Will my PCOS ever go away

Polycystic ovary syndrome

PCOS is used by those affected and in specialist circles as an abbreviation for polycystic ovarian syndrome (more rarely Stein-Leventhal syndrome). This is understood to be a pathological dysfunction of hormone production that affects 8-10% of all women of childbearing age. The impairment of the hormonal balance is problematic not only in everyday life, but also when there is a desire to have children.

Symptoms

Thick hair growth on the face, chest or thighs, skin problems in the form of acne, being overweight, unusually long menstrual cycles or missing your period - all of these can be characteristics of an existing polycystic ovary syndrome. If these factors occur individually or in combination, an extraordinary stressful situation arises for those affected.

Almost masculine body hair, oily skin and problems with weight lead to a negative experience of one's own femininity. The irregular monthly cycles also have a negative effect on everyday life - this is especially true for those women who would like to become pregnant. A study by PCOS Selbsthilfe Deutschland e.V. has also shown that affected women are exposed to greater psychological stress than those who do not suffer from PCOS. They experience pronounced deficits in the areas of quality of life, life satisfaction and in their own sexuality.

The cause of PCOS is not yet known. All that can be determined is that a disturbance in the hormonal balance is responsible for the symptoms of the disease. Specifically, this means an overproduction of so-called androgens, which is the name given to the male sex hormones. The increased concentration of androgens disrupts the female cycle and leads to a stronger development of a male appearance, e.g. in the form of dense hair growth on the upper lip or in the chest area.

diagnosis

There are a number of diseases that are very similar in their symptoms to polycystic ovarian syndrome. These include, among other things, hypothyroidism, dysfunction of the ovaries, Cushing's disease, an increased prolactin level or tumors on the ovaries.

In order to determine whether it really is PCOS, the treating doctor has two diagnostic guides available. The older one refers to a disease definition of the NIH (National Institutes of Health) from the year 1990. According to this, PCOS is present in the absence of the menstrual cycle / a rare cycle (chronic anovulation) and an increased level of male hormones in the blood (hyperandrogenism).

In 2003 the NIH definition was updated by the European Society for Reproductive Medicine and Embryology (ZESHRE) and the American Society for Reproductive Medicine (ASRM). So-called polycystic ovaries were added as an additional diagnostic criterion. These are small follicles that collect on the ovaries because they do not burst due to the lack of ovulation.

In practice, the procedure for clarification is usually as follows: in a personal interview, the patient describes her symptoms, the previous history, possible family burdens and whether she wants to have children or whether she has already tried to become pregnant several times. The gynecologist will then use an ultrasound examination to determine whether polycystic ovaries and / or other abnormalities can be seen. A comprehensive blood test including hormone status is also prescribed. As part of the diagnosis, the results of the ultrasound examination, the blood count and the verbal anamnesis are evaluated and an appropriate therapy is suggested.

Basically, a quick medical clarification is advisable in any case, because in the long term an undetected polycystic ovarian syndrome affects the state of health. Those affected have an increased risk of developing metabolic syndrome, diabetes, insulin resistance or uterine cancer. Cardiovascular problems, adult-onset diabetes and infertility have also been observed in connection with PCOS.

therapy

Polycystic Ovary Syndrome is an incurable disease. However, if treatment is timely, the chances of therapy are very good. The aim of the therapy is to alleviate the symptoms that burden the patient the most and to prevent sequelae such as diabetes.

Major issues in connection with PCOS are the desire to have children and problems with fertility. There are different treatment options depending on whether the affected woman wants to become pregnant or not. As already mentioned, the therapy is based on the symptoms. There are ailments that can be treated locally. In the case of excessive hair, professional hair removal is indicated; in the case of skin problems and acne, laser treatments or medicinal ointments can help.

Taking medication has been shown to help with diabetes and metabolic problems, as has weight reduction. The change in lifestyle (change in diet, exercise / sport, stress reduction) has a positive effect on the entirety of the complaints. Women who do not want to have children are usually prescribed the pill to normalize their hormonal balance.

Desire to have children

Pregnancy cannot be ruled out, but it is often not possible spontaneously. Experience has shown that younger PCOS patients have a greater chance of becoming pregnant, as the cycle only changes over the years under the influence of male hormones.

The problem is obvious: the disturbed hormone level leads to a considerable disturbance of the menstrual cycle. Affected women do not ovulate or only rarely ovulate, the menstrual period does not occur at all, occurs irregularly or only 2-3 times a year. Additional excess weight, which can be an accompanying symptom of PCOS, also makes it difficult for a natural pregnancy to occur. Gynecologists therefore recommend medical treatment as soon as possible. For example, one can try to regulate the cycle with the help of hormones, but there is no guarantee that ovulation will continue to occur regularly after discontinuing therapy.

A reduction in weight and a fundamental change in lifestyle may also have a positive effect on fertility. Prescribing the drug metformin also seems to have a positive effect on the cycle. Often, however, pregnancy is only possible artificially, and PCOS patients have a relatively good chance of actually becoming pregnant after fertility treatment. Which type of artificial insemination comes into question is determined individually.

pregnancy

Pregnancy is often extremely pleasant for PCOS patients, as it can sometimes be a long way to get there. However, the special circumstances must be taken into account, as certain risks persist during pregnancy. Experience shows that those affected more often suffer from the following complications:

  • Miscarriages: This is understood as the discharge of the fetus at an early stage of pregnancy. The fetus cannot survive outside of the womb at this point. Up to the 16th week of pregnancy one speaks of early abortion, then of late abortion.
  • Gestational diabetes: is also called gestational diabetes and is a form of the sugar metabolism disease diabetes. The disease only occurs during pregnancy. The increased blood sugar level puts both mother and child at risk. Pregnant women are more likely to suffer from urinary tract infections, high blood pressure and tend to gain weight quickly. In the meantime, the unborn child grows unusually quickly - this means that the maturation of the organs can no longer keep up with the accelerated growth. Malfunction of the placenta and complications in childbirth are also possible.
  • Eclampsia: this is a serious complication in the last trimester of pregnancy that can have serious consequences for the mother and the unborn child. Severe high blood pressure leads to pain, nervousness, dizziness - in the worst case to convulsive seizures. Pregnancy poisoning (eclampsia) is an acute emergency that requires prompt treatment for the pregnant woman.

Even if there are some risk factors for pregnant PCOS patients, an uncomplicated pregnancy is still possible in many cases. Like other expectant mothers, those affected should ensure that they gain healthy weight, eat a balanced diet, and get enough exercise. In addition, the intake of vitamins and trace elements plays an important role. Many gynecologists who offer PCOS therapy and / or fertility treatments also care for their patients during pregnancy. This is definitely desirable, as the doctors are then already familiar with the woman's state of health and can make optimal recommendations with regard to pregnancy.

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