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Dr. Qassem Shihab gives you a complete explanation about Polycystic Ovaries, its causes, symptoms, how to diagnose it and how to prevent it

Polycystic ovary syndrome, also known as PCOS, is one of the most common hormonal disorders in women of childbearing age (15-44 years old). Women with PCOS suffer from the emergence of fluid-filled sacs inside the ovaries called ovarian cysts. These cysts form as a result of a hormonal imbalance and a high level of male hormones (androgens) that cause the ovaries to be unable to release a mature egg ready for fertilization, and these eggs remain inside the ovarian follicles or follicles. Ovarian cysts (cysts).

The risk of polycystic ovary syndrome lies in its association with the occurrence of many other conditions such as type 2 diabetes and other metabolic problems, high blood pressure, and heart disease, in addition to that, it is a common cause of infertility in women as a result of weak ovulation.

Causes of polycystic ovaries?

There is no known major cause of polycystic ovary syndrome, but a female may be more susceptible to it in each of the following cases:

  • Heredity; Family history and having a close family member, such as a mother or sister, may increase the risk of developing polycystic ovary syndrome.

  • The high level of the hormone insulin in the body, which leads to an increase in the secretion of the hormone androgen and thus prevent ovulation, and this happened as a result of insulin resistance, which is the body's natural failure to respond to the hormone insulin, so that levels of the hormone insulin in the blood are higher than usual, especially in women who suffer from obesity, Unhealthy dietary patterns, lack of physical activity, and a family history of type 2 diabetes.

  • The high level of male hormones in the body that obstruct the ovarian function and prevent it from releasing an egg during the menstrual cycle.

Symptoms of PCOS?

Symptoms of polycystic ovary syndrome usually begin to appear in some women at puberty, that is, at the time of the first menstrual cycle, while others reveal this later when they have difficulty getting pregnant after marriage or as a result of gaining weight. PCOS symptoms are associated with a hormonal imbalance that causes:

  • The high level of male hormones (androgens) is associated with the frequent unwanted hair growth (known as hirsutism) in the face, especially in the beard, sideburns and upper lip, and the appearance of hair in the chest or lower abdomen, or in the area around the nipples, as well as causing male hormones. The occurrence of male pattern baldness and hair loss on the scalp.

  • Acne Male hormones cause an increase in sebum production and the accumulation of oils on the skin, and thus the appearance of pimples on the face, chest, and upper back.

  • Irregular menstruation , or its absence for a longer period of time that may exceed 35 days, and the occurrence of heavy bleeding during the menstrual cycle due to the accumulation of the lining of the uterus for a longer period of time and thus women with polycystic ovary syndrome get fewer menstrual cycles (approximately 8 menstrual cycles per year) But it is heavier than usual.

  • overweight.

  • Blackening of the skin and the appearance of dark spots, especially in the area under the armpits, the neck, under the breasts, and the thighs.

  • Infertility , delayed pregnancy

What women complain about the most is excessive hair, acne, or an irregular menstrual cycle. Many women do not know about the presence of any disorder until they are contemplating pregnancy.

How is polycystic ovaries diagnosed?

There is no specific test to diagnose the infection, usually the doctor will ask you about the symptoms that you are suffering from or in the event of any change in hair growth, weight, irregular menstruation, etc., as well as the doctor may recommend all of the following in order to exclude all cases that mimic multiple ovarian syndrome Cysts:

  1. Perform a blood test to detect the level of male hormones (androgens), check the level of the prolactin hormone ( milk hormone ), which causes symptoms similar to those of polycystic ovary syndrome, and check the level of blood sugar, insulin, and other hormones to rule out conditions such as thyroid disorder .

  2. Ultrasound imaging (ultrasound), which is usually resorted to after the doctor examines the pelvic area and notices the presence of enlargement or swelling in the area, as it helps in examining the ovaries and the endometrium and making sure of the presence of ovarian cysts on one or both of the ovaries.

Treating polycystic ovary syndrome with polycystic ovary syndrome

In general, there is no single treatment for PCOS, but positive measures can be taken to help manage the symptoms and reduce the risk of complications and other conditions associated with PCOS. This includes:

  1. Weight loss and dieting (being careful to reduce carbohydrates and fats in the food intake in order to reduce the level of the hormone insulin)

  2. With a commitment to constantly performing aerobic exercise; Studies have shown that losing approximately 5-10% of weight helps regulate menstruation, improve symptoms associated with polycystic ovary syndrome, and reduce the risk of complications, especially type 2 diabetes, high cholesterol and heart disease.

  3. Taking metformin (glucose regulator): It is one of the drugs used in the treatment of type 2 diabetes. It helps lower blood sugar, improve insulin resistance, reduce the level of the hormone insulin and androgens in the body, and thus restore ovulation. Metformin is often prescribed along with an ovulation-stimulating medication (clomiphene) to increase the chances of getting pregnant.

  4. Fertility drugs that help stimulate ovulation to increase the chances of pregnancy, including (clomiphene, letrozole, injectable gonadotrophins such as follicle stimulating hormone (FSH) and luteinizing hormone (LH)).

  5. Hormonal birth control methods such as the hormonal contraceptive pill , vaginal ring, or patch which consists of the main female hormones estrogen and progesterone, which help to regulate the level of hormones and reduce the level of androgens and thus regulate the menstrual cycle, and reduce the appearance of unwanted hair and acne. For women with polycystic ovary syndrome and wanting to become pregnant, it is possible to resort to the use of tablets that contain only the hormone progesterone or the hormonal IUD composed of progesterone, which helps in regulating the menstrual cycle without preventing pregnancy, but these methods do not affect the level of the androgen hormone in the body.

  6. Anti-androgens, such as spironolactone and fluornithine, these treatments help reduce or prevent unwanted hair from developing. It is also possible to resort to other methods used in hair removal, such as laser and electrolysis.

We must know that there is no final cure. And that women are prone to diseases such as diabetes and endometriosis, they should see a doctor.

Treatment can be symptomatic. For example, menstruation disorder, or excessive hair, etc. If a woman wants to get pregnant, there is a treatment to stimulate the ovaries.

Surgical treatment for polycystic ovaries

And it is considered the last resort after drug treatments failed to improve fertility and get pregnancy, surgical treatment includes doing what is known as ovarian perforation, which is a surgical procedure that involves making some small holes on the surface of the ovary to get rid of the thick crust formed on it, either by using a laser or needle

It is heated with electricity with the goal of re-ovulation. This is done by laparoscopic surgery and under general anesthesia

Dr. Qassem Shehab , consultant of advanced laparoscopic surgery, gynecology and obstetrics. Subspecialty specialization in the treatment of urinary incontinence and gynecological edema

Abdali Hospital , Boulevard, 24th floor

Oman Jourdan

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