Polycystic Ovary Syndrome
Polycystic ovary syndrome (PCOS) is a health condition that affects one in every ten women of reproductive age and may cause symptoms such as irregular menstrual periods, infertility and increased hair growth. Women with polycystic ovary syndrome may experience hormonal imbalances and metabolic problems that can affect their general health and physical appearance. Polycystic ovary syndrome is a common and treatable cause of infertility.
What Is Polycystic Ovary Syndrome?
Polycystic ovary syndrome is a health condition caused by an imbalance in reproductive hormones. This hormonal imbalance causes problems in the ovaries. During a healthy menstrual cycle, the ovaries stimulate dozens of eggs each month. One or two of these become dominant follicles and are released from the ovary.
In women with polycystic ovary syndrome, dozens of eggs attempt to develop, but no dominant follicle emerges and ovulation does not occur. This may cause menstrual periods to become irregular or stop completely. These irregular cycles may lead to:
- Infertility, or an inability to become pregnant
- The development of small, fluid-filled cysts in the ovaries
What Causes Polycystic Ovary Syndrome?
The exact cause of polycystic ovary syndrome is unknown. Various factors, including genetics, are thought to play a role:
High Insulin Levels
Insulin is a hormone that regulates the conversion of the food you eat into energy. Insulin resistance refers to a condition in which the body’s cells do not respond properly to insulin. In polycystic ovary syndrome, this insulin resistance may eventually lead to type 2 diabetes.
High Androgen Levels
Androgens are commonly known as “male hormones”; however, all women naturally produce small amounts of androgens. Women with polycystic ovary syndrome have higher-than-normal androgen levels. This may prevent the release of an egg from the ovaries during each menstrual cycle.
Who Is Affected by Polycystic Ovary Syndrome?
Women of all racial and ethnic backgrounds are at risk of developing polycystic ovary syndrome. The risk may be higher if you are overweight or have obesity, or if your mother, sister or maternal aunt has polycystic ovary syndrome.
Many women discover that they have polycystic ovary syndrome in their twenties or thirties when they experience difficulty becoming pregnant, menstrual irregularities or a history of prolonged intervals between menstrual periods.
What Are the Signs and Symptoms of Polycystic Ovary Syndrome?
- Irregular menstrual cycles or prolonged absence of menstruation: Women with polycystic ovary syndrome may have fewer menstrual periods, with fewer than eight periods per year. In some women, however, menstrual cycles may occur every 21 days or more frequently.
- Male-pattern hair growth, or hirsutism: This affects approximately 60–70% of women with polycystic ovary syndrome.
- Oily skin and acne on the face, chest and back
- Thinning of the scalp hair or hair loss and male-pattern baldness
- Weight-related problems, including excess weight, rapid weight gain and difficulty losing weight
- Darkening of the skin, particularly along the folds of the neck, in the groin and beneath the breasts
- Heart disease, impaired glucose tolerance and diabetes in later stages
Does Having Polycystic Ovary Syndrome Mean That I Cannot Become Pregnant?
Having polycystic ovary syndrome does not mean that you cannot become pregnant. In women with polycystic ovary syndrome, hormonal imbalance prevents the eggs from growing and being released from the ovaries through ovulation.
Irregular menstrual periods and not knowing when ovulation will occur may make it more difficult to become pregnant. Recommendations from your physician regarding nutrition, diet, weight loss and medications that support ovulation and increase the likelihood of pregnancy should be followed.
How Is Polycystic Ovary Syndrome Diagnosed?
There is no single diagnostic test for polycystic ovary syndrome. To assist in diagnosing PCOS and to exclude other possible causes of your symptoms, your medical history is assessed, and a physical examination and various tests may be performed.
Physical Examination
Your blood pressure, body mass index and waist circumference are evaluated. The skin is examined for the distribution of hair on the face, chest or back, acne and changes in skin colour. Hair loss and signs of other health conditions are also assessed.
Pelvic Ultrasonography
This method is used to evaluate the ovaries and the inner lining of the uterus, known as the endometrium.
Blood Tests
Androgen hormone levels are measured. Tests may also be performed to assess thyroid disease, adrenal hormone levels, blood lipid levels and blood glucose levels.
