Can acne be caused by polycystic disease? What is polycystic disease? Acne in women with hormonal imbalances

Hi all.

I haven’t written anything here for three years, but I can’t help but ask those who are experiencing similar problems like me, so I’ll create a topic.

In general, the standard scheme: I was 22 years old, suddenly there were some acne on my cheeks, oh oh, we run to the gynecologist - polycystic disease, take COCs.

At first I took Yarina (all according to the doctor, of course, not from the bullshit), which gave me migraines, then I quit because I didn’t understand how it helps to “treat”? (And the doctor said to drink until you plan a pregnancy (as usual, it’s natural)

In the same way, after the break I was showered even more severely, the picture in the mirror became completely ugly, I treated it in all ways with the help of a dermatologist. All kinds of peelings, masks, ointments and medications. (hundreds of thousands of billions of rubles were spent on this crap, hysteria, I really can’t go out and throw away the trash, tears, but to hell with it) The acne did not go away. I returned to the gynecologist, they prescribed Diana-35, from which the side effects were even worse than with Yarin. My legs were pulling, and since I drank at the same time in the evening, before going to bed I had a constant feeling of suffocation, which caused outright panic. After three months of my “patience” I was told to switch to Jess. By this time, of course, all the pimples have disappeared, the cycle is normal, I take it diligently, but after two months I already see - oops, a capillary on my nose has burst, first one, then a second, then bam, again this migraine is even stronger, and I’m at work I sit and endure it. On some days, the feeling of heaviness in my legs moved from one point to another, making it difficult to do normal routine tasks.

I’ve already re-read all the articles here, I tried to comprehend every comment, everything is wonderfully written, I understand everything and how, I’ve been to 10 doctors, they all tell me different crap, one means against COCs, the second is for COCs (be patient and drink, on top of you Phlebodia for veins and go for a walk Vasya) but I didn’t find any information from one comment - DO I really need to take this crap for life now? I want to study, I’m still far from having children (I think), I have ambitions, explain if someone has already understood everything.

Now I have stopped drinking Jess, these protruding veins on my face seem to me to be clearly too much, shouldn’t I continue to drink them with a calm look?

Now I'm afraid that all the ugly Akneshechki will come to the clearing again and hang out. Maybe the damn thing won't come back? how was it for anyone?

Thank you in advance for any advice and kind words. (thanks for the bad word, too, because I understand that the topic is very hackneyed)

P.S. I took absolutely all the tests, did an ultrasound, donated blood for hormones, everything was as it should be

Hormones play an important role in the appearance and development of acne in women, and although the exact mechanism of action is unknown, androgens have been shown to act on the follicles and cause excess sebum production. Androgens are the so-called male hormones, but are normally present in both men and women. They are produced in the testicles (in men), ovaries (in women) and adrenal glands (in men and women). The most well-known androgens are testosterone and dihydrotestosterone, or DHT.

WHAT HORMONES AFFECT ACNE IN WOMEN

Research has shown that androgen receptors exist in the sebaceous glands and the cells lining the pores. If a woman has high levels of testosterone and dihydrotestosterone, they will in most cases affect these receptors. Simply put, these acne-causing hormones cause the skin to produce more oil, which will further feed the bacteria. Thus, by reducing androgens and testosterone, acne can be reduced.

In addition, the testosterone precursor hormone DHEA also influences the functioning of the sebaceous glands. DHEA sulfate levels begin to rise long before puberty, when the adrenal glands begin to produce it. At this time, acne begins to appear in adolescents who have a genetic predisposition to it.

Considering the above, when dealing with acne, women and girls first need to take hormone tests:

• testosterone,
• DHT (dihydrotestosterone),
• DHEA (dehydroepiandrosterone sulfate).

Additionally, the doctor may prescribe:

• androstenedione,
• cortisol

One of the factors that influence the increase in hormones is the food we consume. The typical diet for most people is high in saturated fat, processed grains, meat fats, refined sugars and low in fresh vegetables, fruits, fish, fiber, antioxidants and seaweed.

A healthy diet is one form of natural treatment for hormonal acne in women, not because it occurs from junk food, but because the quality of food can affect hormonal levels, especially during adolescence or if there are endocrine problems.

Another way to balance your hormone levels is to take certain herbs.

