers)
6-Weight gain
7-Mood fluctuations
8-Over cysts – polycystic ovary
9-Menstrual pains
10-Chronic fatigue
11-Pelvic pain
12-Having very painful menstrual cycles
***In menstrual irregularities, the interval between menstrual days may be more than 35 days or the number of menstruation will be less than 12 per year (in some advanced patients, even once or twice a year).
***The periods can be quite heavy or the bleeding is very little.
***21-35 days is perceived as normal in terms of menstrual cycle time. in fact, only 15-20% of women in the world have a regular period every 28 days; the rest are cycles of 21-35 days. In order for us to say that there is menstrual irregularity in polycystic ovary syndrome, there must be cycles lasting longer than 35 days. Or the balance of your menstrual cycles should be different from each month to each month.
***Symptoms due to high levels of androgen hormone = acne, hair growth, male pattern hair loss, etc.
***Although the appearance of cysts in the ovaries is one of the most important findings in polycystic ovary syndrome, not every polycystic ovary syndrome means polycystic ovary syndrome. Polycystic ovary is predominant (without causing any symptoms) in the ovaries of 5-15% of women worldwide. You will also see when we talk about diagnostic parameters below. Polycystic ovary appearance never makes a diagnosis on its own.
Polycystic ovary syndrome brings many risks. Patients may be predisposed to many diseases.
1-High cholesterol and triglyceride
2-Infertility
3-Cardiovascular disease risk
4-Obesity
5-Pre-diabetes-type 2 diabetes (diabetes risk increases 7 times)
6- Hypertension
7- Sleep apnea
8-Endometrial cancer
9-Breast cancer
10-Mood disorders
11-Depression
12-Essential diabetes-hypertension ( during pregnancy )
13-Low risk
14-Premature delivery risk
15-Metabolic syndrome
16-Non alcoholic steatohepatitis (non-alcoholic fatty liver)
17-Eating disorders
18 -Abnormal uterine bleeding
19-Chronic headaches
A little information for you to understand some parts;
Note: Each month your ovaries release one egg to be fertilized by sperm. This is called ovulation. Basically, the hormones FSH and LH secreted from the pituitary take part here. Fsh stimulates the ovaries to develop follicles. These are your eggs. Lh stimulates the release of this egg, and it moves from the ovary to the uterus.
Note: Your reproductive organs mainly produce estrogen and progesterone, but they also produce androgen hormones at a low rate.
Note: Polycyst means more than one cyst.
Note: Those transferred as polycysts in your ovaries are actually multiple cysts containing immature eggs. The eggs here were not mature enough to trigger ovulation.
