The main cause of infertility in polycystic ovary syndrome. Polycystic ovary syndrome (PCOS): causes, manifestations, diagnosis, treatment

Weight problems, persistent anxiety or depression, chronic acne, irregular periods or even infertility - all of these problems that many women face can be symptoms of one of the most common women's diseases.

Polycystic ovary syndrome (PCOS) is a common disorder that is still unknown, and the name itself indicates a spectrum of symptoms.

The name “syndrome” is used because this disorder manifests itself in different ways: a different set of symptoms occurs from woman to woman, which can arise for various reasons.

Many girls ignore polycystic ovary syndrome for a long time due to the absence of classic symptoms, but this cannot be done, since the far-reaching consequences can be serious:

infertility,
type II diabetes,
high cholesterol,
hypertension (high blood pressure),
endometrial cancer.

But a diagnosis of PCOS does not mean that a girl is doomed to suffer from chronic health problems for the rest of her life. Although there is no specific known cure for this disorder, there are still ways to successfully manage it.

“Polycystic ovary syndrome is highly treatable with diet, lifestyle changes and therapeutic agents,” say gynecologists. “About 20% of patients are women with polycystic ovary syndrome. A diagnosis of PCOS should not be an obstacle to having a child. If a woman is willing to change her diet and lifestyle, and take a number of medications, fertility will be restored and pregnancy will occur.”

The first step in the fight against PCOS is to fully understand this endocrine disorder.

POLYCYSTIC OVARY SYNDROME: WHAT IS PCOS

Polycystic ovary syndrome is most often caused by hormonal imbalance, which in turn affects various processes in the body. When just one hormone is produced in deficiency or excess, it can cause a cascade of other hormonal problems. It's not always clear what causes the initial imbalance, but genetics may play a role.

Women with PCOS typically begin to produce increased amounts of the male hormone androgens. This excess production can disrupt the normal balance of progesterone and estrogens, the female sex hormones. This syndrome can also affect the body's ability to properly use insulin, a pancreatic hormone that allows the body to process glucose from food and keep blood sugar stable.

Most women (though not all) with the syndrome also have many tiny cysts along the edges of the ovaries, hence the term polycystic.

It is estimated that 5-10% of women of childbearing age have PCOS, but only 30% of them exhibit symptoms.

POLYCYSTIC OVARIAN SYNDROME: SYMPTOMS

To make a diagnosis of polycystic ovary syndrome, it is not necessary to have all the symptoms at once. However, it is important to remember that this diagnosis cannot be made based on just one sign. A complete examination is of paramount importance: from ultrasound and blood tests for estrogens and androgens to examination of the thyroid gland, tests for cortisol, ACTH, prolactin and 17-OH progesterone.

The following symptoms are usually present in most girls.

Irregular periods: The cycle is extremely unstable, usually from the very onset of menstruation. Very often, a woman has fewer than 8-9 menstruation per year or no menstruation at all. The opposite situation with too short and frequent cycles is much less common.
Excessive production of male hormones: High androgen levels often lead to hirsutism (male-pattern hair growth on the face and body), acne (and oily skin) and hair loss.
"Pearl necklace": If a doctor suspects a patient has PCOS, he should order an ultrasound to detect cysts on the ovaries. Cysts in themselves do not necessarily indicate polycystic syndrome; other signs must also be present - increased androgens and menstrual irregularities. Some women with polycystic disease do not have cysts on their ovaries at all.

POLYCYSTIC OVARIAN SYNDROME: TREATMENT

Although there is no one-size-fits-all treatment for PCOS, there are various ways to influence symptoms and keep them under control. It is important to discuss all treatment options with your doctor and choose the safest and most appropriate one. Some of the most common treatments include:

Lifestyle change

Because many women with PCOS are overweight or obese, maintaining a healthy weight with the right foods and exercise is critical. Even minimal weight loss of 5-10% has been proven to restore menstrual cycles and fertility. A diet rich in whole grains, fruits and vegetables and containing unprocessed foods helps maintain normal blood sugar levels and improves insulin sensitivity. If you smoke, be sure to quit this habit, as smoking increases androgen levels in women.

Hormone therapy

If you do not want to become pregnant in the near future, your doctor will prescribe oral contraceptives, which can regulate your menstrual cycle and reduce excess androgens and acne. If you are trying to get pregnant, medications such as clomiphene (Clomid) can help stimulate ovulation.

Taking OCs is usually well tolerated by healthy women who do not have problems with reproductive function. In girls with PCOS, the hormonal levels are very unstable, and taking COCs (especially long-term) followed by them often aggravates the situation and worsens the manifestation of symptoms of polycystic disease, adding new problems. Alternatively, you can use natural extracts, fish oils and oils, vitamins and minerals, supplements and preparations such as "" with or NAC.

Treatment of diabetes

A common treatment for PCOS associated with insulin resistance is (Glucophage), which is usually prescribed to treat type 2 diabetes. It is often used to control insulin and blood sugar levels, which leads to decreased testosterone production in women.