After other conditions have been excluded, you may be diagnosed with PCOS if you have at least two of the following findings:
- Irregular menstrual cycles or absence of ovulation, known as anovulation
- Signs that your androgen levels are elevated, including:
- Increased hair growth on the face, chin and other parts of the body, known as hirsutism
- Acne
- Thinning of the scalp hair
- Higher-than-normal blood androgen levels
- The presence of numerous cysts measuring between 8 and 10 mm, arranged in a necklace-like pattern in one or both ovaries on ultrasonography
How Is Polycystic Ovary Syndrome Treated?
There is no definitive cure for polycystic ovary syndrome; however, its symptoms and findings can be managed. The treatment and methods used vary depending on whether the patient wishes to have children.
The first step is always to maintain an ideal body weight through healthy eating and exercise. Healthy dietary habits and regular physical activity are valuable at every stage of life.
Losing weight may help lower blood glucose levels, improve the body’s use of insulin and restore hormone levels to a normal range. A 10% reduction in body weight may help regulate menstrual cycles, which may increase the likelihood of becoming pregnant.
Your physician may recommend oral contraceptive pills or progesterone-containing medications in the form of tablets, injections or an intrauterine device for the treatment of polycystic ovary syndrome.
What Is Done When a Woman with Polycystic Ovary Syndrome Wishes to Have a Child?
Weight Loss
If obesity is present, healthy eating, regular physical activity and weight loss may help improve fertility.
If there are no other accompanying causes of infertility in the male partner or in the woman with polycystic ovary syndrome, medications that support ovulation may be recommended. These treatments may be administered as oral tablets, such as clomiphene citrate, or as injections.
If these treatments are unsuccessful, in vitro fertilisation may be performed. Although in vitro fertilisation is costly, it is superior to other methods in terms of pregnancy rates.
During IVF, an egg is fertilised with the partner’s sperm in a laboratory and is then transferred into the woman’s uterus for implantation and development. Compared with medication alone, IVF has higher pregnancy rates and provides greater control over the risk of twin or triplet pregnancies than other treatment methods.
Frequently Asked Questions
I Have Polycystic Ovary Syndrome. Will This Affect My Pregnancy?
Women with polycystic ovary syndrome have higher rates of the following complications during pregnancy:
- Miscarriage
- Gestational diabetes
- Pre-eclampsia
Does Polycystic Ovary Syndrome Disappear During Menopause?
Polycystic ovary syndrome is a condition that affects all systems of the body. Many women with this syndrome report that their menstrual cycles become more regular as they approach menopause.
However, the hormonal imbalance does not disappear with age, and the long-term effects of polycystic ovary syndrome may become apparent. The risks of diabetes, stroke and heart attack may increase with age.
What Is the Polycystic Ovary Diet?
Following a healthy and balanced dietary programme is essential. The term “polycystic ovary diet” should not be understood as referring to a single food or nutrient.
- Foods containing added sugar and processed foods should be avoided.
- Wholegrain products and high-fibre foods, including oats, legumes and green vegetables, should be consumed.
- A diet containing sufficient fruit, vegetables, plant- and animal-based proteins and healthy fats should be followed.
- Packaged products and ready-made foods containing preservatives should be avoided.
- Unprocessed foods should be preferred. Products sweetened with artificial sweeteners and marketed as diet products should not be preferred. Packaged foods containing refined sugar should be avoided.
- Plenty of fluids, particularly water, should be consumed.
Do Diane-35 and Yasmin Cause Infertility?
No. Contrary to common belief, neither Diane-35 nor Yasmin nor other oral contraceptive pills cause infertility. They prevent pregnancy while they are being used, but they do not have a permanent effect.
Their effects end after the medication is discontinued, and pregnancy may then occur.
What Are Hormone Levels Like in Patients with Polycystic Ovary Syndrome?
Blood hormone levels vary among patients with polycystic ovary syndrome. The levels of two hormones released from the brain that stimulate the ovaries differ.
When blood hormone levels are evaluated on the second or third day of menstruation, the ratio of luteinising hormone to follicle-stimulating hormone is between 2 and 3. In addition, elevated levels of prolactin, the hormone that stimulates milk production in the breasts, may be observed.
In Which Clinics Is Polycystic Ovary Syndrome Treated?
The treatment of polycystic ovary syndrome should be planned by a specialist in obstetrics and gynaecology with expertise in this field in cities such as Ankara. You may contact us for detailed information about polycystic ovary syndrome and for diagnosis and treatment.