ACNE IN WOMEN WITH HORMONAL DISORDERS

Very often (especially after 30 or at a later age) they appear due to hormonal imbalance, for example due to polycystic ovary syndrome. is a condition in which a woman has a hormonal imbalance. Typically, in this case, there are low levels of estrogen and progesterone and high levels of androgens (male hormones that occur in small quantities in women). It is still not entirely clear what causes this violation.

Symptoms of PCOS include:

• absence or irregular menstrual cycle,
• cystic ovaries (on ultrasound),
• hair on the body, chest, face and around the nipples,
• thinning hair on the head,
• acne,
• dark spots on the skin around the neck, armpits, groin area or chest,
• reduction in breast size.

An increase in male androgen hormones is responsible for these “masculine” characteristics.

You can treat hormonal imbalance and acne using natural and natural methods: by changing your diet to one that will reduce androgens, taking herbs (for example) and other natural supplements. Although (mainly oral contraceptive pills) are perhaps the most popular way to combat PCOS and acne, they should only be used as prescribed by a doctor and in cases where gentler methods have not helped.

If you suspect that your acne on your face, chin, or chest may be caused by PCOS or another hormonal disorder, consult your doctor for testing and diagnosis.

HORMONAL ACNE IN WOMEN: NATURAL TREATMENT

1. Take vitamins and herbs

Omega-3 fatty acids can lower testosterone in women and girls. Taking EPA and DHA supplements (such as quality fish oil) and adding more Omega 3s to your diet can help your body balance testosterone levels and eliminate acne.

Hormonal acne in women usually appears in the chin area. If you experience acne in this area during your period, chasteberry may help. Chasteberry is an herb also known as chasteberry and tree of Abraham that can be considered a folk remedy. It has been used with great success to treat women who have low progesterone in the luteal phase (the part of the cycle that begins after ovulation and ends the day before the next menstrual period) and high estrogen. Signs of low progesterone in women:

• depression,
• depression,
• mood swings,
• hormonal acne,
• nervousness and anxiety.

Symptoms of elevated estrogen include:

• breast pain and tenderness,
• bloating during menstruation.

Prutnyak acts on the pituitary gland and hypothalamus by increasing luteinizing hormone (LH) and slightly suppressing the release of follicle-stimulating hormone (FSH). This leads to a shift in the ratio of estrogen to progesterone, increasing the latter. Chasteberry's ability to increase progesterone is a side effect, as the herb itself is not a hormone. You can take it only after taking a test for the content of this hormone in the blood, in order to avoid an excessive increase in progesterone, which can, on the contrary, stimulate acne. Also, if LH levels are elevated, it is not advisable to drink Vitex.

The optimal time to take Vitex herb is in the morning between 7-8 o'clock, because at this time the pituitary gland and hypothalamus are active and regulate female sex hormones. To get the effect, you need to take prutnyak for about three months.

1. Eat right

Studies have shown that when switching from a diet high in saturated fat to a diet with less fat and more polyunsaturated fat (nuts, fish, seaweed, green leafy vegetables) over six weeks, there was a significant decrease in androstenedione (a testosterone precursor). na) and testosterone in the blood. These studies have been conducted over many years, also studying the effect of fiber (grains, vegetables, beans) on a woman's hormonal levels. A high fiber diet has also been found to reduce blood levels of testosterone, DHT and DHEA.

The average daily fiber intake for the average person is approximately 13 grams. The recommended daily dose is 25 grams for women and 38 grams for men. Including fiber in your diet is beneficial for those who suffer from acne.

1. Reduce your milk intake

DHT is able to bind to receptors in the sebaceous glands and “turn them on,” triggering acne and increased sebum production. Milk, in turn, increases DHT levels. Doctors have found that increased consumption of meat, protein foods, coffee, alcohol, sugar and processed grains worsens acne. On the contrary, it is beneficial to include fruits, vegetables and whole grains in your diet. Consuming too much meat, protein and milk leads to acidosis. The main symptom of acidosis is fatigue. Other symptoms include:

• loss of motivation,
• decreased libido,
• poor quality of sleep,
• depression and rapid mental and physical fatigue.

Additional symptoms of acidosis:

• sensitivity to cold,
• low blood pressure,
• hypo- or hyperthyroidism,
• low blood sugar.

These symptoms are caused by the fact that the body uses essential minerals that are needed to nourish the nervous system, such as calcium, magnesium and potassium, to neutralize acids. Stress also causes increased acidity in the body, which has been proven by studies. Alkaline foods (vegetables, fruits, honey, nuts, green tea) neutralize these acids and reduce levels of cortisol, the stress hormone (which is most often elevated in women with hormonal acne).