Are there alternative treatments for polycystic ovary syndrome in women?

Research suggests that additional dietary changes and certain supplements may help treat PCOS. It is important that the diagnosis is made correctly and the cause of polycystic disease is established as accurately as possible. In this case, instead of

Treatment of polycystic ovary syndrome is a long process and not always effective. The form of the disease and provoking factors play an important role.

The main reason forcing a patient with PCOS to seek medical help is infertility.

PCOS is a disease of the reproductive system accompanied by an increase in androgens. Polycystic ovary syndrome has different causes, but one way or another leads to the formation of many follicular cysts in the ovary.

Polycystic ovary syndrome is called Stein-Leventhal syndrome, in which multiple cysts form in the gonads.

The pathology is diagnosed in 5 women out of 100 who are of reproductive age.

Polycystic ovary syndrome has various manifestations that form a clinical picture, culminating in infertility.

Both girls and women who have already given birth are susceptible to the disease. In accordance with individual characteristics, the type of PCOS is determined:

primary – formed during puberty and is accompanied by menstrual dysfunction from menarche;
secondary - develops after the establishment of regular menstruation under the influence of external and internal factors.

Despite the prevalence of the disease, its causes remain unknown to this day.

However, almost all women with polycystic ovaries have hyperandrogenism and insulin resistance.

Factors of occurrence

The etiology and pathogenesis of the disease are being studied by specialists to this day. It is impossible to name clear reasons for the formation of PCOS. However, we can talk about the prerequisites for the disease:

infectious processes occurring in the genitals;
surgical interventions (curettage, abortion, operations);
excess body weight;
diabetes mellitus, pancreatic diseases;
endocrine disorders;
hereditary predisposition;
use of intrauterine contraceptives;
injuries and damage to the pelvic organs.

The pathological process is based on hormonal and endocrine abnormalities, involving the ovaries, adrenal glands, hypothalamic-pituitary system, and pancreas.

Complex changes in the functioning of the body, dependent on each other, are accompanied by an increase and thickening of the capsular covering of the ovary.

As a result of gynecological changes, a hormonal imbalance occurs and a persistent increase in the level of male hormones - androgens.

Symptoms of PCOS

Signs of a hormonal disorder may have a pronounced clinical picture or be mild.

The period of onset of the disease in women with a secondary form of PCOS is clearly noticeable.

The following manifestations of multicystic disease can be distinguished:

menstrual irregularities (lack of ovulation, high levels of androgens lead to a delay in monthly bleeding for up to six months, which is replaced by heavy periods);
a change in the girl’s appearance that is not the type of woman (the greasiness of the hair increases, the face becomes covered with acne, and symptomatic treatment of hirsutism and acne does not give positive results);
obesity (distortion of carbohydrate-lipid metabolism leads to the formation of a fat layer according to the male type or evenly throughout the body, often accompanied by diabetes mellitus);
hirsutism - excessive on the face, groin area, chest and thighs (caused by the result);
abdominal pain (caused by enlargement of the ovarian capsule, proliferation of gonad tissue and displacement of neighboring organs);
absence of ovulation (accompanied by the following signs - stability of BT, negative tests, infertility and a corresponding ECHO picture).

In the primary form of PCOS, it can be difficult for a girl to catch the first manifestations of the disease, since after menarche the cycle may be irregular, which is a natural process of formation.

In addition, this form of pathology is not accompanied by obesity, hair growth and distortion of the skin structure.

First of all, parents should suspect the disease based on signs such as cycle disturbances and abdominal pain.

Diagnosis of the syndrome

If there is a suspicion of polycystic ovary syndrome, an ultrasound will be the first diagnostic procedure that the doctor will prescribe after a manual examination.

A gynecological examination may show enlargement of the gonads and a discrepancy between the size of the reproductive organ and the day of the menstrual cycle.

Based on the patient’s additional complaints, already at this stage of diagnosis it is possible to assume the nature of the pathology.

However, it can only be confirmed using ultrasound scanning. The ECHO picture for PCOS has the following indicators:

the volume of the gonads is more than 9 cm;
the capsule is thickened;
the stroma is hyperplastic;
there are more than 10 cyst-shaped ones, the size of which is up to 10 cm;
the endometrium is thin and does not correspond to the day of the menstrual cycle.

An ultrasound sign of secondary polycystic ovary syndrome is the formation of cysts along the periphery of the gonad, which is often compared to a necklace.

In the primary form of PCOS, cysts do not have a specific localization and form chaotically, forming multiple clusters.

An additional criterion in establishing the diagnosis of PCOS is laboratory blood tests: FSH and LH (ratio), progesterone, androgen, testosterone, estradiol, sugar level.

Treatment of polycystic disease

PCOS is treated using different methods. The effectiveness of the same procedure may be different for each patient.

Therefore, based on the etiology, pathogenesis, clinical picture and examination results, the doctor chooses the most appropriate therapeutic method.

