Polycystic ovary syndrome (sop): symptoms and diagnosis

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Polycystic ovary syndrome (PCOS), also known as Stein-Leventhal syndrome, is a very common endocrine disorder that can have consequences on women's fertility. Their symptoms are varied and may even not reach the diagnosis until they detect problems to achieve pregnancy and it is necessary to perform an assisted reproduction treatment.

Below you have an index with all the points that we will discuss in this article.

Index

Polycystic ovarian syndrome (PCOS): symptoms and diagnosis

What is SOP?

Polycystic ovary syndrome is the most frequent endocrine pathology in women of childbearing age: it affects approximately 4-8% of these. Frequently it is associated to:

  • Anovulation (absence of ovulation) and, therefore, sterility. In fact, it is the most common cause of anovulatory infertility.
  • Obesity.
  • Hyperandrogenism (excess of male hormones).
  • Resistance to insulin.

With polycystic ovary syndrome, more androgens are produced than usual and the menstrual cycle is not regulated correctly. In the ovary, the follicles do not release the ova because they do not mature and cysts are produced. Due to this lack of maturation and release of the ovule, women with polycystic ovary syndrome have fertility affected.

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This syndrome is a problem of metabolic origin that should not be confused with polycystic ovaries, which is only an echographic characteristic that may or may not be present in patients with PCOS and that does not have to be accompanied by sterility.

16-25% of women of reproductive age have polycystic ovaries and not all are diagnosed with polycystic ovarian syndrome. Therefore, having polycystic ovaries does not necessarily imply suffering from the syndrome.

The causes of this syndrome are not completely determined, although it seems that there is a genetic predisposition and that there are several genes involved. The most accepted is that it is a multifactorial disease, that is, influenced by both genetic and environmental factors.



Diagnosis

Since the SOP was described for the first time, the diagnostic criteria for this syndrome have been varying while it has been known more about its pathophysiology.

Currently, the most common diagnostic for PCOS is to use the Rotterdam criteria. These determine that, in order to define an SOP, it is necessary that the patient present at least two of the following signs, having excluded other pathologies:

  • Oligo / anovulation (ovulation less frequent than usual or absent).
  • Clinical or biochemical signs of hyperandrogenism.
  • Polycystic ovaries on ultrasound: presence of 12 or more follicles from 2 to 9 mm in radiated crown (in the form of pearl necklace) in each ovary or enlarged ovarian volume (more than 10 ml). It is enough that these characteristics occur in one of the ovaries.
Diagnosis of polycystic ovary syndrome: Rotterdam criteria

symptom

The most common clinical manifestations suffered by women with polycystic ovarian syndrome are the following:

  • Menstrual irregularities: oligomenorrhea (less than 9 rules per year) or amenorrhea (absence of menstruation).
  • Anovulatory sterility.
  • Hirsutism: excess hair.
  • Alopecia or hair loss.
  • Acne.
  • Hormonal alterations: elevated testosterone, elevated LH hormone, high LH / FSH ratio, high ?4-androstenedione (androgen), etc.
  • Antimüllerian hormone (AMH) high.
  • Resistance to insulin.
  • Polycystic ovaries.
  • Breast and uterine hypoplasia.
  • Obesity.
  • Acanthosis nigricans: dark and thickened skin in the neck or armpits.


Treatment

Given a predisposition to suffer from polycystic ovarian syndrome, it is important to modify the lifestyle, take a balanced diet, not exceed a body mass index of 25 and perform a treatment with contraceptives and antidiabetics. It is also advisable to avoid sedentary lifestyle, not just obesity.

Treatment for polycystic ovarian syndrome

Metformin, an antidiabetic drug, has been widely used for the desensitization of the ovaries to excess insulin and thus promote follicular maturation.

In the case of wishing to be mothers, the first approach for obese patients will be lifestyle modification. If it is not enough or if it is not necessary to lose weight, we will try to induce ovulation with drugs such as Omifin.

Patients in whom these strategies are not effective will have to undergo assisted reproduction techniques. It may be sufficient to perform an artificial insemination and that it is not necessary to resort to in vitro fertilization (IVF) to achieve pregnancy.



Questions from users



Does Polycystic Ovary Syndrome have a cure?

The fact that there are genetic factors involved makes it difficult for this alteration to disappear. However, you can try to avoid their appearance or reduce their symptoms by following a healthy lifestyle and controlling diets.

Does metformin help patients with polycystic ovarian syndrome get pregnant?

Metformin helps restore ovulatory cycles and achieve menstrual regularity in obese patients with insulin resistance. However, if only this medication is given, it does not seem to increase the rate of clinical pregnancies. It only seems to provide benefits to achieve pregnancy in certain patients who also receive clomiphene, such as Omifin.

Recommended reading

If you want to know more about the effects that polycystic ovaries may have on fertility, we recommend that you read this article: Fertility with polycystic ovaries.

On the other hand, we also recommend that you visit the following page: Polycystic ovaries. In it you will find detailed information about PCOS and polycystic ovaries.


gynecological surgery in Zaragoza(Spain)

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