Polycystic ovary syndrome is a common problem faced by many women. The formation and growth of multiple cysts is usually associated with hormonal disorders. If untreated, the disease leads to infertility. That is why it is worth learning more about this pathology.
Why does polycystic ovary syndrome occur? How to treat such a pathology? What symptoms should not be ignored? Is it possible to get pregnant with such a disease? The answers to these questions are of interest to many women.
What is a disease?
What information about pathology does the ICD contain? Is polycystic ovary syndrome dangerous? What symptoms are accompanied? This information is sought by many patients.
So, polycystic ovary syndrome (ICD-10 assigned pathology code E28.2) is a disease in which multiple small cysts form in the tissues of the ovaries. As a rule, the disease is associated with hormonalproblems.
What is the mechanism of development of polycystic ovary syndrome? The pathogenesis of the disease is well understood. Increased secretion of estrogens, androgens and insulin leads to disruption of the growth and maturation of eggs. Cystic structures begin to form from immature follicles.
The neoplasms themselves are small, with a dense shell and liquid contents inside. In most cases, cysts appear in both ovaries. The presence of such structures in approximately 25% of patients leads to infertility.
Depending on the origin, two forms of pathology are distinguished.
- Primary polycystic ovary syndrome is the result of congenital anomalies. This form can also occur in girls during the formation of the menstrual function.
- The secondary form of the disease develops in adulthood and is usually associated with acquired pathologies of the endocrine glands or previous inflammatory lesions of the reproductive system.
Polycystic ovary syndrome: causes
Unfortunately, this is a very common pathology. Why does polycystic ovary syndrome develop in women? In fact, the reasons may be different.
- Often the disease develops against the background of pathologies of the hypothalamic-pituitary system. The fact is that follicle-stimulating and luteinizing hormones are synthesized in the pituitary gland, which are responsible for the growth and development of follicles, the processes of ovulation. Against the background of an increase in the level of these hormones, hyperproduction of androgens in the tissues of the ovary is observed, which leads to the appearance and development ofcyst.
- Polycystic ovary syndrome may be associated with cell resistance to insulin. An increase in insulin levels affects the entire endocrine system. In particular, the amount of synthesized androgens and luteinizing hormone increases. Such changes lead to the active growth of follicles. However, none of these structures mature - premature aging of the follicles sets in, increasing the likelihood of multiple cysts.
- Risk factors also include an excess of male sex hormones, which also disrupts the growth and maturation of eggs in the ovaries.
- There is a genetic predisposition. To date, there is no data that would confirm the hereditary transmission of the disease. However, women who have had people with a similar ailment in their family are at risk.
- It is worth noting that certain medications are also considered risk factors. It has also been proven that against the background of obesity, polycystic ovary syndrome occurs in a more severe form. By the way, according to statistics, about 40% of patients are overweight.
- Risk factors also include stress, a sharp change in climate, past infectious diseases (if the patient has prerequisites for the development of pathology).
Polycystic ovary syndrome symptoms
Sometimes the pathology occurs without the appearance of any specific signs - in some patients, the disease is diagnosed by chance. But in most cases, a number of violations appear that indicate the presencepolycystic ovary syndrome. Symptoms vary from woman to woman.
- Pathology primarily affects the menstrual cycle. It becomes irregular - long delays in menstruation are possible, up to their complete absence (amenorrhea). There are violations, and sometimes the disappearance of ovulation. Sometimes long delays in menstruation are replaced by full-fledged uterine bleeding.
- Because the processes of maturation of the egg are disrupted and ovulation is absent, women develop infertility.
- Increased androgen levels lead to increased sebum production. Patients suffer from seborrhea, increased greasiness of the hair. The skin is covered with pimples and blackheads. Such disorders are permanent and practically not amenable to symptomatic treatment.
- A very characteristic feature of polycystic disease is obesity. The patient's body weight sharply increases by 10-15 kg for no apparent reason (the woman continues to eat in the usual way). Sometimes fat deposits are distributed evenly throughout the body. But due to the increase in androgen levels, male-type obesity is possible. Excess fat accumulates in the waist and abdomen.