In the secondary form of PCOS, drug therapy gives good results. It includes hormonal correction and the use of symptomatic medications.

In the case of the formation of primary polycystic disease, surgical treatment is usually resorted to.

However, for both forms of the disease, it is advisable to carry out measures aimed at the general improvement of the female body.

Treatment of excess hair growth

Modern cosmetology offers effective ways to eliminate it.

However, they all involve eliminating the consequences, not the root causes.

Normalization of body weight

Diet for PCOS is an important point in treatment. With a decrease or even a slight decrease in weight, the condition of the female body improves significantly.

There are cases where proper nutrition alone helped normalize hormonal levels and cure secondary polycystic ovary syndrome.

Moderate physical activity and adherence to the following rules will help to cope with the problem:

limit the amount of kcal consumed to 1500;
eat 5-6 times a day;
lean on low-calorie foods (vegetables and fruits);
consume a lot of protein (lean meat, fish, dairy products);
replace animal fats with vegetable ones;
give up sweets and carbohydrate foods;
exclude alcohol in any form;
Arrange fasting days 2-3 times a week.

If this is necessary, then drugs that regulate metabolism are additionally prescribed: Sibutramine or Orlistat.

For reference!

Establishing a normal weight contributes to the proper functioning of the endocrine system and hormone-producing organs. A healthy body mass index also helps medications be better absorbed.

Regulation of menstrual function

After the correct body weight has been restored or at least the first steps have been taken towards this, the patient is prescribed drug therapy that involves restoring menstrual and reproductive function.

Clomiphene – a drug to stimulate ovulation, creates conditions for the possibility of becoming pregnant with secondary PCOS. It has virtually no effectiveness if the disease develops in its primary form.

HCG-based products – are introduced to stimulate rupture of the follicle, if its size is at least 18 mm. Preferably used in primary PCOS.

Medicines with progesterone are prescribed to maintain the second phase of the cycle and regulate the timing of menstruation.

To restore menstrual function, gestogens and progestogens are prescribed.

If insulin resistance is diagnosed, then its analogues are prescribed.

The lack of a positive result with drug treatment and nutritional correction is a reason for surgical intervention.

Operation

Surgical treatment of PCOS shows good results, especially in patients with the primary form of the disease.

The treatment method chosen is laparoscopy, and less commonly, laparotomy.

The procedure involves wedge resection of the ovaries, which is most effective. Also in certain cases, electrocautery of the ovaries or decapsulation is practiced.

Surgical treatment is performed under general anesthesia, and the operation lasts no more than 1-2 hours.

Traditional methods

Alternative remedies rarely help cure PCOS.

Folk remedies can cope with increased levels of insulin in the blood, normalize metabolism, slightly affect hormonal levels and establish proper endometrial growth.

At the same time, it will be difficult to eliminate the dense capsule, cause the resorption of the resulting cysts and restore fertility.

Inept and uncontrolled use of herbs and phytohormones can aggravate the course of the pathology.

The effect of PCOS on pregnancy

Polycystic ovary syndrome has a bad effect on pregnancy. The disease does not allow ovulation to occur, and this, in turn, creates a state of infertility.

Some women manage to miraculously become pregnant with polycystic glands. However, problems begin already during gestation.

The main one is hormonal imbalance and lack of progesterone.

If you manage to get pregnant with polycystic disease, you should immediately seek help from a doctor. Otherwise, there is a high probability of miscarriage in the early stages.

Features of the functioning of FSH and LH

Possible complications, prognosis and prevention

The prognosis for treatment of polycystic ovaries is favorable. Women who have undergone drug therapy have a greater chance of conceiving naturally.

If treatment with drugs does not help, then decortication of the ovaries, at least temporarily, will eliminate the symptoms of the disease and increase the likelihood of pregnancy. Complications of PCOS include:

persistent infertility;
breast or endometrial cancer;
type 2 diabetes;
arterial hypertension;
cardiovascular diseases;
inflammation and fatty liver;
gestational diabetes and preeclampsia in case of pregnancy.

There is no specific prevention for PCOS.

To reduce the likelihood of disease, you should lead a healthy lifestyle, moderate physical activity, treat diseases of the genital organs in a timely manner and regularly visit a gynecologist.

A woman’s ability to conceive largely depends on how her ovaries function, in which an egg must mature every menstrual cycle.

Stable functioning of the female reproductive glands ensures regular menstruation and ovulation, but some women are forced to struggle with the diagnosis of PCOS, which not only becomes a serious obstacle to pregnancy, but also provokes the appearance of other endocrine pathologies.

What it is? PCOS - this disease stands for polycystic ovary syndrome and involves the presence of many small follicles that significantly increase the volume of the female reproductive gland.

Clinical picture on ultrasound

Ultrasound examination reveals multiple follicles up to 10 mm in diameter. They are localized along the edge of the ovary and resemble a necklace in their arrangement.

