He Polycystic ovary syndrome (PCOS) is a disease of unknown etiology of endocrine and gynecological type. This causes hormonal imbalances in women of reproductive age with relatively high incidence, this problem being the most frequent in the gynecologist's office.
This syndrome, which practically all doctors call a"condition", presents a plurality of symptoms that differ from one woman to another, ranging from the mildest, such as the appearance of hair in androgenic areas (for example, the linea alba ), To some more serious ones like type II diabetes or infertility.
Some of these symptoms cease with proper medication and aesthetic treatments. Others, however, can lead to more serious problems of a psychological nature.
Characteristics of polycystic ovary syndrome
It is defined as a syndrome and not as a disorder due to the plurality of symptoms and the indeterminacy of the physical etiology. After all, a syndrome is just a set of symptoms without a clear cause.
This condition, which is often difficult to diagnose using imaging tests or even blood tests, need not present problems in the social function of women or in their personal or sexual life.
Today there are very effective treatments and hormonal preparations to help reduce the symptoms of PCOS.
The name may be misleading, since it does not mean that cysts are conceived as such in the ovaries.
When menstrual cycles occur in which the eggs do not fully mature ( Follicles Immature), the ovary may present a bulky appearance, called the ovary in a pearl necklace because of the appearance of the ovary when performing an ultrasound test ( Vaginal ultrasound ).
symptom
It is more frequent than we think that this syndrome is diagnosed in the consultation"inadequate". By this we mean that many women who, in their early adulthood still have acne on the face, go to the dermatologist complaining about that problem.
The pattern is usually so typical (hair in unusual areas for a woman and acne usually located on the chin) that the shunt is instantaneous to the gynecologist.
That being said, the most commonly reported symptomatology is described below:
Amenorrhea
Absence of menstruation. To diagnose amenorrhea, it must be three months since the last rule.
Oligomenorrhea
They are rare but very abundant and usually painful rules.
Acne
Acne is commonly found on the face in late adolescence or early adulthood due to increased levels of Androgen hormones .
The skin and appendages (the hair, for example, which we will discuss later) are sensitive to the action of the Testosterone , Which causes the annoying acne, which does not stop with the Conventional cosmetic treatments .
Alopecia
Like the skin, hair also reacts with testosterone, causing hair to mature earlier and, therefore, to fall prematurely.
This symptom undergoes great improvement when the woman approaches a hormonal treatment, since they normally act to inhibit to a certain extent the production of male hormones (they are also present in the woman's body).
Hirsutism
Hair is sensitive to the action of androgens, which is why more hair appears in typically male areas (androgenic areas) such as the face, underarms, Linea alba The areolas.
This involves an aesthetic problem that refers very well to advanced techniques such as those that exist today. Medical or laser photoepilation are some of them.
Type II Diabetes
Although it is not known whether this is a cause or a symptom of PCOS, what is clear is that the research relates to the syndrome more or less clearly.
Type II diabetes is a metabolic disease characterized by high levels of glucose In blood (hyperglycemia) due to insulin resistance. It is of an acquired character and can be improved with a healthy life style And with a Adapted feed To this type of medical condition.
Heart disease
Normally associated with hyperglycemia and the high levels of cholesterol and triglycerides that are usually present in women with PCOS, it is one of the most serious problems they can present. They also present a higher risk of thrombosis than the normal reference population.
As with diabetes, these ailments can be prevented or treated with a Healthy eating regimen And continuous physical activity. Also noteworthy l Periodic visits to the doctor, which are crucial to these problems.
Overweight
Weight loss becomes more complicated when a woman suffers from PCOS. However, and as is logical to think, some Good habits of life And exercise helps to alleviate and prevent overweight and its next stage: obesity.
Infertility
Of course, it does not always show up. It is the most serious symptom and, unfortunately, is quite frequent because women with PCOS usually have anovulatory cycles. That is, they do not mature into eggs throughout their menstrual cycle.
The infertility secondary to this type of syndrome can be solved with the correct treatment and with a stimulation of the ovarian activity.
It is often due to the hormonal imbalance itself, which prevents the LH peak ( luteinizing hormone ) To trigger and cause ovulation. The large amount of male hormones does not help to make the rules normal.
Diagnosis
As discussed above, imaging tests or blood tests are not very useful for declaring with complete confidence that a person suffers from this condition.
However, they may well guide the way forward to make a decision about which treatment to administer.
