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Polycystic ovaries: causes, symptoms and treatment

What it is?

Polycystic ovary is a violation of normal ovarian function in combination with cystic degeneration. The disease can be found under a different name - polycystic ovary syndrome - a more capacious definition, as it combines several symptoms that form this pathology.

There are other definitions in the medical literature: ovarian sclerosis (due to sclerotic changes in the ovarian capsule) or Stein-Levintal syndrome (by the names of the authors who first described this syndrome).

Content

Causes of polycystic ovary

Polycystic ovary

To name the exact reasons contributing to the development of polycystic ovary, at the moment it is impossible. The disease is a syndrome in which changes are found in several organs of the endocrine system: the pancreas, the adrenal glands, the ovaries, the pituitary gland and the hypothalamus.

The main value is given to the hormone - insulin, produced by the pancreas. Often in women with polycystic ovarian obesity is observed for the male type. Adipose tissue is insensitive to insulin and the pancreas is forced to produce a hormone in large volumes.

Insulin stimulates the ovaries to produce androgens, which leads to a violation of the main function of the ovaries - to produce an egg cell that can be fertilized.

Also, the development of polycystic ovaries can occur with disorders in the hypothalamic-pituitary system. This system regulates the production of follicle-stimulating and luteinizing hormones (FSH and LH), which contribute to the growth and development of follicles in the ovary and the onset of ovulation.

The concentration of hormones should be in a certain ratio, with an increase in the number of LH, the ovaries produce male sex hormones, which inhibits ovulation.

During puberty, hormonal disruptions can occur, then the adrenal glands of the girl begin to produce more androgens than necessary. This inhibits the normal functioning of the ovaries.

Special attention is paid to the hereditary factor. Although there is no 100% confidence in this, yet in families where polycystosis suffered close relatives of the woman, the risk of the disease is very high.

When burdened with heredity in the family should be carefully examined girls who entered the period of puberty. With the early diagnosis of the syndrome, the chances of recovery are much greater.

Signs and symptoms of polycystic ovary

symptoms of polycystic ovary

Symptoms of polycystic ovaries are very diverse and may resemble manifestations of other diseases. A special feature is the fact that the presence of all the symptoms at once is not necessary for one woman.

Symptoms of polycystic ovary may be invisible for many years. Most often, a woman learns about her diagnosis only at the moment when she plans to become a mother.

The main symptom of polycystic ovary, forcing to see a doctor - the inability to get pregnant.

The most frequent causes and additional symptoms of polycystic ovary are:

Менструальный цикл нестабилен. 1. The menstrual cycle is unstable. Violations begin to manifest from the onset of menstruation: irregular cycle with scanty menstruation, or vice versa, with prolonged bleeding.

Often the monthly may be completely absent for several months. Due to the hormonal imbalance, the endometrium of the uterus increases in thickness, but monthly rejection does not occur or occurs late.

Болезненность в области живота. 2. Abdominal tenderness. Pain symptom may be permanent. This is explained by an increase in the ovaries and pressure on the pelvic organs.

Нарастание массы тела. 3. The increase in body weight. The symptom is impermanent, but is noted in many women. Characterized by obesity-type "apple" - the bulk of the fat is located in the abdomen and waist.

Obesity is associated with excessive insulin formation - insulin increases appetite, a constant feeling of hunger does not leave a woman. Due to a sharp increase in weight, stretch marks (striae) appear on the skin of the body.

Изменяется внешний облик. 4. Changing appearance. The appearance of acne on the skin is noted, the hair and skin are oily, and oily dander is often detected. Girls and women show increased hairiness on the body in the genital area, on the legs.

So-called female mustaches make their way over the upper lip. On the head, on the contrary, focal hair loss (alopecia) can occur with the formation of bald patches. These changes indicate an increased production of male hormones.

Отмечается усилением пигментации кожи на спине, в области подмышек. 5. It is marked by increased pigmentation of the skin on the back, in the armpits.

Со стороны нервной системы может наблюдаться раздражительность, сонливость, колебания настроения, т. е. признаки, напоминающие ПМС. 6. On the part of the nervous system, irritability, drowsiness, mood fluctuations, that is, signs resembling PMS, can be observed.

Can I get pregnant with polycystic ovaries?

Polycystic ovaries and pregnancy, at first glance, the phenomenon is not feasible. But it is not. With timely treatment and compliance with preventive measures, the long-awaited pregnancy may occur.