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Development scheme

The phases of egg maturation are coordinated by hormones of the pituitary gland, ovaries, and adrenal glands. With polycystic ovary syndrome, the biosynthesis of estrogen decreases, and the level of androgens increases, which interferes with the normal maturation of the dominant follicle. The rupture of the follicle membrane and the release of the egg into the abdominal cavity do not occur. The egg remains in the follicle, where it dies, and the follicle is filled with serous fluid and turns into a cyst.

If this process is repeated several times in a row, the ovaries soon turn into cellular cystic formations and practically lose their function. Under the influence of androgens, the outer tunica albuginea of ​​the ovaries becomes denser, the ovaries increase in size by 2-3 times.

The exact reasons for the development of polycystic disease are still not fully understood.

Symptoms

The first symptoms of polycystic ovary syndrome appear at the stage of menstruation in girls and often go unnoticed.

• Acyclicity of menstruation or its absence. The intervals between menstrual cycles range from two to three months to six months.
• The nature of the discharge changes - in the form of a slight menstrual secretion (oligomenorrhea) or heavy, reminiscent of bleeding.
• Tendency to obesity. Excess weight is combined with the development of insulin resistance.

The predominance of androgens - male sex hormones - leads to a whole complex of symptoms characteristic of this type of hormonal disorder:

• Hirsutism is hair growth in areas unusual for women: above the upper lip, on the chin, on the skin of the mammary glands and abdomen.
• Hypertrichosis - increased hairiness on the arms, thighs, and legs.
• Partial alopecia is hair loss in areas characteristic of men (formation of bald patches on the forehead, on the back of the head).
• Acne, pimples on the face, back, shoulders with the formation of comedones caused by blockage of the sebaceous glands.
• Hyperpigmentation - brown pigment spots on the skin: on the neck, under the arms, in the groin folds.
• Striae are stretch marks on the skin. Divergence of skin fibers in the area of ​​the mammary glands, thighs, and abdomen.
• Primary infertility. If there is a hormonal imbalance, ovulation does not occur; the immature egg dies in the unruptured follicle.
• Increased premenstrual symptoms - strong emotionality, pastiness, pain in the lower back, abdomen, swelling and tenderness of the mammary glands.
• A change in the psycho-emotional background, with a characteristic sharp change in mood in the form of nervousness, aggressiveness or apathy and lethargy.

Signs of the disease: increased greasiness of the skin and hair, acne, stretch marks on the skin are regarded by women as a defect in appearance. They try to cope with these problems in beauty salons. Often, only after many years of unsuccessful attempts to get pregnant does a woman consult a doctor.

Consequences of polycystic disease

• More than half of women suffering from this disease experience infertility. If pregnancy does occur, there remains a high risk of miscarriage.
• Iron deficiency anemia, resulting from blood loss during bleeding.
• Violations of lipid and carbohydrate metabolism lead to type 2 diabetes mellitus.
• During pregnancy, the formation of gestational diabetes and preeclampsia is possible - an increase in blood pressure that threatens the life of the mother and fetus.
• Early development of atherosclerosis due to lipid metabolism disorders: increased blood cholesterol and triglyceride fractions. Atherosclerosis provokes the development of heart attacks and strokes.
• Fatty hepatosis is fatty degeneration of hepatocytes, leading to impaired liver function.
• The threat of uterine cancer due to hypersecretion of estrogens and increased proliferation of endometrial cells against the background of a long absence of menstruation.

It is impossible to cure polycystic ovary syndrome, that is, to get rid of cystic growths. But with adequate treatment, there is a chance to normalize hormonal levels, get rid of unpleasant changes in appearance, protect yourself from possible complications and give birth to a child.

Nutrition

Excess adipose tissue not only accumulates steroid hormones, but is also capable of their biosynthesis. It contains several times more androgens than blood plasma. Getting rid of extra pounds with polycystic disease reduces the level of these hormones in the blood, and therefore increases the chances of conceiving a child.

It has been proven that a decrease in body weight of just 5-10% leads to the restoration of regular menstruation and the ability to become pregnant.

According to the theory of rational nutrition, the diet for polycystic ovary syndrome:

• must provide the biological needs of the body;
• contain a sufficient amount of food ingredients: proteins, fats, carbohydrates, vitamins, microelements.