When measuring the parameters of this reproductive organ, it turns out that its width is more than 30 mm, its length is more than 37 mm, and its thickness is more than 22 mm. In general, the volume of the polycystic ovary exceeds 10 cm3. The follicle capsule is often thickened, which prevents it from rupturing during the LH surge before ovulation.

Symptoms of PCOS (polycystic ovary syndrome)

Signs of ovarian dysfunction and the presence of polycystic disease will be noticeable to every woman, since this pathology cannot be asymptomatic. To provide a more complete picture of the clinical picture, the doctor, in addition to the ultrasound results, will also take into account the patient’s complaints.

Symptoms of polycystic ovary syndrome include the following:

Infertility – is a consequence of the lack of ovulation. They may not occur at all, or may occur very rarely: 2-3 times a year. The inability to conceive a child may also be due to the fact that the dominant follicle in PCOS tends to either regress or develop into a follicular cyst.

The latter option is much more common, because the follicle capsule with this diagnosis is significantly thickened.

Large delays in menstruation – are associated either with anovulatory cycles or with prolongation of the first phase of the cycle, when a dominant one does not stand out from many antral follicles for a long time.

High testosterone levels – is formed as a result of dysfunction of the ovaries and adrenal cortex, which begin to produce too much androgens. Exceeding the norm of these hormones slows down the maturation of the egg, prevents the growth of the endometrial layer and causes thickening of the capsule of the dominant follicle.

In addition, an increase in the level of androgens also affects a woman’s appearance in the form of the appearance of hirsutism and male-type obesity.

Regular pelvic pain - have an aching character and appear due to the fact that enlarged ovaries compress the pelvic organs.

Pain can be intense towards the middle of the cycle, when multiple follicles in the ovaries begin to increase and exceed a volume of 10 cm3.

Chest pain – throughout the entire cycle, the mammary glands are sensitive, sometimes there is a tingling sensation and a feeling of swelling. Normally, these symptoms may be present in a woman several days before menstruation, but with polycystic ovary syndrome they are constant.

PCOS is considered one of the most important diseases in gynecology. And if, for example, in case of obstruction of the fallopian tubes, IVF can help, then in the case of ovarian dysfunction, even conception in a test tube often becomes impossible: either it is not possible to stimulate superovulation, or improper production of hormones will kill the implanted embryo that has already attached to the uterus.

Types of PCOS

Gynecologists, based on the results of ultrasound examination, distinguish 2 types of polycystic disease: diffuse and peripheral. They have different symptoms and have different effects on the well-being of patients.

Diffuse location of follicles (type I polycystic disease) - suggests that the follicles do not have a specific location in the ovary and are scattered in the stroma.

Such patients often have normal body weight, mild manifestations of hirsutism, secondary amenorrhea and resistance to the drug Clomiphene (stimulates ovulation). In 10–12% of women with type I polycystic disease, the ovaries are able to ovulate regularly.

Peripheral location of follicles (II polycystic disease) is more common and in obstetric practice is considered classic PCOS.

The follicles are located along the edge of the stroma and look like a necklace. Such patients are often obese and have a history of pregnancies that ended in early miscarriages.

From time to time, women even experience ovulation, but almost always luteal phase deficiency (LPF) is diagnosed.

The type of polycystic disease can only be determined using ultrasound. A treatment regimen for PCOS should be prescribed only after studying the location of follicles in the ovaries and the frequency of ovulation.

To determine how much polycystic ovary syndrome can affect the process of bearing a child, you need to keep in mind two main effects that such a pathology has on the reproductive sphere:

Increased androgen levels;
Presence of thin endometrium.

Both pose a danger to the embryo. High testosterone can cause miscarriage in both early and late stages of pregnancy.

Therefore, the woman is prescribed special hormonal therapy and is recommended to constantly monitor the concentration of androgen levels in the blood.

Thin endometrium can be an obstacle to the implantation of the fertilized egg and the cause of its detachment in the first 3-4 weeks of pregnancy. The mucous layer of the uterus, which is thin, is not always able to sufficiently nourish the embryo and create a good network of blood vessels for it.

Diagnosis of PCOS

Currently, it is customary in the world to diagnose polycystic ovary syndrome if the doctor detects two of the three following symptoms:

Oligomenorrhea (rare menstruation) - occurs with PCOS against the background of anovulation. Confirmed by the results of folliculometry, which is carried out over 7-8 months.
Hyperandrogenism – occurs in PCOS due to dysfunction of the ovaries and adrenal cortex. Confirmed by blood tests for androgens (testosterone and dehydrotestosterone).
Sonographic signs of polycystic ovaries require an assessment of the results of ultrasound diagnostics. Moreover, this diagnosis must be carried out at least twice per cycle: at the beginning and at the end.

The presence of two out of three conditions gives rise to a diagnosis of PCOS if a woman has excluded any other reasons why polycystic disease could have formed.

