It can cause irregular menstrual cycles andinfertility .

PCOS can also cause changes in physical appearance. If not addressed, in the future can lead to serious health problems such as diabetes and heart disease.

In most women with PCOS, many small cysts form on the ovaries.

Most women with this disease have many small ovarian cysts. 
However, one can have cysts in the ovaries for many reasons, even if the young woman is a virgin.

To confirm the diagnosis of polycystic ovary syndrome, the symptoms are more important than the presence of cysts. 
Polycystic ovary syndrome occurs in 5-10% of women and is the most frequent cause of infertility in women. 
Symptoms of polycystic ovary syndrome may begin in adolescence with menstrual irregularities, but a woman can not know if she has the disease until symptoms occur and / or infertility.

 

How do hormones act in the menstrual cycle?

Boys and girls produce sex hormones, but in different amounts. In females, the ovaries produce estrogens, progesterone, and androgens. These hormones regulate a girl’s menstrual cycle and ovulation , that is, when the egg is released. 
Although androgens are referred to as “male hormones,” each female produces these hormones. 
In women with polycystic ovary syndrome, the ovaries produce higher amounts than normal levels of androgens and this can interfere with egg development and release. 
Sometimes, instead of the maturation of eggs, cysts develop which are small pockets with liquid.
Instead of an ovum released during ovulation, such as during a normal menstrual cycle, the cuisses that develop in the ovaries can expand. Since girls with polycystic ovary syndrome can not ovulate and release an egg each month, it is normal to have irregular periods or delays.

 

 What are the causes of polycystic ovary syndrome?

The cause of Polycystic ovary syndrome is unknown. But most experts think that several factors, including genetic factors, may play a role in this disease. 
A major problem linked to polycystic ovary syndrome is hormonal imbalance. 
In women with polycystic ovary syndrome, the ovaries produce more androgens than normal. 
Androgens are male hormones that are also produced by women. 
High levels of these hormones can influence the development and release of eggs during ovulation. 
Researchers think that insulin may be linked to polycystic ovary syndrome. 
Insulin is a hormone that is needed to let sugar into cells to produce the energy needed.
Many women with polycystic ovary syndrome have too much insulin in the body. 
Excess insulin appears to cause increased production of androgens. High levels of androgens can lead to:

  • Acne,
  • Excessive hair growth,
  • Weight gain.

 

What are the symptoms of polycystic ovary syndrome?

Symptoms of polycystic ovary syndrome may vary from woman to woman. 
Symptoms include: 
Infertility , that is, you can not continue the pregnancy due to lack of ovulation. 
Polycystic ovary syndrome is the most common cause of female infertility (the female can not get pregnant) and spontaneous abortion .

Possible cycle changes are:

  • Menstruation block (amenorrhea),
  • Alteration of the normal rhythm (oligomenorrhea) and delayed menstruation ,
  • Bleeding not linked to ovulation,
  • Hirsutism, increased hair growth, especially on the face, chest, stomach, back, thumbs or toes.
  • Cysts in the ovaries ,
  • Acne or oily skin,
  • Calvície ou alopécia,
  • Pain in the ovary ,

 

Testing and diagnosis of polycystic ovaries

There is no specific test to definitively diagnose polycystic ovary syndrome. 
The diagnosis is made by exclusion. 
The doctor considers all the signs and symptoms and excludes other possible diseases. 
Two of the three following criteria allow the diagnosis of the disease.

  • Polycystic ovaries (12 or more peripheral follicles or increased ovarian volume.
  • Little ovulation or lack of ovulation.
  • Clinical or biochemical signs of hyperandrogenism.

During this process, the doctor takes into account several factors:

Medical history The physician should examine changes in menstrual periods, weight, and other symptoms.

Physical
examination During physical examination, the doctor checks for height, weight, and blood pressure.

Pelvic Exam
During pelvic examination, the physician inspects his reproductive organs manually and visually for signs of mass or other abnormalities.

Blood tests
Blood should be analyzed to measure the levels of certain homones and rule out possible causes of menstrual abnormalities or excess androgens that suggest polycystic ovary syndrome. Additional 
blood tests may include fasting cholesterol, triglycerides , blood glucose, and glucose tolerance testing.

Pelvic Ultrasonography
pelvic ultrasound  can show the appearance of the ovaries and the thickness of the inner wall of the uterus. 
During the examination, the doctor inserts a device with a sensor (transducer) directly into the vagina (transvaginal ultrasound).

 

Polycystic Ovarian Complications

Polycystic ovary syndrome is a serious illness in certain cases, it can be dangerous because of the complications it causes. Oligomenorrhea (frequent menstrual cycles) or amenorrhea (absence of menstruation) are known to predispose to endometrial hyperplasia and endometrial carcinoma in untreated cases. 
It is a good idea to take a progestin treatment to induce a withdrawal bleed at least every 3-4 months. 
Cardiovascular risk factors are higher, for example, obesity, hyperinsulinemia, dyslipidemia and hyperandrogenism. 
For this reason it is recommended for women with polycystic ovary syndrome to control their weight because they have an increased risk of cardiovascular disease.
Women with polycystic ovary syndrome have an increased risk of type 2 diabetes , especially if:

  • They are obese,
  • They have a family history of type 2 diabetes ,
  • They are over 40 years old,

should do the analysis.