Diet principles:

1. Gradual reduction in calorie intake to 1800-2000 kcal per day.
2. Cooking methods: boiling, stewing, baking, steaming.
3. Divide daily calories evenly over 5-6 meals.
4. Increase the volume of water consumption to 2 liters per day.
5. Inclusion in the diet of foods containing plant fiber (bran, fresh vegetables, nuts).
6. Consuming carbohydrates with a low glycemic index.
7. Fasting days (cottage cheese, apple, kefir) every 7-10 days.

Allowed:

• meat - veal, chicken, turkey, rabbit;
• seafood and fish - pike, cod, pollock, hake, shrimp, squid;
• vegetable oil - sunflower, olive;
• lactic acid products - cottage cheese, cheese, fermented baked milk, kefir;
• cereals - oatmeal, buckwheat, brown rice;
• legumes - beans, soybeans, peas;
• vegetables - cabbage, eggplant, zucchini, peppers, tomatoes, onions, greens;
• fruits and berries - apples, pears, plums, strawberries, raspberries, citrus fruits, quince, apricots;
• mushrooms;
• nuts;
• eggs;
• drinks - jelly, compotes;
• limited sweets - dark chocolate (80% cocoa), marshmallows, marmalade;
• rye bread with bran.

Prohibited:

• pork, lamb, ducks, geese;
• all processed meat products - sausages, sausages, boiled pork, ham;
• canned foods;
• honey, sugar;
• cereals - semolina, rice;
• confectionery products - cookies, sweets, cakes, waffles;
• baked goods made from wheat flour - rolls, pies;
• sweet carbonated drinks;
• sauces, mayonnaise, margarine, lard, animal fats;
• salted crackers, chips, popcorn;
• alcoholic drinks.

In parallel with the diet, physical activity is increased: therapeutic exercises, swimming pool, walking, gym classes.

Therapy

Treatment of polycystic ovary syndrome is a complex task. The choice of drugs depends on the root cause of the pathology:

1. If a woman is not planning a pregnancy in the coming years, treatment for polycystic ovaries begins with the prescription of oral contraceptives. These drugs will resume the regular menstrual cycle, prevent endometrial hyperplasia, and reduce the likelihood of developing uterine cancer.
2. In the presence of insulin resistance - a reduced ability of cells to respond to insulin, which helps absorb glucose, metformin drugs are prescribed: Glucophage, Siofor.
3. For severe androgenization (hair growth, sebaceous skin, acne) - combined oral contraceptives: Diane-35, Yarina, Midiana, Belara. They are prescribed together with drugs that have an antiandrogenic effect: Spironolactone, Flutamide, Finasteride.
4. If the tasks of losing weight and establishing the menstrual cycle are successfully completed, they move on to the next stage: stimulation of ovulation with Clomiphene, Clostilbegit.

If drug treatment is ineffective, surgical methods are resorted to.

• Partial resection of the ovaries is performed endoscopically.
• Part of the affected ovary is removed by electrocoagulation or exposure to a laser beam.

The purpose of surgery is to stimulate the functioning of the remaining healthy ovarian tissue.

ethnoscience

Herbalists suggest treating polycystic ovary syndrome at home with herbs containing phytoestrogens. They help normalize the menstrual cycle in women by correcting hormonal imbalances.

Traditionally, these plants were used to treat infertility: red brush, knotweed, hogweed, sage, red clover.

The peculiarity of using folk remedies (decoctions, tinctures) is a three-week course of administration with a week-long pause during menstruation.

Folk remedies cannot be a complete replacement for hormonal therapy. Treatment for polycystic ovary syndrome will take a long time and hard work.

Much depends not only on adequate drug treatment, but also on the lifestyle led by a woman suffering from this disease.

A low-calorie diet, physical activity, and giving up bad habits (smoking and alcohol) will help improve the condition.

According to statistics, polycystic ovary syndrome is diagnosed in 5–10% of women of reproductive age. The heyday of the disease is observed by the age of 30. Polycystic ovaries lead to disruption of the menstrual cycle and seriously worsen a woman’s appearance, but the most serious complication, perhaps, is the development of infertility.

Polycystic ovary syndrome: what is it?

There are two forms of pathology. The first includes polycystic ovary disease or primary polycystic ovaries, which is formed from the moment the ovaries function, and accordingly, clinical signs appear during puberty. Primary polycystic disease hereditary, that is, genetically determined disease. A synonym for primary polycystic ovary syndrome is Stein-Leventhal syndrome.

