Polycystic ovary syndrome is a major concern for women these days. If you have entered adolescence or teenage years and feel that your hair is falling out profusely, that you have hirsutism in separate areas of your body, or that you experience irregular periods, this article may direct you to the problem you are suffering from, or urges you to go to a specialist for an accurate diagnosis.

What is Polycystic Ovary Syndrome?

It is a hormonal disorder that is common in women, especially during puberty, in which the ovaries grow many groups of small fluid-filled sacs, and fail to produce ova. The reason behind this syndrome is still not completely clear, but there are several important factors, including increased insulin. Or low-grade inflammation, and there is also a role for the genetic factor in its occurrence. [1]

How do you detect symptoms of Polycystic Ovary Syndrome?

These symptoms often appear around the time of the first period during puberty, or they may occur later in response to some predisposing factor such as being overweight. [1]

For the diagnosis of this syndrome, at least two of the following signs must be present: Irregular menstrual cycles, as well as short or long menstrual cycles, are among the most common signs. Hyperandrogenism and subsequent symptoms resulting from high levels of male hormones, such as excessive hirsutism on the face and body, severe acne, or male-pattern baldness. Ovarian cyst, when the ovaries swell and fill with the sacs that surround them, leads to dysfunction.

Does PCOS stop here or are there complications I could have?

Treatment for polycystic ovary syndrome is essential. Because, like other diseases, if neglected, it will lead to other complications [1], including:

• Infertility.
• Spontaneous abortion or obstructed labor.
• Having type-2 diabetes or prediabetes.
• Sleep apnea.
• Depression, anxiety, and eating disorders.
• Endometrial cancer.
• Metabolic syndrome is a group of medical conditions that include high blood pressure, blood sugar, cholesterol, or triglyceride levels in the body, and the resulting increased risk of heart attacks.

How to diagnose PCOS?

There is no confirmed examination for the presence of the syndrome in the patient, but the doctor may start by asking some questions that are indicative of this disorder, first: about periods and weight changes, then follow up with a physical examination that aims to look for signs of excessive hair growth, acne, and insulin resistance. In addition to the following checks:

• Pelvic examination, as examination is done visually and manually to look for any growths or abnormal structures.
• Blood tests, to measure the levels of hormones in the body, and this test is useful in excluding other causes of changes in the menstrual cycle.
• Ultrasound examination, in order to detect the shape of the ovaries and the thickness of the endometrium. [2]

As for the additional tests that tell us about the presence or absence of complications, they are:

• Periodic examinations of blood pressure, glucose tolerance, cholesterol, and triglyceride levels.
• Screening for depression and anxiety.
• Screening for obstructive sleep apnea. [2]

What is the pharmacological treatment protocol for Polycystic Ovary Syndrome?

In the event that the doctor diagnoses the syndrome, a group of medications is prescribed, namely:

1. Combined contraceptive pills, which reduce the production of androgens in the body, regulate the level of estrogen, and thus reduce the appearance of acne and excessive hair growth, as well as reduce the risk of endometrial cancer.
2. Progesterone treatment, which helps regulate the menstrual cycle and reduces the risk of endometrial cancer, when taken for a period ranging between 10-14 days every month or two.
3. The doctor’s recommendations regarding medications that assist in the ovulation process, such as Letrozole, which may play an effective role in stimulating the ovaries, Clomiphene which is taken in the first phase of the menstrual cycle, and Metformin which improves insulin resistance. Additionally,  in the event that the patient has prediabetes, Metformin can reduce the chances of the condition worsening to type 2 diabetes, and it also plays a role in weight loss.
4. Reproductive gonadotropins are given by injection.
5. The importance of lifestyle in addition to drug therapy. [2]
6. Changing the patient’s lifestyle helps to reduce the severity of this syndrome. Some of these changes:

• Maintaining a healthy weight plays an essential role in lowering insulin and androgen levels and restoring ovulation.
• Reducing carbohydrate consumption.
• Increase physical activity, as doing exercise helps lower blood sugar levels. [2]

The high prevalence of this syndrome among women requires us to be more aware of its existence and its symptoms, in order to reach the correct diagnosis and thus avoid many unwanted complications. The Uplifting Syrian Women initiative supports the need to raise health awareness about gynecological diseases and urges women not to neglect any sign or symptom, because it may hide an important problem behind it.

Also read:

• Attention Deficit Hyperactivity Disorder.
• Panic Disorder.
• Insomnia.

References:

[1] Mayo Clinic

[2] Mayo Clinic