PCOS – Polycystic Ovary Syndrome: Symptoms, polycystic changes, PCO syndrome, and symptoms and treatment of polycystic ovary syndrome

PCOS refers to the formation of ovarian cysts, which are fluid-filled sacs on the ovaries. They appear there in a string-of-pearls-like pattern.

This leads to a disruption of the hormonal balance. As a result, excessive amounts of male sex hormones are produced, which cause the typical symptoms. These male sex hormones are testosterone, which belongs to the group of androgens.

The condition occurs in women of childbearing age. Worldwide, the prevalence in this population is reported to be between five and twelve percent. In most cases, changes in the ovaries begin as early as puberty. However, symptoms often do not appear until the age of 20 to 30.

Ovarian cysts can develop during puberty and then resolve on their own. They lead to what is known as temporary polycystic ovary syndrome.

The body’s endocrine system is subject to a complex regulatory cycle. Minor changes can lead to significant disruptions in hormonal balance, which can throw the entire metabolism out of whack.

The anatomy of the uterus © bilderzwerg | AdobeStock

The exact cause of PCOS has not yet been definitively established. Since a familial clustering of the condition has been observed, experts suspect a genetic component.

Risk factors that contribute to the development of PCOS include:

• a high-fat diet
• a high-sugar diet
• Being overweight
• lack of physical activity
• diabetic metabolic state

A large proportion of affected women suffer from obesity. PCOS promotes insulin secretion and thus the development of insulin resistance. This, in turn, further increases the secretion of male sex hormones and thus exacerbates PCOS-related symptoms.

The following symptoms may occur as a result of PCOS:

• Menstrual irregularities
• Infertility
• Increased, predominantly “male-pattern” body hair (hirsutism / virilization)
• Increased hair loss on the scalp
• Skin blemishes (acne)

In women with PCOS, the menstrual cycle is disrupted: This can lead to

• irregular or absent menstrual periods, or
• an anovulatory cycle (a cycle without ovulation)

. In the latter case, the woman is infertile.

The excess of male hormones leads to increasing “masculinization.” With hirsutism, the woman develops male-pattern hair growth, which is characterized, for example, by

• facial hair,
• chest hair,
• prominent hair on the thighs and back, as well as
• extended pubic hair reaching as far as the navel and the thighs

.

Virilism includes, among other things,

• a deeper voice,
• increasing hair loss, and
• enlargement of the clitoris,
• and, in some cases, a reduction in breast tissue.

If any of the symptoms listed above apply to you, do not hesitate to seek medical advice. Especially if there is a family history of PCOS, you may also be affected.

Only through appropriate treatment can this hormonal imbalance be managed. Otherwise, there is a risk of various secondary conditions and complications:

• Diabetes mellitus
• Fatty liver
• Thyroid disorders
• Heart disease
• Stroke
• Sleep apnea
• Infertility
• Depression

Medication is important not only for the physical health but also for the mental health of affected women. Patients often suffer greatly, particularly from the visible physical changes.

PCOS falls within the field of general gynecology. You should therefore consult a gynecologist.

During your examination appointment, the doctor will first take a detailed medical history. This involves asking various questions about your symptoms and how they have developed. The doctor will also ask you about any cases of PCOS among your relatives.

The diagnosis of PCOS is based on the three “Rotterdam criteria”: 

• Oligo- and/or anovulation (irregular cycles without ovulation)
• Virilization due to hyperandrogenism
• Polycystic ovaries.

PCOS is generally not curable, but it is treatable: Symptoms can be significantly alleviated through medication and by optimizing diet and lifestyle.

Taking the birth control pill (“the pill”) helps stabilize the menstrual cycle. The pill is effective for PCOS because it has an antiandrogenic effect. It therefore helps regulate the menstrual cycle and counteracts oligomenorrhea.

If you are trying to conceive, your gynecologist will instead prescribe medications to stimulate the ovaries. This induces ovulation, which had previously not been occurring. Be sure to take the medications exactly as directed. Regular ultrasound checkups are also necessary. An overdose can sometimes lead to fluid retention or a multiple pregnancy.

Depending on your individual symptoms, you may be prescribed additional medications, such as an antidiabetic drug. This breaks the vicious cycle caused by insulin resistance.

In addition to medication, a weight-loss diet is strongly recommended if you are obese. In general, a balanced diet and regular exercise are effective in helping to stabilize your menstrual cycle.

In some cases, surgery is recommended. This is performed laparoscopically, meaning via a laparoscopic procedure. During the procedure, the surgeon destroys the cysts using localized heat.

With the help of well-adjusted medication and a healthy lifestyle, affected women can lead a normal life and even become pregnant.

However, the risk of miscarriage and other pregnancy complications is higher in women with PCOS than in healthy women.

Regular checkups with a gynecologist are particularly important for women with PCOS. This allows the doctor, for example, to detect gestational diabetes and multiple pregnancies early on and take appropriate action.

A diagnosis of PCOS is made when typical characteristics such as menstrual irregularities, hyperandrogenism, and changes in the ovaries are present, indicating a hormonal imbalance. Polycystic ovary syndrome is often characterized by numerous follicles in the ovaries, increased androgen production, and a hormonal imbalance.

Polycystic ovary syndrome affects many women, as a high percentage of women of childbearing age are affected and PCOS often goes undiagnosed for a long time. PCOS may also be accompanied by metabolic syndrome, type 2 diabetes, and excessive body hair, which increases the risk of long-term health consequences.

PCOS can be exacerbated by obesity and unhealthy lifestyle habits, which is why a healthy lifestyle plays a central role. Once PCOS is diagnosed, treatment is tailored to the individual’s symptoms, particularly for women who wish to become pregnant.

Commonly referred to as PCOS, this condition often requires long-term medical care, as the ovarian syndrome affects many women and individualized treatment is crucial.

What is PCOS?

PCOS stands for polycystic ovary syndrome, a hormonal disorder characterized by irregular menstrual cycles, elevated levels of male hormones, and polycystic ovaries. The condition commonly occurs in women of childbearing age.

What are the symptoms of PCOS?

Typical symptoms of PCOS include irregular menstrual cycles, anovulation, acne, excessive body hair, hair loss, and obesity. Insulin resistance and hormonal changes are also common.

How is PCOS diagnosed?

PCOS is diagnosed based on symptoms, a gynecological examination, an ultrasound of the ovaries, and blood tests to measure hormone levels. It is important to rule out other conditions.

How is PCOS treated?

Treatment for PCOS depends on the patient’s symptoms and her desire to have children. It may include hormonal therapies, metformin to improve insulin resistance, and lifestyle changes.

Can you get pregnant with PCOS?

Many women with PCOS can get pregnant. Fertility can often be improved through targeted treatment, cycle regulation, and, if necessary, fertility treatments.