Polycystic Ovary Syndrome

What is polycystic ovary syndrome (PCOS)? 

Polycystic ovary syndrome occurs due to impaired interactions between the central nervous system, pituitary gland, ovaries, adrenal gland and other tissues. It is the most common endocrine disorder in women of reproductive age.

What is wrong with polycystic ovary syndrome?

The main problem is the production of too much androgen hormone (male hormone) or increased hormone sensitivity. Insulin dysfunction occurs. There is a marked increase in the level of LH hormone secreted from the brain. 

What causes polycystic ovary syndrome?  

It is a chronic disease that can negatively affect women's quality of life. Although the initiating factor or factors are not yet fully understood, it is a disease that has emerged with the interaction of genetic and environmental factors, insulin resistance and inflammation.

How is polycystic ovary syndrome diagnosed?

PCOS is diagnosed by a combination of certain findings. These are,

High androgen levels,

Irregular periods,

Ovarian cysts

At least two of these findings must be present.

What is polycystic ovary?

Polycystic ovary is the presence of cysts smaller than one centimeter arranged peripherally in the ovary. It is defined as a pearl ovary. But this appearance can also be seen in normal women. Therefore, other findings should accompany.

Typical polycystic ovaries (ovarian tissue containing multiple cysts) occur after a prolonged absence of ovulation. Up to 25% of normal women have the typical ultrasound findings of polycystic ovaries (follicular cysts arranged like pearls in the ovaries). 

What are the most important symptoms of polycystic ovary syndrome?

 Prolonged absence of ovulation, high androgen hormone levels and insulin resistance can lead to the following conditions:

✅ Infertility

Menstrual irregularity, infrequent menstruation, excessive bleeding

✅ Increased hair growth, hair loss and acne, weight gain, darkening of the skin, headaches, stuttering, sleep apnea, depression

✅ Increased risk of uterine cancer and possible breast cancer

✅ Increased risk of cardiovascular diseases

✅ Increased risk of diabetes (Type 2 diabetes) and menstrual irregularities in women with increased insulin levels

Can polycystic ovary syndrome cause pregnancy?

Inability to conceive, infertility, is more common. Some of the patients come to us because of infertility. But they can conceive spontaneously. If ovulation is present and menstruation is regular, treatment is started if they cannot conceive for a year. It should not be rushed. 

PCOS patients who become pregnant have a higher risk of high blood pressure and gestational diabetes during pregnancy. They should be monitored more closely during pregnancy.

How is polycystic ovary syndrome treated?

The aim is to reduce androgens, to protect the endometrium, that is, to protect against cancer, to reduce the risk of diabetes and heart disease, to ensure ovulation and conception, and to maintain normal body weight. 

PCOS is treated according to the patient's complaints. 

If there is menstrual irregularity, it must be corrected. The longer the irregularity persists, the more severe and worse the symptoms become.  

The most important treatment is exercise and weight loss. Only these measures can improve menstrual patterns and increase the chances of conception. Diet and lifestyle changes are the most important treatment.

If menstrual irregularities persist, they are treated with hormone therapy and birth control pills (OCS). Treatment is continued for up to one year. Birth control pills should be suitable for these patients, especially those that lower androgens (male hormones). This reduces hair growth and acne.

If there is a problem of inability to conceive or infertility, the patient should be treated accordingly. The patient's ovulation is ensured in a controlled manner. For this, some ovulation-inducing drugs are given. If the patient cannot conceive with these treatments, in vitro fertilization treatment is performed. 

What is the use of metformin in polycystic ovary syndrome?

Metformin reduces insulin levels and resistance and is used to treat PCOS. It is useful for menstrual regularity and ovulation. It also helps with initial weight loss.

Is polycystic ovary syndrome easy to diagnose?

PCOS is diagnosed simply with a gynecological examination and some blood tests.