Polycystıc Ovary Syndrome
Polycystic Ovary Syndrome (PCOS) is an endocrine, i.e., hormonal disease that occurs due to the disruption of interactions between the nervous system, pituitary gland, ovaries, adrenal glands, and other tissues. It is commonly seen in women of reproductive age, causing irregular periods and reducing the likelihood of pregnancy. It is a chronic condition, and if not treated in the early stages, it negatively affects women's hearts, blood vessels, and external appearance.
Polycystic Ovary is known as the most common hormonal disorder during the reproductive years. According to studies conducted in the USA and Turkey, it affects 10-15 women out of every 100.
Polycystic Ovary Syndrome generally begins during adolescence; its cause is the malfunction of the hormonal system that becomes active during puberty. The likelihood of this disease increases with the rise in obesity because excess insulin hormone secretion negatively affects the ovaries and hormonal system, creating an environment for the syndrome to develop.
How Does Polycystic Ovary Syndrome Develop?
The ovaries in the female body develop a mature egg during the menstrual cycle, which completes its development and maturation in a fluid-filled sac called a “follicle.” In Polycystic Ovary Syndrome, many eggs attempt to mature simultaneously, but they fail to do so. As a result, there are many eggs, but none of them develop to be fertilized. In ultrasound examination, the ovaries are seen as numerous cyst-like sacs containing undeveloped eggs.
Symptoms of the Syndrome
The disease generally manifests in symptoms such as irregular periods, acne, oily skin, increased hair growth, infertility, and weight gain. Polycystic ovary usually appears when menstruation begins during adolescence. At these times, irregularities in the menstrual cycle are the most significant warning signs and are seen in almost 75% of individuals. The most common irregularity is infrequent periods. Many times, amenorrhea, the absence of menstruation, may occur. Following a delay, the bleeding that occurs is often heavy and prolonged. This irregularity is a sign of an ovulation disorder.
Polycystic Ovary Syndrome Treatment
Polycystic Ovary Syndrome is a chronic condition. Therefore, it is important to learn about this disease and adopt an appropriate lifestyle. Not every woman with polycystic ovary exhibits the same symptoms. However, women with polycystic ovary should primarily adjust their diet and be encouraged to exercise. Although every patient with the syndrome is not the same, the key factors at the beginning of the treatment process are maintaining a healthy weight, exercising, lowering insulin levels, avoiding smoking, and refraining from alcohol consumption. The most important factors are exercise, weight control, and healthy, regular nutrition.
In patients with insulin resistance, weight loss alleviates the symptoms of polycystic ovary syndrome. For example, in patients with acne, hirsutism, and elevated androgen levels, controlling blood sugar and insulin levels with diet and exercise accelerates the improvement of these symptoms. Exercise and healthy nutrition are also important because they reduce the risk of developing diabetes due to polycystic ovary syndrome in the future.
Irregular Periods Treatment: In patients considering pregnancy, treatment that restores ovulation will also regulate the menstrual cycle. For patients under 35 years of age and those not wanting children, the most commonly used drug is birth control pills. The second option is progesterone medications taken 15 days after the period.
Infertility Treatment: In Polycystic Ovary Syndrome, the inability to ovulate causes infertility. The first line of treatment in patients is oral medications that induce ovulation. These drugs promote egg development and ovulation as soon as they are used. However, they must be used every month. If there is no response to the oral medications, two different approaches are tried. One is hormone therapy with injections to induce ovulation, and the other is a surgical procedure called laparoscopic diathermy (LOD) performed to induce ovulation.
Hirsutism Treatment: In patients with Polycystic Ovary Syndrome, excessive hair growth, male-pattern baldness, and acne can occur due to the testosterone hormone. To prevent hirsutism, birth control pills can be used. These medications lower androgen hormone levels in the blood, preventing the formation of new hair. To achieve successful treatment with birth control pills, it is important to use them regularly for 6 months. This is because hair growth is slow. The medication does not remove the hair that existed before; hair removal treatments like epilation are used for hair that grows after treatment.
How Is Polycystic Ovary Syndrome Diagnosed?
Changes in the growth rate of your hair or the development of acne may indicate high levels of androgens like testosterone, which can help your doctor determine the presence of the condition. Otherwise, blood tests can detect elevated androgen levels. A blood test can also be used to check prolactin levels, a hormone produced by the pituitary gland in the brain. Very high prolactin levels may indicate a pituitary tumor, which can cause symptoms similar to those of polycystic ovary syndrome.
If your symptoms exclude other causes, and a blood test shows high testosterone levels and you have infrequent periods, your doctor will likely diagnose you with polycystic ovary syndrome. If you are currently using birth control pills, testosterone cannot be clearly tested. To be certain of your diagnosis, your doctor will test other hormone levels that may be related to or cause similar symptoms to high testosterone.
During a pelvic examination, if your ovaries are enlarged, your doctor may prefer to use ultrasound to examine them. An ultrasound test may show multiple cysts on the ovaries. Some women may have all the specific hormonal abnormalities but no cysts on their ovaries. These women are diagnosed and treated in the same way.