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Tuesday, October 8, 2019

Polycystic Ovary Syndrome

Polycystic Ovary Syndrome Polycystic ovaries in the language of professionals called Stein-Leventhal syndrome or sklerokistoz ovaries. But the name of the disease does not change its essence. Under polycystic ovarian disease understand hormone (endocrine) system, in which there is an increase in growth of the ovaries and their cavities in the form of fine bubbles filled with liquid.

According to statistics, PCOS affects about 5-10% of women who have not reached menopause. The real figure could be much higher, as many potential patients do not seek medical help, and do not even know about the presence at this pathology.

Physiology bit

Every woman during the menstrual cycle in the ovaries is the formation of such small bubbles (follicles). Under normal physiological conditions in the middle of the menstrual cycle when ovulation occurs (rupture of the follicle and release of an egg), a single follicle leaves only one egg. Others follicles “overripe” grow old and cease to exist. And with polycystic ovarian egg does not mature, not ovulation. Follicle rupture does not occur, but instead of a cavity filled with a liquid to form small cysts. As a result, the ovaries increase in size 2-4 times. Polycystic ovary develops when increased production (formation) in the ovaries of male sex hormones (androgens), which normally have to produced in minuscule quantities. Why is this happening?

The causes of polycystic

Ironically, polycystic has a clear and precise reason. Quite often polycystic ovaries occur in Cushing’s syndrome, tumors of the adrenal glands and ovaries. However, this is only the disease, contributing to the development of polycystic. Although consensus on the occurrence of polycystic as an independent disease is not present. But we know that if there is polycystic ovary decreased sensitivity to insulin, a hormone involved in the regulation of blood sugar levels. Knowing this, scientists have suggested that high levels of insulin in the blood leads to the fact that there is excess in the ovaries production of male sex hormones (androgens).

What are the symptoms of the polycystic ovary?

The first signs of the disease can occur at any age. But often polycystic develops around the age of 30 years. This is the average age of the “debut” of polycystic. It can also occur in puberty. And if this happens, the woman discovers the delay or absence of menstruation.

Patients with PCOS are often overweight. They characterized by the growth of hair on the male type: the appearance of hair on the face, chest. The presence of polycystic patients is quite accurate: greasy skin, acne on the body, thinning hair or male pattern baldness, the deposition of fat in the waist. Symptoms include heavy menstrual bleeding and – long and painful they may be irregular for some time absent. The cardiovascular system reacts to failure in the field of hormone rise in blood pressure. However, most patients with this diagnosis get to see a doctor because of infertility, which is also a consequence of the disease.

Since impaired regulation of insulin in the blood, the patients can be manifestations of diabetes: obesity, increased urination, chronic skin infections, candidiasis (vaginal thrush).

How to recognize polycystic?

The correct diagnosis can be made with a combination of clinical symptoms (increased body hair of male type, menstrual disorders and so on. D.), Hormones, the study results (blood test for androgens, insulin and so on. D.) And other diagnostic methods. Additional studies to establish the diagnosis of polycystic ovary syndrome refers ultrasound. With the help of ultrasound, the doctor is quite able to diagnose polycystic. But in most cases still, need to use a combination of all the above data.

What can cause polycystic ovaries?

Polycystic ovaries increase the risk of various diseases. Some people believe that after menopause, polycystic symptoms may disappear. And on the one hand, it is so: the primary symptoms go, but at the same time there are other diseases, “generated” polycystic. Such conditions include:

1. The type 2 diabetes. Very often (50%), diabetes mellitus develops in women who have reached menopause and having to “Arsenal” polycystic ovaries.

2. Hypercholesterolemia (high cholesterol). At higher levels of androgens in the blood, especially testosterone, and increases the level of low-density lipoprotein (the most dangerous form of cholesterol), and this enhances the risk of cardiovascular disease (heart attacks, strokes).

3. One of the terrible consequences of polycystic ovaries – cancer of the endometrium (uterus). The development of endometrial cancer because in this condition the regular ovulation does not occur, and the endometrium (the inner surface of the uterus) thickens, “incremented”. And overgrowth of uterine lining increases the risk of cancer.

Is it possible to fight with polycystic yourself?

If the diagnosis of polycystic ovary syndrome is confirmed, it is something to improve their health, and the patient can do on their own. For example, diet will contribute to the normalization of insulin and cholesterol levels and weight loss. And in combination with physical exercise, these preventive measures can favorably affect the reproductive function, that is, the patient will have a chance to get pregnant.

What kind of assistance can offer a doctor?

Can treat polycystic conservative manner and surgically. Traditional polycystic ovarian hormonal therapy involves the use of medicines that stimulate follicular growth and resulting in ovulation. The effectiveness of drug treatment reaches 50%. During this treatment is often used oral contraceptives, which primarily leads to the elimination of the disease symptoms. These drugs have anti-androgenic properties, that is, block the action of male sex hormones. They take 2-3 months. During this period, restored ovulation and increases the chance of pregnancy. If this technique does not give positive results, conduct ovulation stimulation: under the control of US patient gets a special hormone in the first phase of the menstrual cycle, followed by the use of drugs that stimulate ovulation. The course of treatment takes 4-6 months.

If a patient with polycystic ovaries increased body weight, it needs to take measures to reduce weight. Sometimes with a decrease in body weight restored ovulation yourself.

Surgical treatment of polycystic ovaries in 90% of cases, allows for ovulation in 70% of cases – pregnancy. The essence of surgical treatment is to remove the part of the ovary that produces the male sex hormones (androgens), which subsequently leads to the restoration of relations between the administrative centers in the brain and the ovaries. The effectiveness of such operations there, but the effect is short-lived: the ovary quickly restored. Therefore, the patient recommended becoming pregnant within 4-5 months after surgery.

What kind of assistance can offer the doctor?

Among of polycystic treatment operations standard wedge resection, recover ovulation in 85% of cases, and laparoscopic ovarian electrocoagulation, more gentle operation which allows reducing the risk of adhesions in the pelvis and subsequent infertility.

Begin treatment of polycystic conservative (drug) therapy, and if within 4-6 months. The effect is not to resort to surgical intervention.

After operation increases the effects of hormone replacement therapy and increases the chances of pregnancy at times.

Timely diagnosis and proper treatment of polycystic ovaries reduces the risk of complications (diabetes, cardiovascular diseases) and, importantly, increase the likelihood of pregnancy.

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