What is Polycystic Ovary Syndrome?

Polycystic ovary syndrome is a common ovulation problem that can be found in ten percent of women. It is a serious disease that can cause infertility as a result of hormonal irregularities due to increased insulin levels. Therefore, women should have regular gynecological examinations once a year.

What are the Symptoms of Polycystic Ovary Syndrome?

• Irregular menstruation or no menstruation at all
• Increased hair growth on the face or body
• Acne problems
• Acanthosis nigricans (discoloration of the neck, arms, breasts and folds between the legs)
• Hair loss
• Obesity
• Fatty deposits on the face
• Weight gain
• Inflammation
• Complaints such as depression
  are among the symptoms of polycystic ovary syndrome.

In addition, vaginal ultrasound examination reveals proliferated small follicular cysts (polycystic ovaries 6-10 mm in size). This appearance can be seen in 1 in 10 women of normal reproductive age.

One of the most important indicators of polycystic ovary syndrome is insulin resistance in the blood, accompanied by increased fasting blood insulin levels. Hyperinsulinemia also leads to high levels of male hormones. High levels of androgen hormones (male hormones) cause infertility by disrupting the condition of the center in the brain that controls the function of the ovaries.

What are the Causes of Polycystic Ovary Syndrome?

The exact cause of polycystic ovary syndrome is not known, but it has been shown to have a hereditary component. Relatives (both male and female) of women with the disease have been found to have diabetes, obesity, elevated blood lipids, high blood pressure and infertility, as well as excessive hair growth and irregular menstruation. The disease manifests itself in adolescence. The reason for this is the malfunctioning of the hormonal system that starts to take effect during puberty. Today, polycystic ovary syndrome is increasing due to the growing number of overweight children.

Diagnosis of Polycystic Ovary Syndrome

If polycystic ovary syndrome is suspected, the patient’s history is taken and clinical evaluations are performed. Polycystic ovary syndrome is one of the most common endocrine disorders. Polycystic ovary syndrome, which occurs in 10% of women, can also be seen in young girls in adolescence and young adulthood. Polycystic ovary syndrome should be emphasized especially in a young girl who is overweight, has menstruation complaints, acne on her face and oily skin. It is more common in women who are overweight and have male pattern hair growth.

Polycystic ovary syndrome may not be present in every young girl who presents with irregular periods. When young girls first start menstruating, their periods may also be irregular for physiological reasons.

Since the axes between the brain and ovary, which play an important role in the regulation of reproductive functions during puberty, are not fully established, some menstrual irregularities can be considered normal.

Hormone and complete blood count tests are usually ordered to diagnose polycystic ovary syndrome. The level of androgen hormones in the blood and the levels of the hormones FSH and LH are very important in the diagnosis of polycystic ovary syndrome. It can also be diagnosed by seeing the polycystic structure of the ovaries with ultrasonography.

How is Polycystic Ovary Syndrome Treatment Performed?

The first application of polycystic ovary syndrome treatment is to lose weight if the patient is overweight. It is important for the patient to have healthy and regular eating habits and to exercise regularly. In overweight patients, reaching the ideal weight with diet and sports can regulate ovulation functions. This normalizes the menstrual cycle and increases the likelihood of pregnancy.

In treatment, the menstrual cycle is regulated with birth control pills to regulate androgen production. Drugs such as Cyproterone Acetate, Flutamide, Finasteride are used to eliminate excessive hair growth. Metformin, a type of diabetes medication, can be used in treatment due to its positive effects on ovulation by reducing androgen production.

In some patients, cysts need to be removed surgically. However, polycystic ovary surgery is considered necessary when there is no response to medication or other treatment methods, but as with any surgical intervention, some complications may arise in polycystic ovary surgery.

If there is a desire to have a child, the patient should be given appropriate treatment. At the same time, in these cases, the endometrium (the lining of the uterus) is constantly exposed to the hormone estrogen due to chronic anovulation (ovulation disorder) and this leads to the possibility of endometrial cancer. Another goal of polycystic ovary treatment is to prevent this cancer.

Patients who want to have a child are given drugs that contribute to the stimulation of ovulation. Generally, treatment is started with Clomiphene Citrate in the first step and if the desired response is not obtained, more effective drugs are used.
If pregnancy is not possible against all these treatment methods, IVF treatment is applied.