Polycystic ovary syndrome (PCOS or PCOS) is a chronic (chronic) absence of ovulation (chronic anovulation) and the resulting menstrual irregularity or amenorrhea.
It is a condition characterized by high levels of male hormones (hyperandrogenism) and the resulting symptoms such as increased hair growth, acne, hair loss and weight gain.
What causes PCOS?
The cause of the disease is not fully known. Polycystic ovary is a vicious circle situation. Any event that disrupts the ovulation process for any reason may ultimately lead to the development of a condition called polycystic ovary. Other signs and symptoms of PCOS usually develop secondary to incomplete ovulation function. When ovulation is incomplete, the structure called follicle, which contains the egg cell, cannot reach the size that will mature the egg cell and crack and release this cell, and it remains in the ovary as a cystic structure of millimetric diameters. As this vicious cycle continues, a new one joins the small cysts in the ovaries every month, and over a period of time, the ovaries turn into structures containing many cysts and, in advanced cases, reaching larger than normal diameters. Since follicle development is close to the outer surface of the ovaries, these cysts, whose number increases with each interrupted menstrual cycle, are arranged along the edge of the ovary near the surface.
Findings and complaints: PCOS progresses differently in every woman. In some women, the only symptom may be hair growth, while in others, menstrual irregularity may be at the forefront. PCOS, where all symptoms occur together, is rare.
- Menstrual irregularities: Ovulation is the most important event that ensures the regularity of the menstrual cycle. Failure of this function causes irregular, prolonged and excessive bleeding that occurs at long intervals. Sometimes amenorrhoea may last up to 6 months. In very rare cases, a woman with PCOS may continue to menstruate regularly.
- Infertility: Lack of ovulation in a woman of reproductive age and planning pregnancy causes the problem of not being able to become pregnant.
- Hair growth and hair loss: Hormone production is also unbalanced in the cystic structure formed as a result of interrupted ovulation. Testosterone hormone is produced instead of estrogen hormone. This hormone is a hormone that can cause hair growth and acne when secreted more than normal in women. Excessive hair growth and sometimes male pattern hair loss are also observed in patients. The previously scattered, thin hairs on the chin and lips gradually thicken and increase in number, creating an aesthetic problem. In more advanced cases, abnormal hair growth may occur between the breasts, on the nipples and in the belly. To learn more about hair growth and its treatment, please Click here.
- Skin oiliness: Oily skin, acne, and dandruff on the scalp may occur. Additionally, dark brown spots may appear on the skin.
- Obesity: PCOS is a condition usually seen in women who are overweight. It is still controversial whether weight gain develops as a result of PCOS or whether PCOS is more common in overweight women. Today, it is known that treating PCOS with medication makes it easier for women to reach their ideal weight, and that PCOS is easier to treat in women who lose weight voluntarily.
How is it diagnosed?
The most important point for diagnosis is the patient's history. In addition, ultrasonography is performed to check the appearance of the ovaries and hormonal tests are performed. While an increase in the LH hormone is observed in hormone tests, the FSH hormone does not change or may decrease slightly (the LH/FSH ratio is above 3). Additionally, an increase in testosterone and androstenodione, known as male hormones, may be observed. An increase in DHEAS and Prolactin hormones can be observed in 50% of patients and 20%. If two of the history, hormone values and ultrasound appearance are positive, polycystic ovary syndrome can be diagnosed. When it comes to excessive weight gain, studies often include diabetes research.
TREATMENT
The treatment is not a definitive treatment and is only directed at the patient's complaints.
However, with advancing age, menstrual cycles return to normal in some patients and complaints may decrease.
In addition, some patients who could not get pregnant before or who could get pregnant with treatment can become pregnant on their own.
in treatment first stage in overweight patients is weight loss. Even a 5% weight loss in patients can improve menstrual periods in a significant portion of patients and contribute to a response to lower doses of ovulation-inducing drugs.
But it is difficult to lose weight with this disease. A permanent weight loss plan is required. In order to achieve weight loss, gradually increasing daily activity and a stable diet program give satisfactory results.
In fact, the treatment of PCOS should be divided into two.
1. Treatment for women who want to become pregnant
2. For women who do not want to become pregnant, treatment is with medication. basic principle It is to prevent ovulation from being interrupted and thus to prevent the number of cysts in the ovarian tissue from increasing. For this purpose, a woman who does not desire children ovulation never startsIn a woman who desires children, completion of ovulationdirected treatment is given. When the increase in the number of cysts in the ovarian tissue is prevented in this way, the previously formed cystic structures begin to disappear spontaneously after a while and thus the "secretion" secreted from the cysts begins.male hormone" amount begins to gradually decrease. Since the drugs used also provide menstrual regularity, the missing amount progesterone The negativities that may be caused by the hormone are eliminated.
In a woman who does not desire children, treatment is usually birth control pills is preferred. These drugs are drugs that temporarily stop ovulation at its most basic stage, the follicle development stage. The progesterone hormone contained in the drugs protects the inner layer of the uterus from thickening and ensures regular menstrual bleeding. For women who cannot or do not want to use birth control pills for medical reasons, the menstrual cycle is given at regular intervals. progesterone It is provided by the hormone.
In a woman who desires children, ovulation stimulating drugs is referenced. These drugs may be in the form of tablets taken orally, or they may be stronger drugs with more side effects but used in the form of injections if there is no response to treatment.
With these treatments, ovulation can be achieved in more than 80% of women with polycystic ovaries.
Since PCOS is a vicious circle disease, treatment can be achieved by breaking the vicious circle from different points:
* Accessing the ovaries that are enlarged and containing many cysts by laparoscopy and destroying some of the cysts within the ovarian tissue by bursting them can make a significant contribution to the recovery of the disease by breaking the vicious circle. Today, this method is used, although rarely. However, it should not be forgotten that surgical interventions may cause adhesion in the abdomen.
* PCOS and insulin resistance The close relationship between insulin resistance It has brought the use of tablet-shaped drugs (such as metformin-glucophage) to the agenda. This treatment may be beneficial in resistant PCOS.
* If pregnancy cannot be achieved with ovulation treatment and drugs that break insulin resistance, these treatments should be used. vaccination Adding the method would be useful.
To learn more about IUI therapy Click here.
* If pregnancy cannot be achieved after all these treatment stages in PCOS disease, or there is a decrease in the number and motility of male sperm, a blockage in one of the tubes, etc. In the presence of an additional problem such as in vitro fertilization treatment will come to the fore.
Since these women have many egg cells in their ovaries, they are actually treated with in vitro fertilization. The chances of pregnancy are high.
To learn more about IVF treatment Click here.
Hairiness complaint In the treatment of women with obvious birth control pills It is quite effective. With this treatment, the male hormone produced by the ovaries is suppressed. The aim of this type of treatment is to both ensure menstrual regularity and prevent the formation of new hair on the body.
Apart from birth control pills, there are also some new drugs available to treat hair growth.
Hair loss treatment is a long-term treatment. 8-18 months of treatment may be required for success. This is due to slow hair growth
Unfortunately, there is no effective and fast drug treatment for old hairs. What needs to be done for the hairs that have already formed is to remove them by methods such as waxing and electrolysis. If hair is removed without using medications that control hair growth, the method will fail and the removed hair will grow again and more.