Secondary polycystic ovary syndrome is the result of secondary disorders in the genital gonads and is caused by chronic endocrine pathology or inflammatory diseases of the genital organs.

Causes and pathogenesis of the disease

Despite the fact that the disease is one of the most common hormonal disorders among women of childbearing age, the exact causes of its occurrence have not yet been established. In the pathogenesis of polycystic ovary syndrome, disruptions at any level in the hypothalamic-pituitary-adrenal-ovarian system play a role. Not least important is the functioning of the thyroid gland and pancreas.

Development mechanism

It has been established that almost all patients with this disease have insulin resistance, that is, the body reacts “poorly” to insulin, secreted by the pancreas and controlling blood glucose levels. As a result, insulin accumulates and circulates in large quantities in the blood. Excess insulin “stimulates” the ovaries and they begin to produce androgens in quantities significantly higher than normal.

Androgens, in turn, inhibit ovulation, that is, the dominant follicle does not burst and the release of an egg does not occur, and the second phase becomes incomplete due to a lack of progesterone (there is no ovulation - the corpus luteum has not formed - progesterone is not synthesized). The inhibitory effect of androgens on ovulation is explained by their ability to thicken the outer membrane of the ovaries, which a mature follicle cannot “break through” to release the egg. The follicle that has not fulfilled its function is filled with fluid and turns into a cyst. In the next menstrual cycle, history repeats itself and the ovaries are covered with many small cysts, which explains their increased size.

Predisposing factors

Factors that provoke the occurrence of polycystic ovaries include:

• hereditary predisposition;
• diabetes;
• overweight;
• colds;
• chronic stress;
• many abortions (lead to hormonal disorders);
• unfavorable environmental conditions;
• diseases of the endocrine organs (pituitary gland, thyroid gland, hypothalamus and adrenal glands);
• infections;
• chronic inflammatory diseases;
• gynecological pathology (both hormonal and inflammatory diseases).

Symptoms, clinical picture

Menstrual disorders
The first sign that makes a woman worry is irregular menstruation. Menstrual cycle disorders are characterized by infrequent periods (after 3–6 months), scanty periods (opsomenorrhea) or, on the contrary, heavy and prolonged periods after a long delay. The cycle length is 35 days or more, and there are about 8 menstrual bleeding or less per year. Menarche appears on time, but the cycle is immediately irregular. Dysfunctional uterine bleeding occurs as a result of the formation of a hyperplastic process in the endometrium against the background of a long absence of menstruation. In this regard, all patients with polycystic ovaries are included in the risk group for mastopathy, uterine adenocarcinoma and breast cancer.

Hyperandrogenism
High levels of androgens are manifested by a number of symptoms:

• Hirsutism
  Excessive hair growth of the male type is characteristic (on the face, in the parapapillary zones, legs).
• Hypertrichosis
  It is characterized by an increase in the growth of shaft (coarse and thick) hair on the chin, in the neck and around the nipples, in the thigh area. This symptom always indicates hyperandrogenism and occurs in the primary form of the disease.
• Virilism
  Women have a masculine build, their hair pattern is male-type, they are characterized by an enlarged clitoris and hypoplasia of the mammary glands, and a low voice. Alopecia (male pattern baldness) and thinning hair are often observed.

Condition of skin and hair
With polycystic ovary syndrome, the skin is characterized by increased oiliness, enlarged pores with the presence of acne (acne). It is typical that acne occurs not only on the face, but on the neck, shoulders and back. Oily seborrhea is also noted, and the hair itself quickly becomes dirty even with careful care. Dark brown pigment spots may appear on the skin of the inner thighs, in the bends of the elbows, and in the armpits.

Infertility
The most serious and cardinal sign of the disease is infertility due to anovulation. It is precisely because of the absence of pregnancies that women with this pathology most often consult a doctor. Approximately 85% of patients have primary infertility, that is, they have never been pregnant.

Accompanying illnesses
As a result of increased levels of insulin in the blood, there is a high likelihood of developing diabetes mellitus. Arterial hypertension and hypercholesterolemia (high levels of cholesterol in the blood) are also often observed, which in turn provokes the development of hypertension and atherosclerosis.