- Obesity, impaired metabolism of carbohydrates and lipids sometimes lead to the development of type 2 diabetes.
- Increased hair growth on the body is possible: an increase in the level of male sex hormones leads to male pattern hair growth - “antennae” appears above the upper lip, hair growth is observed on the chest, abdomen, inner surfacehips.
- Many women complain of chronic pain in the lower abdomen. Soreness is moderately pronounced, pulling in nature. Sometimes the pain spreads to the pelvic region and lower back.
The presence of such violations cannot be ignored. If left untreated, pathology leads to complications.
Possible Complications
How dangerous can polycystic ovary syndrome be? Reviews of experts indicate that with early diagnosis and proper treatment, the disease can be de alt with. However, in some cases, the disease leads to the development of certain complications.
- Pathology is accompanied by hormonal disorders, as a result of which the patient does not ovulate. This, in turn, causes infertility.
- Prolonged course of the disease, lack of therapy may result in the appearance of malignant tumors in the tissues or cervix.
- PCOS, combined with diabetes and obesity, is also thought to increase the risk of developing breast cancer.
- Hormonal disruptions lead to disruption of normal fat metabolism. Excess weight, coupled with metabolic disorders, leads to disruption of the heart and blood vessels. That is why the list of complications includes atherosclerosis, stroke, myocardial infarction.
Diagnostic measures
What to do if you suspect polycystic ovary syndrome? The symptoms described above are a good reason to see a doctor. Do not self-medicate or try to determine the problem yourself, as this can be dangerous.
How to identify polycystic ovary syndrome? Diagnosis in this case includes a number of procedures.
- First, you need to take an anamnesis and a general examination. The doctor pays attention to the features of the physique, examines the skin and mucous membranes, notes the nature of hair growth, notes all the symptoms that may indicate hormonal disorders.
- Followed by standard gynecological examination and palpation of the abdomen. So the doctor may notice a hardening or enlargement of the ovaries.
- Ultrasound of the pelvic organs is mandatory. During the procedure, you can notice an increase in the ovaries, confirm the presence of cysts.
- Doppler ultrasound helps to assess the nature of blood flow in the ovaries.
- The patient also donates blood for analysis. It is necessary to determine the level of estrogens, progesterone, androgens, cortisol, insulin, pituitary hormones.
- The blood is also checked for the presence and level of lipids - this makes it possible to detect metabolic failures.
- Magnetic resonance imaging allows the doctor to get an accurate image of the ovaries, determine the size, location and number of cysts.
Based on the results, the doctor can make a diagnosis of polycystic ovary syndrome. Treatment in this case will depend on the form and stage of development of the disease, the presence of concomitant pathologies.
Conservative treatment
Unfortunately, it is impossible to completely get rid of such a disease as polycystic ovary syndrome. Treatment in this case is aimed at restoring the normal cycle, stimulating the ovulation process (if the patient wants to become pregnant), reducing the external manifestations of the disease (skin inflammation, hairiness), normalizing carbohydrate and fat metabolism.
- If there is a violation of carbohydrate metabolism, then patients are prescribed hypoglycemic drugs, for example, Metformin. Drugs help normalize blood glucose levels.
- If the patient is trying to get pregnant, then ovulation stimulation is necessary. For this purpose, as a rule, the drug "Clomiphene" is used, which ensures the release of the egg from the ovary. As a rule, the medicine is started on the 5-10th day from the beginning of the menstrual cycle. According to statistics, such therapy in 60% of cases ends with ovulation. In about 35% of patients, it ends with fertilization.
- Combined hormonal contraceptives are used to restore a normal menstrual cycle.
- Sometimes the drug "Veroshpiron" is included in the therapy regimen. This is a potassium-sparing diuretic, which also reduces the level of androgens in a woman's body, blocks their effects. Such therapy lasts at least six months and helps to get rid of uncharacteristic hair growth, normalize the functioning of the sebaceous glands.
Proper diet
A sharp increase in body weight is one of the symptoms of the syndromepolycystic ovaries. Clinical recommendations also apply to nutrition. During therapy, it is very important to normalize metabolism and maintain body weight within normal limits.
