Polycystic ovary syndrome (PCOS) is one of the most common hormonal conditions faced by women worldwide. It is characterized by a complex spectrum of symptoms that can include irregular menstrual cycles, extra male pattern hair, acne or hair loss. It is a complex disease that poses diagnostic and therapeutic challenges, affecting not only the physical health but also the mental health of female patients.

Although PCOS is a disease that covers all periods of a woman’s life, it develops its full clinical picture in women of reproductive age. PCOS affects up to 6 to 13% of women of reproductive age.

One of the main symptoms of PCOS can be ovulation disorders. As a result, many women with PCOS may have trouble getting pregnant. Understanding the condition and accessing effective medical care are therefore crucial, especially for those patients who dream of motherhood.

Causes of polycystic ovary syndrome

Many women with polycystic ovary syndrome want to know the cause of their condition. Unfortunately, the exact causes of PCOS are not fully known. It is believed to be a multifactorial disease.

One of the main symptoms is hormonal imbalance, in particular an increase in hormones such as testosterone, LH (luteinizing hormone) and insulin. Insulin resistance, a condition in which the body’s cells stop responding to insulin, leads to increased production of androgens (male sex hormones) by the ovaries.

In addition, genetic factors play an important role in PCOS.

Environmental factors, such as inadequate diet and poor lifestyle, leading to obesity, can also have an impact on PCOS.

In recent years, it has been increasingly reported that environmental pollutants and exposure to harmful chemicals may also be responsible for the onset of PCOS.

Symptoms of polycystic ovary syndrome

PCOS is most often accompanied by menstrual disorders. Irregularity of menstrual cycles can manifest as stopping menstruation (secondary amenorrhea) or irregular bleeding (periods between periods of more than 35 days).

In addition, many women with PCOS experience difficulty getting pregnant due to irregular ovulation or a complete lack of ovulation.

Women suffering from polycystic ovary syndrome often struggle with hyperandrogenism, or the overproduction of male sex hormones called androgens. Hyperandrogenism is accompanied by symptoms such as:

  • acne,
  • hirsutism, or excessive hair on the face, chest or abdomen,
  • abdominal obesity,
  • male pattern baldness,
  • seborrhea.

In PCOS, you may also experience symptoms such as:

  • fatigue,
  • sleep disturbances,
  • lowered mood,
  • problems maintaining a normal body weight,
  • increased risk of metabolic disorders such as insulin resistance and type 2 diabetes.

Another characteristic symptom of PCOS is polycystic ovaries, visible on ultrasound.

Diagnosis of polycystic ovary syndrome

To make a diagnosis of PCOS, it is crucial to find two of the following three clinical signs:

  • the presence of irregular menstrual cycles,
  • clinical or biochemical signs of hyperandrogenism,
  • high AMH or polycystic ovaries, visible on ultrasound.

In the diagnosis of PCOS, it is also important to exclude other conditions, such as hyperthyroidism or hyperprolactinemia, which can produce similar symptoms.

Polycystic ovaries in ultrasound examination

On ovarian ultrasound in patients with PCOS, characteristic features can be observed that indicate the presence of polycystic ovaries.

Inside the polycystic ovary, numerous small follicles, usually less than 10 mm in diameter, can be seen distributed in the ovarian cortex.

In addition, the volume of the ovary in patients with polycystic ovary syndrome (PCOS) may be increased compared to the ovaries of healthy women. Typically, the ovarian volume in PCOS is above 10mL.

Treatment of polycystic ovary syndrome

Treatment of polycystic ovary syndrome (PCOS) depends on a woman’s individual symptoms. It should also take into account the patient’s procreative plans.

The main therapeutic goals include improving the regularity of menstrual cycles, reducing symptoms of hyperandrogenism, controlling insulin resistance and managing the risk of metabolic complications.

The first step in treating PCOS is lifestyle changes, including a healthy diet based on low-glycemic-index foods. Regular physical activity and weight control are also important.

In addition, various pharmacological options are used, including oral contraceptives, which help regulate the menstrual cycle and reduce hyperandrogenism by controlling hormone levels.

For patients trying to have a baby, treatment may include ovulation-promoting drugs such as clomiphene or letrozole, gonadotropins and medical procedures such as IVF.

Controlling metabolic health, that is the monitoring blood sugar, lipid levels and blood pressure, is also important in PCOS therapy.