Polycystic Ovary Syndrome

What is Polycystic ovary syndrome?

Polycystic ovary syndrome (PCOS) is a common ovulation problem that affects about 10% of women. It is a serious disease that can cause infertility as a result of hormonal irregularities caused by increased insulin levels. For this reason, it is recommended that women have a gynaecological examination every year.

What are the symptoms of PCOS?

Symptoms of polycystic ovary syndrome include irregular or no menstruation, increased hairiness on the face or body, acne problems, acanthosis nigricans (change of colour in parts of the neck, arms, breasts and legs).

In addition, an increased number of small follicle cysts (polycystic-looking ovaries with a size of 6-10 mm) may appear in vaginal ultrasound examinations. This can be observed in 20% of women in normal reproductive age.

One of the most important symptoms of polycystic ovary syndrome is insulin resistance in the blood and increased fasting blood insulin level. The disease also causes hyperinsulinemia and an increase in male hormones. High levels of androgens (male hormones) disrupt the function of the centre governing the ovaries, leading to infertility.

What are the causes of PCOS?

The cause of polycystic ovary syndrome is not clearly known, but it has been found to have a genetic aspect. Relatives of women affected by the disease (both male and female) were observed to have diabetes, obesity, elevated blood fats, high blood pressure and infertility, as well as excessive hairiness and irregular menstrual flows.

The onset of the disease usually occurs in adolescence. That is because the hormonal system, which develops at that time, may fail to function properly. Nowadays, polycystic ovary syndrome is becoming widespread due to an increase in the number of overweight children.

How is PCOS diagnosed?

If you have excess weight, the first step in the treatment of polycystic ovary syndrome is to lose weight. Healthy eating habits and regular exercise are important for a successful treatment. In patients with excess weight, reaching the ideal weight along with diet and exercise can help regulate ovulatory functions. This way, menstruation can return to normal and the chance of pregnancy can increase.

In the course of the treatment, birth control pills may be used to regulate androgen production. This ensures the regularity of the menstrual cycle. To reduce excess hairiness, drugs such as cyproterone acetate, flutamide, finasteride are given. Metformin, a type of diabetes medication, might be used in the treatment because it reduces androgen production while having a positive effect on ovulation.

In some cases, the cysts need to be removed surgically. However, polycystic ovarian surgery is only preferred when medication or other treatment methods are unsuccessful. PCOS surgery is a very simple procedure. However, as in every surgical operation, complications may occur.

If the patient wishes to have children, appropriate treatments should be started. At the same time, the endometrium (internal layer of the uterus) is constantly exposed to the oestrogen due to chronic anovulation, which leads to an increased chance of endometrial cancer. Another aim of this treatment is to lower the risk of cancer.

Patients who want to have children are given medication that help stimulate ovulation. This treatment usually starts with clomiphene citrate. If the desired outcome is not reached, more effective medicines are used.

Patients who still cannot achieve pregnancy with all these treatment techniques, are recommended IVF. Click here for more information about IVF.

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