Diagnostics

In the process of establishing the diagnosis of “polycystic ovary syndrome”, data from anamnesis, general and gynecological examination, indicators of laboratory and instrumental examination methods are taken into account:

History and clinical examination
When collecting anamnesis, the doctor takes into account the nature of the menstrual cycle and its formation, previous infections and hereditary diseases. During the examination, the patient’s weight and height are measured, the weight-height coefficient is calculated, and the degree of obesity and the distribution of fatty tissue are determined (if any). During the gynecological examination, enlarged and dense ovaries are palpated, slightly painful when pressed. The type of hair growth and the presence/absence of pigment spots in friction zones (groin folds, inner thighs) are assessed.

Lab tests
The content of luteinizing and follicle-stimulating hormones is determined (an increase in the LH/FSH ratio is observed), the content of 17-ketosteroids, testosterone and prolactin. Tests for blood sugar and lipids, cholesterol, and insulin are also prescribed. Additionally, the content of thyroid hormones is assessed.

Instrumental studies
Ultrasound of the pelvic organs is important in diagnosing the disease. Echoscopic signs confirming the diagnosis: symmetrical increase in ovarian volume (more than 8 cubic cm), dense hyperechoic stroma with increased blood flow and developed vascular network, thick ovarian capsule, a large number of anechoic follicles (up to 1 cm in diameter, from 10 or more). To confirm the diagnosis, MHT (menopausal hormone therapy), excluding ovarian tumors and diagnostic laparoscopy are prescribed.

Polycystic ovary syndrome and pregnancy

It would seem that polycystic ovary syndrome and pregnancy are two mutually exclusive concepts. No doctor will say a categorical “no” in this case. Most patients are concerned Is it possible to get pregnant with polycystic ovary syndrome?. As already mentioned, the percentage of spontaneous pregnancies is very, very low, and their successful completion is even lower (from 3 to 5) without the lack of proper treatment. In addition to spontaneous abortion in the first trimester, pregnancy against the background of this disease is fraught with another complication - ectopic (usually tubal) localization of the ovum. The fact is that enlarged and heavy ovaries stretch the fallopian tubes, which leads to tortuosity and deformation. Accordingly, the fertilized egg takes longer to travel through the altered tube, which threatens its implantation in the tube or tubal pregnancy.

But even if the “journey” ended successfully, and the egg entered and was implanted in the uterine cavity, the problems do not end there. High levels of androgens prevent the embryo from growing and developing normally, which is accompanied by a permanent threat of miscarriage and often ends in miscarriage. Therefore, all expectant mothers with this diagnosis receive supportive hormonal therapy for almost the entire pregnancy.

Often, neither conservative nor surgical treatment of the disease is successful, and patients are recommended IVF. In addition, pregnancy against the background of this pathology is often complicated by the development of gestational diabetes mellitus, late toxicosis, intrauterine growth restriction and premature birth.

Treatment

How to treat polycystic ovary syndrome? Therapy for polycystic ovaries is a long process that requires patience from the patient and consists of several stages.

Weight correction

Diet is where you should start treating polycystic ovary syndrome. The first stage of treating the disease is normalizing weight. It is important to follow a low-calorie diet for polycystic ovary syndrome. The first principle of the diet is fractional meals, up to 5–6 times a day, and the portions should be small. Small meals allow you to satisfy the feeling of hunger. Refractory fats (fatty meats, poultry, fish), easily digestible carbohydrates (sweets, baked goods, sweet fruits), as well as alcohol and smoking should be excluded from the diet. It is advisable to steam, boil, stew (in a small amount of vegetable oil) or bake (without crust) food. Fried, spicy and fatty foods are not allowed. The diet should contain a large amount of plant fiber (fresh vegetables and fruits). The diet also includes legumes, brown rice, lean meats, fish, low-fat dairy products, and nuts (as a source of vitamin E). Wheat bread must be replaced with rye or bran bread; it is advisable to eat yesterday’s baked goods. You should also follow the drinking regime. Free fluid consumption should be at least 1.5 - 2 liters per day.

In addition, physical activity in the form of moderate sports is recommended, and to normalize carbohydrate metabolism, metformin is often prescribed, which regulates blood glucose levels. Treatment with this drug lasts 3 to 6 months. Often, once the weight is normalized, the menstrual cycle is restored.

