Gynecological Oncology

Polycystic Ovary Syndrome (PCOS)

Polycystic Ovary Syndrome (PCOS)


Polycystic ovary, which develops in the form of the formation of many small and benign cysts in the ovaries, is a female disease that manifests itself with menstrual regularity, in addition to this, it causes the formation of many complaints such as weight gain, hair growth throughout the body, and acne formation. The problem of infertility is frequently observed in women with this disease due to the disruption of the ovulation pattern due to cysts formed in the ovaries. A large number of cysts in the ovaries cause hair growth and acne formation by disrupting the hormonal structure. This disease, which affects the quality of life and appearance negatively by spoiling the appearance, is a type of disease that brings along psychological problems and must be treated.

If polycystic ovary syndrome, which is a serious disease, is not treated for a long time, it can lead to many important problems such as fatty liver, diabetes, hypertension, metabolic syndrome, infertility, depression and anxiety disorders, hypertension, sleep apnea. For this reason, it is necessary to start the treatment process immediately in people with this disease, to ensure rapid weight loss and to control the hormone levels.


Symptoms of Polycystic Ovary Syndrome

Although the disease does not show any symptoms in the initial period, it starts to show itself with some symptoms as the process progresses. Although the symptoms vary depending on the person, the common symptoms seen in most women can be listed as follows:

  • Irregular period
  • Weight gain
  • Pubescence
  • Bleeding between 2 menstrual cycles
  • Getting fat
  • Inability to have children
  • Acne on face and back
  • Deepening of the voice
  • Breast enlargement, shrinkage and tenderness
  • Hair loss
  • Spotting on the skin


The above-mentioned symptoms are the most common symptoms of polycystic ovary syndrome, and the most common symptom is menstrual irregularity. The disease, which manifests itself in the form of abortion, excessive hair growth and acne after a few cycles from the first menstruation, especially in young girls between the ages of 13-19, can also occur at later ages.



What causes Polycystic Ovary Syndrome?
Although the exact cause of polycystic ovary syndrome is not known, it is known that genetic and environmental factors are effective in its emergence. Familial predisposition plays an important role in the formation of the disease. Individuals with a family history of polycystic ovary are more likely to develop this disease than other individuals. In addition, obesity is among the factors that pave the way for the formation of this disease. Excess weight and the resulting insulin resistance cause hyperinsulinemia (increase in the level of insulin hormone in the blood), which increases the synthesis of androgen hormone in the body. As a result, the balance of sex hormones in the body is disturbed, and ovulation disorders and the problem of inability to ovulate, called anovulation, occur. Cyst formation in the ovaries is observed with the disruption of the ovulation pattern, and this situation progresses and leads to the appearance of polycystic ovary syndrome.

One of the causes of PCOS disease is exposure to some harmful chemicals. Some pesticides, dioxins, phytoestrogens, some chemicals such as BPA, Bisphenol A, DBP may affect the hormone production process in the body and cause the hormonal balance to deteriorate. Therefore, exposure to such chemicals is thought to increase the likelihood of many diseases, including polycystic ovarian syndrome.



How is the diagnosis of Polycystic Ovary Syndrome made?
Diagnosis in polycystic ovary syndrome; clinical findings, radiological images and the patient's history are examined in detail. In patients with one or more of the problems such as earlier or late menstruation, amenorrhea, deepening of the voice, hair growth, excessive hair loss, the ovaries and uterus are examined in detail with the help of pelvic or vaginal ultrasonography. As a result of the blood test to be performed on the 3rd day of menstruation, the hormone levels can be measured and the disease can be diagnosed in the light of all these diagnostic tests. In individuals with the disease, especially in the hormone test, it is seen that the levels of FSH and LH hormones that regulate the ovulation cycle are outside of normal, the estrogen hormone level is low, and the male hormone levels are higher than normal. In cases where the ratio of the hormone level that provides ovulation to the level of the hormone that grows the egg is 3 and above, it can be considered that the patient has polycystic ovary syndrome. Ultrasonography is also of great importance in the diagnosis and follow-up of the disease.

The main reason for the absence of ovulation (anovulation) in PCOS disease is the accumulation and cystification of the eggs in the ovarian wall, which cannot develop as they should due to impaired hormone levels. On ultrasonography, it is mostly observed that one or both ovaries have a multicystic appearance. A single ovary with this appearance is sufficient for the diagnosis of the disease to be made. In individuals diagnosed with PCOS as a result of all diagnostic tests, the severity of the disease should be leveled as mild, moderate or severe, and the follow-up and treatment of the patient in the next period should be planned considering the severity of the disease.


What are the treatment methods for Polycystic Ovary Syndrome?
The treatment in polycystic ovary is planned individually by the endocrinologist and obstetrician. In the treatment process, besides fighting the disease, different treatment methods are used to eliminate the secondary problems caused by the disease. First of all, antiandrogen drug treatments can be used to reduce the level of male (androgen) hormones that are above normal in the bloodstream. One of the most important treatment principles in improving the course of the disease is to reduce insulin resistance by ensuring that the person is reduced to their ideal weight with a personalized polycystic ovarian syndrome diet, which will be prepared by a dietitian. If the patient already has insulin resistance, it is very important to normalize the blood sugar and insulin hormone levels by using oral antidiabetic agents in order to correct the hormone levels in the patient.

Birth control pills are often used to maintain menstrual cycle and prevent problems such as hair growth (hirsutism) and acne caused by the disease. This treatment method also contributes to the prevention of excessive thickening of the endometrium, which is the inner layer of the uterus, and different diseases that may occur as a result. Since polycystic ovary syndrome and hair loss are related problems, vitamin and mineral supplements, natural shampoos and hair transplantation techniques can be used when deemed necessary. Antibiotics and acne creams can be used for the acne problem, and laser hair removal techniques can be used for the hair growth problem. In people who want to have children, in addition to the appropriate treatments for the disease, some drug treatments to ensure egg development can be applied. The treatment to be applied to the patient; It should be planned individually by the physician in accordance with the complications that develop in the patient, the stage of the disease, the secondary problems it causes and the general structure of the patient.


As in many diseases, early diagnosis of the disease, making the treatment plan according to the stage of the disease and taking measures to stop the progression of the disease are very important in order to prevent the problems that the disease will cause in the polycystic ovary syndrome. Questions such as can one get pregnant with polycystic ovary syndrome, does this disease prevent them from having children are the questions that confuse patients the most. It should not be forgotten that it is possible to completely control this disease as a result of the right treatment process, especially in people who want to have children, and in this way infertility can be prevented. In the light of the information given above, if you are also a PCOS patient or if you are considering the possibility of having this disease, you can immediately apply to a health institution and have the necessary diagnostic tests done, and increase your quality of life by starting your treatment process immediately.

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