PCO syndrome is a dysfunction of the ovaries. In polycystic ovary syndrome, women have too many male hormones in their blood. The consequences are infertility, increased body hair, acne and menstrual disorders – sexuality also suffers.
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Quick Overview: Polycystic Ovary Syndrome (PCOS)
Definition: Common hormonal imbalance in women that, if left untreated, can lead to infertility and unwanted childlessness.
Symptoms: Menstrual cycle disorders, weight gain, male body hair, blemishes and hair loss.
Diagnosis: Symptoms and appearance, blood work, and ovarian ultrasound.
Therapy: Usually a combination of weight loss, more exercise, hormone treatment with birth control pills and insulin medication.
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What is PCO Syndrome?
Polycystic ovary syndrome (PCOS) is a dysfunction of the ovaries that mostly occurs in young women. Medical synonyms are polycystic ovary syndrome or Stein-Leventhal syndrome. It is one of the most common hormonal imbalances in women.
The affected ovaries are often interspersed with many immature egg sacs (follicles). It is characteristic that women with PCOS have irregular menstruation or no menstruation at all. In addition, in many cases the patients suffer from increased male body hair, acne, hair loss and obesity.
PCOS can have a significant impact on quality of life and sexuality.
PCOS is a common reason for infertility
Experts estimate that between five and ten percent of women suffer from PCOS. The PCO syndrome usually occurs in the childbearing age between the 15th and 25th year of life. As a rule, it leads to problems with fertility: women have considerable difficulties conceiving naturally. Therefore, PCOS is a common reason for infertility and an unfulfilled desire to have children.
PCOS: Possible Symptoms
PCOS manifests itself through various symptoms. They can come in different numbers and strengths. Some women develop only mild symptoms, while others experience extreme symptoms.
Common complaints of PCOS are:
Cycle disorders: Affected Women have either infrequent, irregular (oligomenorrhea) or no menstruation at all (amenorrhea)
male body hair: Increased hair growth is particularly evident on the chest, abdomen, upper lip and chin (beard growth), pubic region, back or thighs. Hirsutism is triggered by increased levels of male sex hormones in the blood (hyperandrogenemia).
Masculinization: Due to the increased concentration of androgens, male characteristics prevail over female ones (virilism). Male sexual characteristics develop, for example a deep voice or an enlarged clitoris, sometimes the breast size also decreases.
skin and hair: The hormonal change can promote hair loss (alopecia) and greasy hair as well as impure, greasy skin and even acne.
weight gain: Overweight or obesity (obesity) often occurs.
If the PCO syndrome is not recognized and treated, infertility and an unfulfilled desire to have children can follow. This and the masculine appearance often lead to the development of additional psychological impairments.
Causes of PCOS Syndrome
The exact causes of PCOS are still largely unknown. Several factors are probably involved in the development, which throw the energy metabolism and hormone balance out of balance.
Possible triggers:
Genetics: Presumably, the genes are involved in the development, because PCOS occurs more frequently in some families.
hormones: The PCOS suppresses a hormone that normally stimulates the immature egg cells in the sacs to mature. They remain immature and ovulation does not take place. In addition, the ovaries can no longer adequately convert the male hormone testosterone, which the female body also produces, into estrogen. This floods the body with male hormones.
Insulin resistance: The body cells are less sensitive to the blood sugar hormone insulin – insulin resistance develops, which is considered a precursor to type 2 diabetes (prediabetes). The pancreas releases more and more insulin to compensate for this insensitivity. Insulin also promotes the production of male hormones and the storage of energy from food in the fat deposits.
Metabolic syndrome: Researchers have shown a connection between PCOS and the metabolic syndrome. This refers to the joint occurrence of obesity, insulin resistance, elevated blood lipid levels and high blood pressure. All factors together influence the function of the ovaries.
overweight: The majority of women with polycystic ovary syndrome are overweight. However, there are women with PCOS who are slim and not insulin resistant.
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Diagnosis: How is the PCO syndrome diagnosed?
At the beginning of the diagnosis there is a detailed anamnesis interview about the symptoms and the medical history. As part of a physical examination, the doctor gets a picture of the extent and locations of body hair. The condition of the skin and hair can also indicate PCOS.
A blood sample that is analyzed in the laboratory is important. In it, the concentration of various hormones is determined:
- male sex hormones (testosterone and androstenedione)
- LH (luteinizing hormone)
- FSH (follicle stimulating hormone)
The level of blood sugar and blood lipids is also recorded.
Ultrasound of the ovaries makes cysts visible
Women with PCOS often have many fluid-filled sacs on the outer edges of the ovaries. These are made visible with an ultrasound examination of the ovaries. The number and size of the ovarian cysts can also be determined. The egg cells accumulate because ovulation does not occur or occurs only irregularly. The ovaries are often enlarged as well.
PCOS diagnosis according to the Rotterdam criteria
According to the so-called Rotterdam criteria from 2003, PCOS is present if two of the following three points are met:
Menstrual cycle disorders due to rare or absent ovulations
Increased levels of male sex hormones in the blood, signs of masculinization, severe acne
Many follicles on the ovaries
Therapy of polycystic ovary syndrome
The treatment of PCOS depends on the symptoms and how severe they are. The question of the desire to have children is also decisive for the choice of therapy.
Therapeutic measures:
Nourishment: If you are overweight or obese, you need to lose weight. With the help of expert nutritional advice, you can switch to a healthy, balanced diet. Ideally, it contains lots of plant-based foods, whole grain products, little fat (plant-based instead of animal-based) and sugar, as well as animal products such as meat and sausage.
Movement: Sport stimulates the metabolism, lowers blood sugar, blood lipid levels, blood pressure and helps to lose weight. Endurance sports such as Nordic walking, hiking, swimming, cycling or jogging are recommended. Weight training in moderation is also healthy: it increases muscle mass, which in turn uses more energy.
hormones: Hormone treatment can also help. Hormonal contraceptives such as the birth control pill with a progestin-estrogen combination are suitable for patients who do not want to have children. The progestins should have an antiandrogenic effect, i.e. dampen the effect of male hormones. The complexion, hair loss and male hair growth also improve. The first successes can often be seen after just a few months.
Drugs for insulin resistance: If diabetes mellitus is also present, diabetes medication, especially the active ingredient metformin, reduces insulin resistance and improves blood sugar levels. The production of male hormones also decreases and the lipid metabolism changes. However, in Germany metformin is only approved for type 2 diabetes, but not for menstrual disorders.
PCOS treatment in women who want to have children
Drugs that trigger ovulation help women who want to have children. An example is the active ingredient clomiphene. However, taking it increases the risk of multiple pregnancies. If treatment with clomiphene is unsuccessful, so-called gonadotropins are an option. It should be noted that pregnancy with multiple births can also occur here.
PCO syndrome increases risk of other diseases
If left untreated, PCO syndrome can have far-reaching health consequences. Possibly develop
- diabetes mellitus,
- thyroid disease,
- cardiovascular diseases,
- Blood clots in the vessels (thrombosis) or
- the metabolic syndrome.
Pregnant women must be closely monitored and treated because they are at increased risk of miscarriage or gestational diabetes. Frequent check-ups are also very important in the case of multiple pregnancies. In addition, pregnant women must not take metformin, they usually have to switch to insulin.
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