Polycystic Ovary Syndrome (PCOS)

 

Polycystic ovary syndrome (PCOS) is a condition that affects the ovaries, causing them to produce an excess of male sex hormones (androgens). It is named for the small cysts that may form in the ovaries, although some women with PCOS do not have cysts, and some women without PCOS may develop cysts. PCOS can interfere with ovulation, which is the process of releasing a mature egg from the ovary so that it can be fertilized by sperm. If the egg is not fertilized, it is expelled from the body during menstruation. In women with PCOS, high levels of androgens can disrupt the menstrual cycle and cause a range of symptoms. While there is no cure for PCOS, it can be managed with medication to reduce symptoms and prevent complications.

What causes PCOS?

The cause of polycystic ovary syndrome (PCOS) is not fully understood, but it is believed to be related to insulin resistance and hormonal imbalances. Many women with PCOS have difficulty using insulin effectively, leading to high levels of insulin in the body and increased production of androgens. Obesity can also contribute to insulin resistance and exacerbate PCOS symptoms. There is also a genetic component to PCOS, as it is common for sisters or mothers and daughters to be affected by the condition.

What are the risks for PCOS?

You may be more likely to have PCOS if your mother or sister has it. You may also be more likely to have it if you have insulin resistance or are obese.

What are the symptoms of PCOS?

The symptoms of PCOS may include:

  • Missed periods, irregular periods, or very light periods
  • Ovaries that are large or have many cysts
  • Excess body hair, including the chest, stomach, and back (hirsutism)
  • Weight gain, especially around the belly (abdomen)
  • Acne or oily skin
  • Male-pattern baldness or thinning hair
  • Infertility
  • Small pieces of excess skin on the neck or armpits (skin tags)
  • Dark or thick skin patches on the back of the neck, in the armpits, and under the breasts

How is PCOS diagnosed?

To diagnose polycystic ovary syndrome (PCOS), your healthcare provider will consider your medical history, symptoms, and the results of a physical exam, including a pelvic exam, which examines the reproductive organs. It is important to note that some of the symptoms of PCOS are similar to those caused by other conditions, so it is important to seek a proper evaluation to determine the cause of your symptoms.
Because of this, you may also have tests such as:

  • Ultrasound is a diagnostic test that uses sound waves and a computer to create images of internal structures in the body, such as blood vessels, tissues, and organs. In the case of polycystic ovary syndrome (PCOS), ultrasound can be used to examine the size and shape of the ovaries, including the presence of any cysts. The test can also assess the thickness of the lining of the uterus (endometrium). Ultrasound is a noninvasive, painless procedure that can provide important information about the health of the reproductive system.
  • Blood tests can be used to help diagnose polycystic ovary syndrome (PCOS) by checking for high levels of androgens and other hormones. In addition, blood glucose levels, cholesterol, and triglycerides may also be measured. These tests can provide important information about hormonal imbalances and the overall health of an individual with PCOS.

How is PCOS treated?

The treatment of polycystic ovary syndrome (PCOS) is tailored to the individual and can vary depending on a number of factors, such as age, symptom severity, and overall health. Whether or not a person wishes to become pregnant in the future may also influence the treatment approach.

If you do plan to become pregnant, your treatment may include:

  • Making lifestyle changes, such as adopting a healthy diet and increasing physical activity, may help manage the symptoms of polycystic ovary syndrome (PCOS) and improve insulin sensitivity. These changes can also assist with weight loss and lower blood glucose levels, which may help with ovulation.
  • Medications that stimulate ovulation can help regulate the menstrual cycle and encourage the ovaries to release eggs normally in people with polycystic ovary syndrome (PCOS). However, these medications may also carry certain risks, such as an increased likelihood of multiple pregnancies (e.g. twins or more) and the potential for ovarian hyperstimulation, which is the release of excessive hormones by the ovaries and can cause symptoms like abdominal bloating and pelvic pain.

If you do not plan to become pregnant, your treatment may include:

  • Birth control pills. These help to control menstrual cycles, lower androgen levels, and reduce acne.

  • Diabetes medication. This is often used to lower insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help you ovulate more regularly.

  • A change in diet and activity. A healthy diet and more physical activity can help you lose weight and reduce your symptoms. They can also help your body use insulin more efficiently, lower blood glucose levels, and may help you ovulate.

  • Medications to treat other symptoms. Some medications can help reduce hair growth or acne.

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