Treatment of PCOS (polycystic ovary syndrome)

Ovarian dysfunction is quite difficult to treat. After all, we have to work to restore the normal functioning of not only the female reproductive glands, but also the entire endocrine system.

Otherwise, PCOS treatment will only bring temporary results. Therefore, the gynecologist-endocrinologist faces the following tasks that require consistent solutions:

Normalization of the patient’s metabolism and body weight;
Restoration of regular menstruation against the background of ovulatory cycles;
Restoration of the endometrial structure in the uterus;
Fight against hirsutism,

Previously, doctors actively used surgical treatment to treat polycystic disease, in addition to prescribing medications. But over time, it became clear that operations are not always possible, and gynecologists focused on improving drug therapy. Currently, both conservative treatment methods and surgical methods are used to combat PCOS.

Drug therapy for PCOS

Stage 1 of treatment: normalization of metabolism and body weight

The better the body can absorb food, the fewer problems there will be with excess body weight - this is what many patients with PCOS suffer from. For this, the following drugs may be prescribed:

Sibutramine - the action is aimed at increasing the feeling of satiety, as a result of which the patient gets rid of the constant desire to eat food. Taking the drug is contraindicated in patients with cardiovascular diseases, even if they have occurred before.
Orlistat – interferes with the absorption of fats. This has a positive effect on the process of losing weight.

Normalizing body weight forces the pituitary gland and hypothalamus to work in a new way, produce hormones in the required concentration, or allow the body to be receptive to further treatment.

Stage 2 of treatment: restoration of menstruation, ovulation cycles

After the body has ceased to be burdened with excess weight, it becomes possible to improve the functions of the endocrine glands. To restore ovulation in PCOS, the following drugs are used:

Clomiphene is a drug that has proven its effectiveness for a long time, and therapy with its participation is actively used by gynecologists to this day. However, it must be taken into account that only representatives of the classical (second) type of PCOS are susceptible to it.
HCG drugs are administered if the patient has the first type of polycystic ovary syndrome, as well as in situations where ultrasound reveals a thickened follicle capsule, the integrity of which cannot be damaged without special stimulation. HCG preparations are administered intramuscularly when the dominant follicle reaches a size of 18 mm.
Synthetic analogs of progesterone are prescribed to maintain the second phase of the menstrual cycle.
Puregon (analogue - GonalF) is a follicle-stimulating hormone (FSH) drug prescribed to patients with clomiphene resistance. The peculiarity of these drugs is that while taking them, the smallest number of cases of ovarian hyperstimulation syndrome (OHSS) was observed.

Stage 3 of treatment: restoration of endometrial structure

The choice of drugs will depend on the success of stage 1 of treatment for PCOS, which involved reducing the patient’s body weight.

Estrogens are prescribed to patients who are not overweight. These can be COCs (combined oral contraceptives): Zhanine, Novinet, Regulon.
Progestogens are prescribed to patients whose body weight is higher than normal. Among them are Duphaston, Megestron, Medroxyprogesterone-LENS, Utrozhestan. It is important that progestogen drugs are chosen that do not have androgenic activity.

Stage 4 of treatment: combating hirsutism

The last stage of treatment for PCOS is often carried out simultaneously with the restoration of the endometrial structure; it also involves taking a COC with an antiandrogenic effect.

Dexamethasone – regulates the activity of the adrenal cortex, has a strong antiandrogenic effect. The dosage should only be prescribed by a doctor. It should be borne in mind that if high doses of dexamethasone are suddenly discontinued, androgen production may increase.
Diane-35 – contraceptives. For the treatment of hirsutism, 1 tablet per day is used for 21 days. Has a pronounced antiandrogenic effect.
Cortisol is a steroid hormone that regulates the functioning of the adrenal cortex. The hormone itself begins to be actively secreted by the adrenal cortex when stressful situations occur.

Surgical treatment of polycystic ovary syndrome

It is used mainly for patients who have clomiphene resistance. In this case, it is not possible to stimulate ovulation with medications, so women undergo laparoscopy.

During surgery, a wedge-shaped resection of the ovary is performed, as well as cauterization (destruction of the ovarian stroma). However, most often conservative methods are used in the treatment of PCOS, and even surgical intervention is supplemented by the prescription of Clomiphene.

With a competent approach to the treatment of polycystic ovary syndrome, this diagnosis is not a death sentence. Appropriate therapy will provide at least a temporary effect and will help stabilize the state of the reproductive system for several months so that conception can occur.

Polycystic ovary syndrome is a disease characterized by the appearance of a large number of cystic neoplasms in both ovaries at once. The diagnosis of PCOS (polycystic ovary syndrome) is one of the main causes of infertility. In this article we will take a closer look at what polycystic ovary syndrome is and how to treat it.

A woman’s reproductive system functions thanks to the proper functioning of the endocrine glands (thyroid and adrenal glands), hypothalamus, pituitary gland and ovaries. In case of dysfunction of any of the above systems, the activity of the entire reproductive system is disrupted. A woman's body becomes more sensitive to infections and inflammation. Thus, not only a simple corpus luteum cyst can occur, but also many small cysts - polycystic disease.

