Polycystic Ovarian Syndrome (PCOS)

What Is PCOS?

Polycystic ovary syndrome is a disease in which the hormonal regulation of the ovaries is disturbed.

This results in typical symptoms such as irregular menstrual cycles or even the absence of menstruation, acne, increased body hair, which corresponds more to a male appearance ("hirsutism"), and overweight.

In addition, affected women often have cysts on the ovaries, which has given the clinical picture its name. The interaction of the characteristic complaints is referred to as a syndrome.

Polycystic ovary syndrome is relatively widespread (5-10%) and is often the cause of an unfulfilled desire to have children.

What Are the Symptoms of PCO Syndrome?

The symptoms of PCOS show up differently in every woman. Not all of the symptoms listed below must be present in every woman.

The first symptoms typically appear during puberty. There is an imbalance of sex hormones and too many male sex hormones in the affected persons. Consequently, young women have underarm hair, increased body odor, and, not infrequently also, acne at an early age.

Over time, menstrual cycle disturbances occur so that the women get their periods less frequently or not at all. Increased body hair on the thighs, around the nipples and on the chest, and on the upper lip or lower abdomen is also a consequence of the high male sex hormones.

These can also lead to increased hair loss or baldness, a deep voice, and incomplete breast development. Many affected individuals also suffer from obesity and weight gain that is difficult to control. Multiple cysts, benign fluid collections surrounded by an even contour, are often found on the ovaries.

In addition to all the physical symptoms that burden those affected, the external appearance of what the disease causes, i.e., male body hair, acne, and obesity, results in psychological stress and reduced quality of life for many women. The PCOS in these women can also be the cause of depression, sleep, or anxiety disorders.

How Is Polycystic Ovary Syndrome Diagnosed?

To diagnose PCO syndrome, it is essential to take a comprehensive medical history. The doctor asks the patient in detail about her symptoms and thus obtains a precise overview of the symptoms.

Information about the menstrual cycle and other gynecological information are particularly relevant. The next step is a physical examination of the patient, during which attention is paid to the relevant symptoms, such as increased body hair. A gynecologic vaginal examination and, if necessary, an ultrasound is also performed to diagnose PCOS.

To verify the suspected diagnosis, the hormone levels of the various sex hormones in the blood can subsequently be determined.

The diagnosis of polycystic ovary syndrome can be made if two of the following three criteria apply:

• Cycle disturbances due to "ovulatory dysfunction," meaning that ovulation occurs only irregularly or is absent
• Evidence of an increase in male sex hormones either in the laboratory or directly visible on the patient, e.g., by increased body hairiness
• Evidence of more than 10 follicles per ovary, best evidenced by ultrasound examination

What to Do in the Case of Polycystic Ovaries?

The therapy of PCOS depends on whether the patient wishes to have children.

If there is no desire to have children, the patient can take "the pill." "The pill" is a medication that contains the female sex hormones and prevents the woman's ovulation and thus has a contraceptive effect. In addition, specific preparations reduce the production of male sex hormones, so the complaints of PCOS patients, such as hirsutism and acne, subside.

However, cosmetic treatments such as shaving, bleaching, or epilation are often still necessary to remove unwanted hair.

Other treatment options can be used if affected women desire to have children.

Is it Possible to Get Pregnant with PCOS?

Yes, it is possible to get pregnant even with PCO syndrome. However, this requires taking medications that initiate ovulation. One of these medications is "clomiphene."

It ensures that the body releases more LH and FSH hormones, which play a key role in ovulation. As with any drug therapy, side effects may occur.

Clomiphene therapy can lead to the development of cysts in the ovaries or the formation of ascites, i.e., "abdominal fluid," due to the intense stimulation of the ovaries from the outside.

Furthermore, pregnancy with PCO syndrome is associated with slightly more risks than pregnancy in a non-affected individual.

Women have an increased risk of developing gestational diabetes or preeclampsia, colloquially known as "pregnancy poisoning." This also increases the risk of premature birth.

Is there a PCOS Diet?

There are no specific dietary guidelines that apply to all PCOS patients. Since each patient's body has individual needs and requirements, the diet must also be individually adapted.

In general, however, it can be said that a balanced diet that provides the body with all the necessary nutrients at regular intervals is important and can positively influence the symptoms. Especially the consumption of whole-grain products and plenty of vegetables, fruits, and fiber-rich products brings positive effects.

Equally important are regular exercise and weight reduction in the case of overweight people. This prevents the development of diabetes mellitus, which often occurs as a complication in the course of PCOS, and ensures that the female cycle is better regulated.

Which Doctors Are Specialists in PCO Syndrome?

The doctors who deal with clinical pictures such as PCOS are gynecologists. Therefore, it is essential to consult a trained gynecologist to diagnose and determine therapy. In addition, there are also offers of self-help groups nationwide that can provide support and experience.

Every patient who needs a doctor wants the best medical care. Therefore, the patient is wondering where to find the best clinic. As this question cannot be answered objectively, and a reliable doctor would never claim to be the best one, we can only rely on a doctor's experience.

We will help you find an expert for your condition. All listed doctors and clinics have been reviewed by us for their outstanding specialization in Polycystic Ovarian Syndrome and are awaiting your inquiry or treatment request.

Sources

• www.msdmanuals.com/de-de/profi/gyn%C3%A4kologie-und-geburtshilfe/menstruationsst%C3%B6rungen/polyzystisches-ovarialsyndrom-pcos
• www.frauenaerzte-im-netz.de/erkrankungen/stoerungen-der-eierstockfunktion/hyperandrogenaemische-normogonadotrope-ovarialinsuffizienz/
• www.pcos-selbsthilfe.org/media/2014/PCOS-Patientinnen-Broschuere-2014.pdf