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Polycystic ovarian syndrome happens during the reproductive age women, and is the most common disease on the gynecological endocrinology.
The basic problem in women of reproductive age is to suppress ovulation and infertility is its effect .
The percentage of women with polycystic ovary syndrome presenting lack of ovulation is at 73%.
In recent years much has been done to clarify the reasons for the cause.
Although the exact cause and pathophysiology of the syndrome is not clear yet it's been proven that heredity is one of the genetic factors.
Recently there have been implicated up to 150 genes involved in polycystic ovary syndrome.
Symptoms of the syndrome may vary. Basically, weight gain, difficulty in weight reduction and increased hair growth in androgenic places such as chin, chest and face, and infertility are few of them.
Since 2003, at a major conference held in the Netherlands scientists from around the world have tried to establish criteria that would lead to the diagnosis of the syndrome.
1. lack of ovulation and infrequent ovulation is the first of them.
2. The characteristic ultrasound appearance in one or both ovaries is the second. The ovaries appear in ultrasound like having a necklace of black pearls around them. These "pearls" are nothing more than small follicles less than 9 mm, which are peripheral to the ovary.
3. Laboratory findings and clinical symptoms also may add to the picture.
If the patient has at least two of the above criteria then we can say that she suffers from polycystic ovaries.
The most common clinical symptoms are infrequent menstrual, menstrual disorders, lack of ovulation, increased androgenic hair type and weight gain while reducing is not easy. The image of one or both ovaries during a vaginal ultrasound shows small cysts as before in the region of the ovary that give the picture AMULETS. It should be noted that all women with PCOS have this ultrasound image.
In recent years it has become clear after investigations mainly done in Great Britain and the United States of America that the PCOS is a metabolic disease associated directly with disorders in lipid profile, ie dyslipidemia, insulin resistance and a tendency for these patients to obtain later lives in diabetes mellitus type II, ie not dependent on insulin.
This shows us that we are dealing with a broader metabolic syndrome.
The basic way of treating PCOS is weight reduction. It is of great importance that the patient has normal body weight because most symptoms begin to appear after increased body weight.
Laboratory check is very important in which we can see some growth hormones such as androgens and growth hormone LH. Given the increase in androgens we see hair growth and as mentioned above this increase is mainly androgenic parts of the body. The doctor who will treat such problems should be specific and informed on new developments in the polycystic ovary syndrome.
Fortunately, in recent years many new drugs were added to the scientific quiver of gynecologists reproduction. One of these is the use of metformin which improves tremendously the image of polycystic ovaries. In some cases, especially the ones associated with acne and menstrual disorders modern contraceptives are helpful, which are hormones, but in very low doses compared to contraceptives of the 70's and 80's.
The big problem of infertility has a solution with the help of new drugs and techniques such as intrauterine insemination and in some cases in vitro fertilization.
A small percentage of women with polycystic ovary use these new techniques because most of the time the modern drugs we use in individual cases in each patient can give us the desired solution. Drug use is also good but have to be only given individually in each case by experienced scientists in order to achieve the best results and aesthetic changes. |
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