- Patients are advised to consume no more than 1200-1800 kcal per day.
- Food should be fractional. Women should eat often (at least 5-6 times a day), but in small portions.
- Be sure to include fresh vegetables and fruits in your diet. They are rich in vitamins and fiber, but also low in calories.
- It is important to provide the body with proteins. The menu is recommended to include cottage cheese, lean meats, fish, seafood.
- The amount of animal fats should be limited. The daily allowance should not exceed 80 g. You can replace these products with vegetable fats, which are more useful.
- It is worth sharply limiting or giving up sugar, pastries, honey, jam, sugary drinks, in a word, from everything that contains a large amount of glucose.
- Experts also recommend giving up canned food, spices, spices, sauces, pickled foods, smoked meats.
- 1-2 times a week you need to spend fasting days. For example, you can eat all day only apples, cottage cheese, kefir. Almost any mono-diet will do.
- It is recommended to give up alcohol, as ethanol negatively affects the functioning of the whole organism.
Physiotherapy
It is worth noting that taking medication is not the only thing required for such a disease,like polycystic ovary syndrome. Doctors' recommendations also apply to the patient's lifestyle.
Of course, an important part of therapy is proper nutrition. In addition, physical activity is also recommended. We are talking about feasible activity, whether it is swimming, Pilates or long walks. The fact is that subcutaneous fat deposits are an additional source of androgens. Weight loss will not only have a positive effect on the figure and well-being, but will also help normalize hormonal levels.
Effective is galvanophoresis using lidase. This procedure allows you to activate the enzymatic system of the ovaries. It also improves organ function. The course of treatment, as a rule, consists of fifteen daily procedures.
It should be understood that therapy for such a disease must be comprehensive. Do not count on a quick and complete cure.
Surgery
In most cases, medical treatment, coupled with physiotherapy and proper diet, is sufficient to keep the endocrine system functioning normally. However, sometimes surgery is necessary. Surgery is usually used to treat infertility. Most often, laparoscopy is performed. Special equipment is inserted inside through small incisions. There are two methods of carrying out the operation.
- Wedge ovarian resection involves the removal of ovarian tissue in which androgenic hormones are synthesized.
- Ovarian electrocauterization consists of point destructionstructures of the ovaries, which are responsible for the synthesis of "male" sex hormones. This is a less traumatic procedure that allows you to save the maximum amount of he althy tissue.
It is worth noting that during laparoscopic surgery, the doctor has the opportunity to eliminate the mechanical causes of infertility, for example, cut the adhesions between the walls or eliminate the obstruction of the fallopian tubes. The operation is performed under general anesthesia and is considered safe.
In the future, conservative treatment is carried out. Often two weeks after the operation, the first ovulation occurs. However, it sometimes takes 6-12 months to restore a normal menstrual cycle. If within 2-3 cycles ovulation is still absent, then the patient is prescribed the same Clomiphene.
It is worth noting that even after successful fertilization and the birth of a child, the risk of relapse is high. According to statistics, often polycystic disease is activated 5 years after undergoing therapy. That is why the patient must be registered with a doctor, undergo an examination and take tests twice a year. The sooner a relapse is detected, the easier it is to stop its symptoms and prevent the development of possible complications.
Prevention measures and forecasts
It is worth noting that it is impossible to completely get rid of such a pathology. Nevertheless, therapy started at an early stage allows women to avoid such unpleasant consequences as infertility (they inevitably end with polycystic syndrome).ovaries). IVF, taking hormones, ovulation stimulation - all this helps a woman become a mother.
Unfortunately, there is no specific prevention. Women are advised to monitor the state of he alth and the regularity of the cycle, and if there are alarming symptoms, immediately consult a doctor. Remember that every six months you need to undergo a preventive gynecological examination. It is also important to follow the diet, keep fit, treat inflammatory and infectious diseases in time.
A girl during puberty must be explained what should happen to her body. Since cysts often begin to form during the formation of the menstrual cycle, girls are also advised to undergo preventive examinations and periodically take tests.