Blood test
A hormone test is usually ordered that includes:
- Luteinizing hormone (LH): the one in charge of provoking ovulation in the middle of the cycle.
─ Follicle-stimulating hormone (FSH): is responsible for ripening the eggs.
─ Level of Estrogens .
─Testosterone: Normally it will be at a higher level than the reference population in women with PCOS.
─Glucose, cholesterol and triglycerides: they will probably also be found at higher levels, although this is not always the case.
Diagnosis by the image
Usually go to:
─ Vaginal ultrasound: it has more resolution than abdominal ultrasound.
─ Magnetic resonance .
Also, although less frequent, the specialist may prescribe a laparoscopy. That is to say, a minor surgery technique very little invasive that is used, among other things, to diagnose diverse affections.
Treatment
People with PCOS usually respond fairly well to treatment if they adhere to it properly.
The first thing to attack is being overweight or obese. With little weight the patient will go down, it will positively affect restoring hormonal balance and, more directly, lowering glucose, cholesterol and triglyceride levels. On the other hand, this way also prevents getting to develop Type II diabetes .
With regard to prescription drugs, it is usual to direct the treatment to the cycles are regular and to stimulate the ovarian action in case the woman is thinking about getting pregnant.
Contraceptives
On the one hand, it is normal to prescribe oral contraceptives to regulate menstrual cycles. Usually these with Antiandrogenic action To eliminate mild (but no less annoying) symptoms such as excessive body hair or hirsutism, acne or alopecia.
Some of the most prescribed are Diane 35 (although not as usual), Donabel or Belara.
Clomiphene citrate
On the other hand, if the woman wants to become pregnant but suffers from PCOS, her treatment will be oriented to stimulate the action of the ovaries through medications such as Clomiphene citrate (Omifin).
Women who are under this treatment should go to the gynecologist's office regularly for follow-up and monitoring, since there is a possibility of multiple pregnancies if the self-administration of the drug is done in an irresponsible manner.
Of course, both treatments for contraception and those indicated for the stimulation of ovulation have to be performed under strict medical supervision, since the specialist will determine which drugs will best suit our complexion and condition, also with a view to reducing Possible side effects.
Psychological effects
PCOS triggers certain psychological reactions, usually of an unpleasant nature that usually causes Bodily dysphoric disorders Associated with the appearance of acne, hirsutism, weight gain and alopecia.
On the other hand, these psychological effects will increase their severity if we add the desire of the woman to become pregnant and the frustration that entails not being able to obtain it.
Low self-esteem
The most common problem in women with PCOS is low self-esteem Due to those unpleasant bodily changes that may result in the girls suffering from it being negatively valued and tormented.
Luckily, PCOS responds fairly well to treatment and symptoms undergo major improvement.
Helplessness learned
Many women feel the effects of frustration, and this leads on many occasions to the phenomenon known as Learned helplessness ("What am I going to do if nothing works").
Complexes
Of course, everyone, whether they have PCOS or not, has complexes. This is very common and has many social connotations related to the current canons of beauty.
That the woman (or man) accept herself does not mean that she likes it completely, it means that she accepts the reality she sees reflected in the mirror, with acne, hirsutism and overweight that will improve with certainty, following some Healthy lifestyles, and long-term adherence to medical treatment.
It is basically about avoiding denying reality. This only leads to an even greater loss of our self-esteem and to a sense of misery and helplessness. Making ourselves aware of how we really are will make us feel calmer, with much lower anxiety levels and ultimately more comfortable and relaxed.
Tips
The defenselessness learned from the one we talked about earlier is also manifested when the woman wants to become pregnant and, after several attempts, she does not succeed. The best thing is to know the problem thoroughly, to have patience with ourselves and to transmit those feelings to our partner, also with the aim of helping and supporting us.
Proper monitoring and follow-up of PCOS will make us better understand our reproductive system, be more patient with it and give ourselves and our partner a certain"mental rest."
It should be noted that, although sometimes they are not accessible to all pockets, there are currently very advanced techniques with very good results in which assisted reproduction is addressed to women with this type of problem, with a proven guarantee of effectiveness and With multidisciplinary teams including psychological assistance and emotional support.
Psychological help in these cases is aimed at reducing anxiety levels of both women and their partners, cognitive restructuring and Treatment of self-esteem , Training and teaching techniques of relaxation and guided imagination that will make Lowering stress levels
Facing SOP with the greatest possible maturity and building an emotional support network is the key to success when dealing with such problems.