Numerous cysts on the ovary can be either single or form entire “clusters”. As a result, follicle maturation is disrupted and ovulation does not occur. Accordingly, conception becomes impossible.

According to statistics, polycystic ovary syndrome occurs in 5-10% of women of reproductive age. There are cases when symptoms of PCOS appear in a teenage girl after the start of her first period. The peak age of the disease is 30 years. It is in women of this age that the signs of PCOS are clearly pronounced; the disease progresses rapidly and requires immediate treatment. After 50 years, polycystic ovary syndrome most often does not occur.

PCOS after childbirth is not uncommon. This is explained by the fact that during pregnancy a woman’s hormonal levels completely change to bear a child. And after childbirth, the body undergoes restructuring and restoration. It is at this moment that polycystic ovaries can begin to develop, which is facilitated by an increase/decrease in estrogen, progesterone, androgens and an imbalance of male and female hormones. Many patients are concerned about the question of how to cure polycystic ovary syndrome and whether it is possible to become pregnant with this diagnosis. In both cases the answer is yes. However, you must follow all the doctor’s recommendations.

Timely diagnosis and proper treatment for polycystic ovary syndrome helps not only to get rid of the disease, but also to prevent the development of complications.

Factors of occurrence

The causes of polycystic ovary syndrome are not fully understood. However, modern medicine identifies a number of factors that contribute to the development of the disease.

Causes of polycystic ovary syndrome:

infections and long-term inflammation of the uterine appendages (ovaries and fallopian tubes);
overweight, obesity;
abortion;
diabetes;
disruption of the endocrine glands;
heredity;
difficult labor;
incorrect installation of the intrauterine device;
pelvic organ injuries;
hormonal disorders.

Treatment of polycystic ovary syndrome consists not only of removing and relieving painful symptoms, but also of necessarily eliminating the root cause of the disease. So what are the symptoms of polycystic ovary syndrome, and when is urgent medical attention required?

Signs of the disease

Symptoms of polycystic disease vary from woman to woman. Some patients experience aching, sometimes sharp pain in the lower abdomen. Others don't care at all. However, the first manifestations of pathology are considered to be:

menstrual irregularities;
causeless weight gain;
the appearance of male pattern body hair (chest, face, abdomen).

If any of the above symptoms appear, a woman should think about the proper functioning of the body and consult a doctor.

The following signs of polycystic ovary syndrome are also distinguished:

lack of ovulation;
discharge between periods;
“daub” in the middle of the cycle;
different duration of menstruation;
frequent delays;
increase in the size of appendages;
aching pain in the lower abdomen;
oily skin and hair, acne on the neck, shoulders or back;
swelling of the mammary glands, the appearance of fibrocystic mastopathy;
increased insulin levels in the blood;
chronic anovulation;
inability to conceive a child for more than one year.

Thus, the causes of polycystic ovary syndrome are varied and can be quite easily confused with the symptoms of another disease of the pelvic organs. However, first of all, a woman should be alerted to unusual discharge and regular delays in menstruation. You can also measure BT (basal temperature), which should increase in the second phase of the menstrual cycle. With polycystic ovary syndrome (PCOS), basal temperature does not change.

Important! If a woman experiences sharp pain in the lower abdomen, nausea, vomiting, fever or loss of consciousness, she urgently needs to consult a doctor!

Ultrasound image of ovaries with polycystic disease

How to identify the disease

It is impossible to make a diagnosis of polycystic ovary syndrome based on ultrasound results alone. This is explained by the fact that the clinical picture of this disorder can also be observed in a healthy woman, that is, an error is possible. In addition, quite often ultrasound reveals polycystic disease of the right ovary, but in fact, affecting one appendage, cystic neoplasms soon affect the other. Diseases that give similar echo signs should also be excluded. These include hypothyroidism, Cushing's syndrome, and hyperprolactinemia. That is why the diagnosis of PCOS includes:

Gynecological examination;
Collecting anamnesis and identifying all symptoms;
Ultrasound of the pelvic organs;
General blood and urine analysis;
Blood test for hormones (LH, FSH, T4, TSH, T3, etc.);
Laparoscopy.

Only a complete transcript of the above tests and examinations makes it possible to see changes in the size, structure and shape of the ovaries, their functionality, confirm/refute the disease and the possible risk of complications.

Treatment

Treatment for polycystic ovary syndrome is long and multi-stage. Unfortunately, it is impossible to completely cure it. The gynecologist’s task is not only to restore the normal function of the appendages, but also to eliminate all the disorders that provoked this disease.

Initially, the doctor prescribes painkillers to relieve the symptoms of polycystic ovary syndrome and treatment of the hypothalamic-pituitary system. Then it is necessary to establish the production of androgens by the appendages, eliminate excess weight and restore the menstrual cycle.

