Polycystic ovary syndrome is a health problem that affects women's menstrual periods, hormones, conception potential, physical appearance, and some systemic organs (such as the heart and blood vessels). Characteristically, it presents with increased androgens, delay or irregularity in menstruation, and the appearance of small, multiple cysts in the ovaries on ultrasonography. Nearly one in 10 women of childbearing age can have PCOS. Polycystic ovary is one of the most important causes of female infertility.
Causes of Polycystic Ovary
Although the causes of the polycystic ovary are not known for sure, some factors (such as genetics and insulin metabolism) are thought to trigger this syndrome. Some researchers have revealed that polycystic ovary has a genetic transition in the family, and even the mother or sister of polycystic ovary patients has this disease. It is thought that insulin, which regulates sugar metabolism and the conversion of food into energy or storage, may be also associated with polycystic ovary. Excessively accumulating insulin in the body causes acne, hair growth, weight gain and ovulation problems in polycystic ovarian patients.
Although not all patients have the same symptoms, The main findings in patients with PCOS are:
- amenorrhea, irregular menstrual periods
- infertility due to ovulation disorders
- hirsutism (hair growth on the face, back, chest, abdomen…)
- ovarian cysts
- acne, oily skin, dandruff
- weight gain, obesity
- insulin resistance or Type 2 Diabetes
- high cholesterol and hypertension
- male-shaped baldness
- stomach ache
- snoring and pauses in breathing during sleep (apnea)
In a normal menstrual period, about 15 to 20 eggs begin to mature each month in women, and usually one of them fully matures and is expelled from the ovary, enters the tubes and is then fertilized with sperm. Due to the disorders in the full maturation process of the egg in polycystic ovary patients, about 20 underdeveloped eggs form cystic formations and ovulation does not occur.
The diagnosis of polycystic ovary is made by examining the patient's symptoms and examination, as well as some hormone levels, and demonstrating small and multiple cysts by ultrasonography.
The treatment of polycystic ovary aims to reduce current symptoms and prevent future systemic diseases (heart diseases, diabetes…).
- birth control pills: they can be used to regulate menstruation, reduce male hormone levels and reduce acne formation in patients who do not want to become pregnant.
- metformin: Glucophage provides control of sugar levels by affecting insulin metabolism in polycystic ovary patients. Besides, it has been shown to reduce hair growth and return ovulation after a few months of use.
- Infertility treatment: Pregnancy can be achieved by using some ovulation-stimulating drugs (clomiphene citrate, gonadotropin) or by in vitro fertilization in very severe cases.
- excessive hair growth and increase in androgen: Antiandrogen drugs such as Diane 35 or Aldactone are used.
- surgical treatment: With the method called laparoscopic ovarian drilling, small cysts in the ovaries are entered and emptied with a needle.