Treatment of dishormonal disorders
After weight normalization, they move on to the next stage - therapy with hormone-containing drugs, which not only help regulate the cycle, but also suppress the action of androgens and their associated effects. For this purpose, combined oral contraceptives are prescribed with a low estrogen content, but with antiandrogenic activity (Yarina, Diane-35, Jess or Janine). The duration of the second stage of treatment is 6–12 months, during which the menstrual cycle is restored, menstrual blood loss is normalized and signs of hyperandrogenism disappear. Also, taking spironolactone helps to cope with excess synthesis of androgens, but it is not recommended for pregnant women or those planning pregnancy, as it can provoke congenital deformities in the fetus.

Ovulation stimulation
How to get pregnant with polycystic ovary syndrome? The final stage of treatment, that is, stimulation of ovulation, is related to this issue. It is carried out with clostilbegit (clomiphene) for 3 menstrual cycles. The drug is prescribed from days 5 to 9 of the cycle, starting with a dose of 50 mg/day. In the subsequent cycle, in the absence of pregnancy, the dosage is increased to 75, and in the third cycle to 100 mg. If pregnancy does not occur, the woman is considered resistant to the drug and surgery is recommended. The long-awaited pregnancy after stimulating ovulation with clomiphene occurs in 35% of cases.

Surgery
If conservative treatment is ineffective and the patient desires to become pregnant, surgical intervention is indicated. The operation is performed laparoscopically. The following surgical methods are used:

• wedge-shaped resection of the ovaries (excision of up to 2/3 of the volume of the ovaries) - in this case, most of the gonads are removed, which stimulates the production of androgens, and with the elimination of hyperandrogenism, hormonal levels are normalized and ovulation occurs;
• decortication of the ovaries (the dense tunica albuginea is excised, and the follicles are pierced with a needle);
• endothermocoagulation (spot cauterization) of the ovaries.

It should be noted that the possibility of spontaneous ovulation after surgery decreases over time. That is, up to 75% of patients become pregnant in the first 3 months after surgery, up to 50% within six months after laparoscopy, and about 25% or less within 9 months. In this regard, the patient is prescribed ovulation stimulation immediately 3 months after the operation, if pregnancy has not occurred.

The problem of acne is not limited to adolescence. Acne with an ovarian cyst is one of its symptoms, along with such as menstrual irregularities, discomfort, pain in the lower abdomen, obesity and even infertility if the pathology is not treated. But a cosmetic defect of all this is not the worst thing, and in order to avoid all these problems, it is necessary to undergo examination by a gynecologist 2 times a year, and if you suspect the presence of this disease, an ultrasound diagnosis.

Causes of acne with cysts

PCOS - polycystic ovarian syndrome. Also known as Stein-Leventhal sm. Accompanied by disruption:

• female gonads;
• pancreas;
• adrenal cortex;
• hypothalamus or pituitary gland.

With polycystic ovary syndrome, acne on the face occurs as a result of an increase in the level of androgens - male hormones in the blood, as well as due to dysfunction of other organs, as a complication of the underlying disease. This leads to increased secretion of the sebaceous glands and the appearance of rashes on the back, chest and facial skin.

Localization

Ovarian cysts can cause rashes on the following parts of the body:

• chin;
• breast;
• back.

How to get rid of it?

To get rid of acne, complex therapy is prescribed, the goals of which are to eliminate the underlying ailment and local treatment. Therapy for PCOS is selected individually. May be medicinal or surgical. Conservative tactics are based on taking bi- or monophasic oral contraceptives in a course of 2 or 3 menstrual cycles. The pimples themselves are eliminated with systemic antibacterial drugs, for example, Amoxicillin, if a bacterial infection has joined the appearance of the rash and the process has progressed to the stage of profuse papular rashes. For local action, “Zinerit” is indicated. To support the body, a course of vitamins K, C, B1, B6, B12, E and A, and homeopathy are prescribed.

No less effective, according to dermatologists, are synthetic retinoids applied topically. These are Adapalene, Differin and Klinzit. When caring for facial skin, doctors recommend using products that will affect the sebaceous gland itself. It is preferable to use pharmaceutical gels and mousses for washing in the mornings and evenings, after which one of the topical products from the list of retinoids is applied to the skin. In some cases, methods such as balneotherapy with mineral water, exercise therapy, acupuncture and diet are also indicated.

Polycystic ovary syndrome and acne need to be treated comprehensively, since eliminating one cosmetic problem will have a short-term effect and the acne will come back over time. If the conservative route does not produce results, then they move on to surgery and further rehabilitation after surgery.