Polycystic ovary syndrome is treated conservatively and surgically. Based on the test results, the severity of the symptoms and the woman’s desire to become pregnant, the attending physician chooses the most appropriate treatment method.

Drug treatment

How to treat polycystic ovary syndrome with conservative methods? First of all, you need to improve your diet and lifestyle. There is even a special diet for polycystic ovary syndrome (PCOS), which consists of eliminating alcohol, coffee, fatty, fried, smoked and spicy foods. It is also recommended to do fasting days. The total number of calories is 1200-1800 per day. Five meals a day. Polycystic ovary syndrome also requires mandatory consumption of vegetables, fruits, herbs, fish, cottage cheese, and kefir. You should avoid sweets, flour products, and honey.

If you are overweight or obese, physical activity is necessary. These should be light exercises that do not cause discomfort to the patient.

Remember! If you experience pain due to polycystic ovary syndrome during exercise, you should immediately stop physical activity and consult a doctor for a re-examination!

As for medications, the doctor prescribes not only painkillers, but also hormonal drugs. Oral contraceptives (birth control pills) restore the menstrual cycle and the functioning of the endocrine system, eliminate hyperandrogenism. Some of them stimulate ovulation and promote the proper release of the egg. Such drugs as Janine, Marvelon, Yarina, Jess have proven their effectiveness for PCOS.

Wedge resection for polycystic disease

Surgery

How to treat polycystic ovary syndrome with surgical methods? To do this, two methods of performing the operation are used:

Wedge resection. Damaged tissue is removed, including the capsule and stroma. Helps restore ovulation and reduce the production of androgens.
Coagulation. The doctor makes incisions on the ovarian capsule and cauterizes the cysts. This method is considered the most gentle.

Surgical intervention is carried out using a method. The operation is performed only if conservative treatment methods do not give the desired result or the patient begins to develop endometrial hyperplasia.

Traditional treatment

Unfortunately, many women do not trust modern medicine and current doctors in particular. Therefore, there are quite a lot of people who are interested in whether polycystic ovary syndrome can be cured using traditional methods.

The ineffectiveness of folk remedies for PCOS has long been proven. However, women still continue to take herbal infusions and herbal teas. Yes, some herbs perfectly relieve painful symptoms and help to reduce and self-resolve a single cystic formation (for example, an ovarian corpus luteum cyst). These include the hog queen and the red brush. But! With multiple cysts, traditional methods are powerless, and in combination with hormonal therapy they can even lead to irreparable consequences. That is why only a competent specialist will tell you how to treat polycystic ovary syndrome and what nutrition is necessary.

What are the risks of PCOS?

If there is no proper treatment or the woman does not adhere to all the doctor’s prescriptions, the consequences of polycystic ovary syndrome will not take long to appear. In addition to the appearance of body hair, increased oily skin, acne and weight gain, PCOS contributes to the development of a host of diseases.

Why is polycystic ovary syndrome dangerous? First of all this:

infertility;
adhesions in the pelvic organs;
hypertension, stroke;
endometriosis;
endometrial cancer;
cervical cancer;
mastopathy and breast cancer.

If polycystic transformation of the appendages is detected during pregnancy, the expectant mother faces the following danger:

severe pregnancy;
spontaneous abortion (miscarriage) in the early stages;
premature and difficult labor (previously 36-38 weeks);
late toxicosis;
pregnancy diabetes.

Thus, it is important for a woman to know the manifestation of the disease, what it is and how to treat PCOS. Early diagnosis and proper treatment will help minimize possible complications and prevent infertility.

Polycystic ovary syndrome is a common problem among women. It is a complex of symptoms that leads to menstrual dysfunction, infertility, and increases the risk of developing tumors of the reproductive organs, diseases of the cardiovascular system, and diabetes. But with timely detection of its signs and proper treatment, the chances of getting rid of such trouble are great.

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Causes of PCOS

Polycystic disease is not a disease, but is characterized as a polyendocrine complex of symptoms. Controversy over the origin of the disease continues to this day. It affects the functioning of the endocrine system, as well as hormone-dependent organs and their parts. These include:

pituitary;
hypothalamus;
adrenal cortex;
ovaries;
pancreas.

Diagram of the development of polycystic ovary syndrome

Experts identify a number of factors that provoke the disorder. These include:

Heredity. The syndrome is not transmitted from mother to daughter, but there is a predisposition factor. Long-term studies have proven that those women whose relatives suffered from a similar problem are more prone to PCOS.
Disorders in the pituitary gland. It is here that the synthesis of the main hormones that affect ovulation and follicle maturation occurs. With such a diagnosis, the level of luteinizing hormone increases, as a result of which excess androgens are synthesized by the ovaries.
Excessive enzyme activity. In some patients with this syndrome, the hyperactivity of certain enzymes in the ovaries inhibits the action of others. This causes an imbalance of enzymatic activity and, as a result, excessive production of androgens, which can lead to the development of cysts.
Excessive concentration of androgens in the blood, which are converted into female estrogens in adipose tissue. The latter stimulate the formation of luteinizing hormone, and at the same time stop the production of follicle-stimulating hormone.
Insulin resistance. Soon leads to diabetes. If cells are resistant to the perception of insulin, then its level in the blood increases, which provokes the synthesis of additional luteinizing and male sex hormones. Androgens and insulin in excessive concentrations stimulate the growth of follicles, but they do not transform into mature eggs and age prematurely. This increases the risk of developing cysts.