A woman needs to learn to be patient, not to violate the plan of action prescribed by the doctor. It can take months or even years, but the result is worth it.

The treatment is aimed at the maturation of a full-fledged egg cell and its release towards spermatozoa for a long-awaited meeting and the birth of a new life.

All pregnancy and at the time of delivery a woman is under the scrutiny of physicians. It should be remembered that the fact of pregnancy is not the result. In case of polycystic ovary pregnancy may end unsuccessfully - the risk of miscarriage, fetal death and premature birth in women with this diagnosis is several times higher.

The risk of exacerbation of extragenital diseases is also high. Especially often in pregnant women with polycystic develops diabetes.

Diagnosis of polycystic ovary syndrome

Diagnosis of polycystic ovaries is a complex process. This is a whole range of studies on the basis of which a diagnosis is made or refuted.

  • The main criterion is infertility, due to rare or ovulation in their absence. Women unsuccessfully attempt to get pregnant, the years go by, and pregnancy does not occur.
  • The second important indicator is considered the quantitative determination of female and male sex hormones in serum. Clinically, signs of an increase in androgens may not always manifest themselves, whereas in laboratory studies, their increase may be detected. It is also necessary to pass tests for glucose and cholesterol.
  • In a two-handed study, the gynecologist can feel for ovaries enlarged in size, dense to the touch.
  • Ultrasound will help examine the structure of the ovaries. The doctor identifies the following ultrasounds - signs: the ovaries are enlarged, small follicles are visualized on the periphery of each, more than 10 in number.
  • Sometimes laparoscopy can be performed. This study is carried out using a device - a laparoscope, which is inserted through a small hole in the abdominal wall. The laparoscope is able to look at the appearance of the ovaries: they are enlarged, their surface is covered with a white capsule, there are no signs of the release of eggs on the surface of the capsule (point breaks). Laparoscopy allows during the study to take a piece of tissue for histological examination, as well as one of the methods of treatment of polycystic ovaries.

The diagnosis is made only on a combination of several signs (infertility, androgen and associated symptoms are considered to be the main ones).

None of the symptoms in a single manifestation can confirm the disease.

Treatment of polycystic ovaries, drugs

Treatment of polycystic ovary

Treatment of polycystic ovaries can be carried out with the involvement of several specialists at once: a gynecologist (and better a narrow specialist is a gynecologist-endocrinologist), an endocrinologist and a nutritionist.

Conservative treatment methods:

  • Hormonal contraceptives. Help restore the cycle and avoid the development of endometriosis. Some drugs have antiandrogenic effects (they fight acne and excess body hair). This method is not suitable for women who dream of getting pregnant.
  • Drugs that stimulate ovulation.
  • Antiandrogenic agents. This is a group of drugs that reduce the amount of male hormones.
  • Drugs aimed at the treatment of diabetes. Usually this drug is metformin, which, in addition to the regulation of insulin, contributes to weight loss.
  • Diet. It is enough for some women to lose weight in order for insulin indicators to return to normal and ovulation occurs. Therefore, diet therapy plays an important role in the treatment of polycystic ovaries. Diet for polycystic ovaries is aimed at eliminating large amounts of fat and carbohydrates. Be sure to combine diet with exercise.

Surgical treatment:

  1. Minimally invasive surgery - laparoscopy. Using a laparoscope, a thick capsule of the modified ovaries is incised to facilitate the release of eggs.
  2. Sometimes surgery is performed to remove part of the affected ovary. This is the most extreme measure and has recently been carried out less and less.

Complications of Polycystic Ovary

In addition to the inability to become pregnant, polycystic ovarian disease has long-term complications.

  1. Uterine cancer. Irregular monthly or prolonged absence contribute to the fact that the inner lining of the uterus (endometrium) gradually thickens, since there is no monthly desquamation. Endometrial cells first change their size and shape ( hyperplasia ), and then can degenerate into malignant.
  2. The development of obesity and diabetes due to insulin resistance of the organism.
  3. Diseases of the heart and blood vessels due to high cholesterol levels (heart attacks and strokes).

Prevention

Prevention of disease recurrence is reduced to the constant maintenance of weight in the norm. Even after successful treatment, ending with the birth of a child, you need to maintain a diet all your life. At any time, polycystic ovaries may reappear.

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