Women with polycystic ovary syndrome may suffer from drowsiness / fatigue and may snore, these symptoms may be caused by sleep apnea.

 

Pregnancy Complications

There is a high risk of gestational diabetes in women with polycystic ovary syndrome, it may be more than twice as normal. 
Women with this disease before becoming pregnant should have gestational diabetes screenings before 20 weeks of gestation if abnormalities are detected should see a specialist. 
Women with polycystic ovary syndrome also have higher risks of preterm pregnancy and preeclampsia.

 

Treatment for polycystic ovary syndrome

Polycystic ovary syndrome can not be cured, but symptoms can be reduced. 
Treatment options may vary because someone may have different symptoms or just one. Treatment options include:

  • Lose weight and follow a healthy diet.
  • Hormone treatment, some types of birth control pills or anti-androgen drugs that block the effects of male hormones in the body.
  • A drug called metformin to improve the body’s sensitivity to insulin.
  • A fertility drug called clomiphene (Clomid) sometimes leads to more complex treatments, such as in vitro fertilization.
  • A cream called Eflornithine to stop excessive hair growth (hirsutism).
  • Surgery to treat ovary known as laparoscopic ovarian perforation.

Other medications

Quem está acima do peso pode tomar um remédio para perda de peso, como o orlistat, mas deve ter cuidado para possíveis contra-indicações e efeitos colaterais.
Se existem níveis elevados de colesterol no sangue, seu médico pode prescrever um medicamento para baixar o colesterol (estatinas), tais como sinvastatina. É difícil que este medicamento seja prescrito se o paciente planeja engravidar.
Seu médico também pode sugerir um tratamento para acne.

Tratamento hormonal

Alguns medicamentos hormonais masculinos podem ser tomados para bloquear os efeitos dos hormônios masculinos (p. ex. testosterona) que podem causar os sintomas da síndrome do ovário policístico (especialmente o excesso de pêlo facial e perda de cabelo).
Entre estes medicamentos estão:

  • Acetato de ciproterona
  • Espironolactona
  • Flutamida
  • Finasteride.

Hormone treatment can also solve the problem of irregularity or absence of menstrual cycles. 
The contraceptive pill may be recommended to induce regular cycles. This also reduces the long-term risk of endometrial cancer if there are no cycles.

Gonadotrophins (hormones produced by the body that stimulate the ovaries) may be recommended for some women with polycystic ovary syndrome who do not respond to clomiphene (see below). However, gonadotrophins can over stimulate the ovary and lead to multiple pregnancies. 
An alternative to this treatment is surgery (see below).

Clomiphene
If you try to get pregnant but without ovulation, the ovaries can be stimulated with a fertility drug called clomiphene. 
Clomiphene corrects hormone imbalance and makes ovulation more likely, thus improving fertility.

Medications for diabetes
diabetes drug called metformin can increase ovulation in women with polycystic ovary syndrome along with other treatments. 
It can also reduce health risks caused by insulin resistance and the effect of abnormal levels of male hormones. It can be taken with clomiphene. 
However, it is not a drug for weight loss.

Eflornithine
Eflornithine is a cream that blocks the action of an enzyme present in the hair follicles that is needed for hair growth. 
The cream slows the growth of unwanted facial hair that can be a symptom of polycystic ovary syndrome. 
However, it removes unwanted facial hair and then a product can be used for epilation. 
The improvement can be seen four to eight weeks after treatment.

 

Surgery for polycystic ovary syndrome

A small surgical procedure called laparoscopic ovarian perforation may be a treatment option. 
Under general anesthesia, the doctor makes a small cut in the lower abdomen and passes a long surgical instrument called the laparoscope in the abdomen. 
The ovaries are then treated surgically with heat or a laser. 
The goal is to destroy the tissue that produces androgens (male hormones). 
Laparoscopic ovarian perforation serves to lower testosterone and luteinizing hormone levels and increase levels of follicle stimulating hormone. The operation corrects the hormonal imbalance and then restores normal ovarian function.

 

Natural Remedies for Polycystic Ovary Syndrome

In overweight women, the symptoms and risk of long-term complications due to polycystic ovary syndrome can drop significantly if one loses excess weight. 
Losing weight reduces the amount of insulin the body should produce. 
This reduces testosterone levels and improves the chances of ovulation. 
Menstrual and fertility problems improve along with excessive hair loss. 
You can lose weight by following a proper diet and doing 45-60 minutes of aerobic exercise every day. 
Your doctor can advise a nutritionist, who knows what to recommend. 
Weight loss of only 5% can lead to a significant improvement in polycystic ovary syndrome.

Natural remedies include:

  • Acupuncture that promotes female fertility.
  • The agnocus affects the pituitary gland and can increase the production of the hormone LH (luteinizing hormone) and reduce the release of FSH (follicle stimulating hormone) in the blood

Supplements of vitamin B and folic acid

Some scientific studies show that a food supplement called myo-inositol, which derives from vitamin B along with folic acid reduces the symptoms because:

  • It promotes the activity of insulin (the hormone that serves to carry glucose into cells and thus lowers blood glucose),
  • It regulates the androgen hormones in the blood.

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