Symptoms of polycystic ovary syndrome

Hyperandrogenic chronic anovulation, as PCOS is also commonly called, makes itself felt with the following manifestations:

Menstrual dysfunction. The main symptom of the syndrome is disruptions in the cycle. They are expressed by excessively abundant or rare discharge (oligomenorrhea), scanty, spotting discharge, or may be completely absent (amenorrhea). This is due to the influence of the hormone estrogen on the inner mucous layer of the uterus - the endometrium.
Ovarian enlargement. Their sizes can increase several times due to the formation of many cysts.
Infertility. Polycystic disease is considered one of its main causes. Occurs due to frequent or complete absence of ovulation.
Overweight. Weight gain is a common problem among women with polycystic disease. This is explained by cell resistance to insulin, as a result of which the body processes glucose poorly and fatty tissue accumulates. Sometimes obesity occurs according to the male type, with deposits accumulating in the abdominal area.
Masculinization. Male secondary sexual characteristics accumulate in women with polycystic syndrome due to excess androgen concentrations.

This is expressed in baldness, hypertrichosis, seborrhea, skin rashes, and hair growth in uncharacteristic places.

The appearance of stretch marks on the abdomen, thighs, buttocks due to rapid weight gain.
The outer surface of the ovaries becomes thicker and acquires a pearly white hue.
Increase in LH concentration, as well as the LH/FSH ratio.

Watch this video about the symptoms of polycystic ovary syndrome:

Possible complications

Polycystic syndrome has many unpleasant consequences. If the problem is not detected in a timely manner and proper treatment is not applied, complications are possible:

Miscarriage ending in miscarriage.
Inability to conceive due to lack of ovulation or irregular menstrual cycle.
Endometrial pathology. Hyperplasia and even cancer are possible. This occurs due to the insufficient influence of progesterone in the second phase of the cycle or hyperstimulation of the endometrium by estrogen, due to which the mucous layer is not excreted on time and grows.
Overweight, obesity.
Diabetes mellitus type 2.
Cardiovascular disease, high blood pressure.
Increased blood clotting.

Ultrasound and other diagnostic methods

Some symptoms of this pathology are similar to other disorders of the reproductive and endocrine systems. To find out an accurate diagnosis, a thorough examination is carried out.

In most cases of suspected polycystic disease, diagnosis begins with an ultrasound examination. But ultrasound alone is not enough to determine PCOS. Sometimes a woman's ovaries are detected by ultrasound, but her egg matures and ovulation occurs.

Ultrasound picture of PCOS

An important stage of diagnosis is collecting a blood test to determine the concentration of estrogens, progesterones, androgens, LH, FSH.

Sometimes an extended ovarian biopsy is performed to confirm the diagnosis.

Treatment of PCOS

Since this disorder is characterized by a polyendocrine complex of symptoms, one should contact not only a gynecologist, but also an endocrinologist to restore ovarian function.

Treatment of polycystic disease in most cases begins with normalizing weight and adjusting the diet. It is recommended to avoid fried, spicy, salty foods that contain a lot of carbohydrates and animal fats.

It is worth eliminating bad habits and choosing a healthy lifestyle. Active sports, long walks, and frequent exposure to fresh air will benefit you. Often, after losing excess weight, a woman manages to normalize her cycle, return ovulation and regular periods.

When the girl’s goal is not to become pregnant, to eliminate the symptom, hormonal contraceptives are prescribed, which combine substances that simulate the action of estrogens and progesterones. This allows you to reduce the production of male sex hormones by the ovaries, as well as eliminate the aggressive effects of estrogens on the endometrium.

After discontinuation of therapy, ovulation returns, and accordingly, the chances of conception increase.

Laparoscopy

In rare cases, surgery is used. A type of surgical treatment for polycystic disease is laparoscopy, which has a number of advantages. Unlike other types of operations, this does not entail heavy blood loss, it is less traumatic and painful, it also makes it possible to eliminate adhesions in the pelvis, and the rehabilitation period after it is much faster.

Polycystic ovary syndrome is not such a terrible diagnosis as many women imagine it to be. It is quite easy to suspect it on your own and easy to diagnose by contacting specialists. Despite this, the syndrome carries a threat in the form of possible complications. In most cases of timely diagnosis and treatment of polycystic disease, patients manage to get rid of it, restore ovarian function and even become pregnant.

Useful video

For information on the treatment of polycystic ovary syndrome, watch this video: