PCO syndrome (polycystic ovarian syndrome) is a hormone imbalance in women. This disorder leads to an increase in male hormones, the so-called androgens, which can result in menstrual disorders and infertility. PCO syndrome is also known as Stein-Leventhal syndrome.
What is PCO syndrome?
PCO syndrome occurs mostly in women of reproductive age. Due to the increased production of male hormones (androgens), the ovaries (ovaries) malfunction. In order for the diagnosis of PCO syndrome to be made, several criteria must be met.
Criterion No. 1: So-called polycystic ovaries must be present. This means that cysts are growing in the ovaries. At least 8 cysts must be detectable. See AbbreviationFinder for abbreviations related to PCO.
Criterion No. 2: The menstrual bleeding occurs only very rarely or not at all. Ovulations occur very rarely or not at all.
Criterion No. 3: The concentration of male hormones is very high. The PCO syndrome occurs relatively frequently. About 10 percent of all women between the ages of 15 and 25 suffer from PCO syndrome (polycystic ovary syndrome).
A primary cause of the PCO syndrome has not yet been found. However, it was possible to distinguish various factors that are present in many of those affected.
Many women have a family predisposition. It is therefore assumed that there is a hereditary component, although the causative gene has not yet been clearly identified.
Brain disorders are also possible. In the case of a PCO syndrome, the pituitary gland (pituitary gland) produces more of the hormone LH (luteinizing). The production of the hormone FSH (follicle-stimulating), on the other hand, is reduced. Due to this imbalance, there is an increased production of male sex hormones in the ovaries.
Disorders in the pancreas can also be a cause. PCO syndrome has been found to have an increased concentration of insulin in the blood. The excess insulin stimulates the ovaries to produce more male hormones, which in turn stimulates the pituitary gland to release more LG.
Other possible causes of polycystic ovarian syndrome are puberty, hypothyroidism, stress and tumor diseases.
Symptoms, Ailments & Signs
The PCO syndrome is a versatile clinical picture that can be accompanied by various symptoms. Menstrual cycle disorders are a common symptom. Patients have prolonged menstrual cycles, lasting longer than 35 days, and menstruate less frequently. Menstrual bleeding can also stop completely. In this case one speaks of amenorrhea.
Intermenstrual bleeding or even additional bleeding may occur during the course of the cycle. Menstrual cycle disorders lead to reduced fertility or complete infertility. Due to the increased concentration of male sex hormones in the blood, women with polycystic ovarian syndrome have a male pattern of hair (hirsutism).
The hair grows not only in the intimate area, but also on the thighs or on the stomach and in the area of the upper lip. The patients also suffer from hair loss, oily skin and acne. They also tend to be overweight and have elevated blood sugar levels. True masculinization, with a deepening voice and clitoral enlargement, is less common.
In principle, not all symptoms are equally pronounced in women with PCO syndrome. However, the majority of those affected suffer greatly from the symptoms. In particular, the lack of fertility or complete infertility can lead to severe depressive moods if the desire to have children is unfulfilled.
Diagnosis & History
The PCO syndrome is diagnosed by the gynecologist. In addition to a general anamnesis (medical history), a gynecological examination is carried out. If PCO syndrome is suspected, imaging procedures such as B. Ultrasound and MRI are used to visualize the ovaries. In this way, cysts in the ovaries can be detected.
A blood test is also performed to confirm the diagnosis. In addition to a general blood count, the various hormone levels in the blood are examined. In particular, the hormones LH and FSH are trend-setting values for PCO syndrome.
If the affected person wishes to have children, laparoscopies can also be carried out. The ovaries in particular are examined in detail. If necessary, biopsies are also carried out. Tissue is removed from the ovaries and examined histologically and cytologically.
The course of PCO syndrome depends on when the disease was discovered and how it was treated. Since this disease is often associated with adiposity (obesity) and increased insulin levels, this means an additional risk for the patents, since these symptoms can also cause diabetes mellitus and lipid metabolism disorders in addition to cardiovascular diseases. With early and adequate treatment, the course of the PCO syndrome is good and can be cured without consequences. Inadequate treatment can lead to long-term effects such as infertility.
Once PCO syndrome has been diagnosed, it is advisable to see a specialist for treatment. Only gynecologists with an additional qualification in reproductive medicine have the necessary experience to successfully treat PCO syndrome (polycystic ovary syndrome).
The PCO syndrome usually has a very negative effect on the quality of life of the affected woman. In most cases, this increases the concentration of male hormones, leading to androgenization in women. In most cases, many different psychological complaints develop and in some cases depression.
Those affected are often ashamed of the symptoms and sometimes suffer from inferiority complexes and significantly reduced self-esteem. Social problems can also occur as a result of the PCO syndrome. Especially at a young age, this syndrome can lead to teasing or bullying. Those affected continue to suffer from pimples and impure skin. Obesity and hair loss can also occur as a result of the PCO syndrome and have a very negative effect on the aesthetics of those affected.
Some of the patients have a lady’s beard, and infertility can also be a symptom of the disease. As a rule, the desire to have children cannot be pursued. In severe cases, PCO syndrome can also lead to miscarriage. PCO syndrome is usually treated with medication. A healthy lifestyle can also have a very positive effect on the disease.
When should you go to the doctor?
PCO syndrome can only be diagnosed in sexually mature and reproductive young and adult women. If those affected have an unfulfilled desire to have children, it is advisable to see a doctor for a check-up. If, despite all efforts and known methods of conception, no offspring could be fathered for several months, a doctor’s visit is advisable. Irregularities in the female menstrual cycle or the absence of menstrual bleeding should be reported to a doctor.
Bleeding between periods or a very weak menstrual period often indicate a health impairment. A doctor’s visit is necessary so that the cause can be investigated. Obesity or weight problems despite a low-calorie and balanced diet can be discussed with a doctor. Blemishes, acne or very oily skin are signs of a condition that needs treatment. If you notice behavioral problems or if you become depressed, you should see a doctor.
Changes in personality, a deep voice and irregular hair growth on the body are complaints that should be clarified by a doctor. It is advisable to consult a doctor or therapist in the event of persistent or increasing dissatisfaction with one’s own life, a decrease in well-being and a reduced quality of life. In many cases, the emotional problems are based on physical imbalances that can be treated.
Treatment & Therapy
The treatment of a PCO syndrome includes several therapy goals. Acute symptoms are treated primarily. However, the long-term goal of therapy is to normalize the metabolism and prevent possible secondary diseases such as diabetes mellitus and cardiovascular diseases.
Since polycystic ovarian syndrome is often associated with being overweight, it is important to change your diet. Sufficient physical exercise in the form of sport is also important. Especially in the early stages of the PCO syndrome, these two measures can have a positive influence on the menstrual cycle and ovulation.
When treating the PCO syndrome, it must also be taken into account whether the affected women wish to have children. In women who do not want to have children, hormone imbalances are often treated with birth control pills. The composition of various female hormones such as estrogen and progestin succeeds in slowing down the release of male hormones, so that the consequences such as increased body hair and skin problems are reduced. However, this type of therapy is only intended for women who do not wish to have children, since the “pill” has a contraceptive effect.
If women who want to have children suffer from the PCO syndrome, the aforementioned therapy is not recommended. In these cases, low-dose cortisone preparations are often used. These act on the adrenal glands, where male hormones are produced. If ovulation does not occur despite treatment, ovulation-triggering medication can be administered.
If the cause has been diagnosed as an excessively high insulin level, the first priority is to lower it. The hormone FSH is often injected as the drug of choice. However, the patient must be informed that with this form of therapy, the probability of a multiple pregnancy is very high.
In exceptional cases – especially in women who want to have children – it may be indicated that the PCO syndrome has to be treated by means of an operation. Here, the cysts in the ovaries are destroyed with a laser during a laparoscopy (abdominal endoscopy).
Outlook & Forecast
The prognosis in the presence of PCO syndrome, also known as polycystic ovarian syndrome, is not very good. In addition to physical symptoms that are a burden, female fertility is also restricted. Both can lead to mental stress and social withdrawal. Therefore, polycystic ovarian syndrome not only leads to increased miscarriages, but also to mental disorders or depression that requires treatment.
PCO syndrome can lead to increased body hair, a lack of menstruation and infertility. Even if it is still possible in principle to have children, it is becoming much more difficult. The pregnancies in women with PCO syndrome are at higher risk. Those affected are more heavily burdened by gestational diabetes, miscarriages or multiple pregnancies. Complications are also more common during pregnancy.
As a result, women with PCO syndrome develop an increased risk of suffering from cardiovascular diseases. Drug treatments and dietary changes can increase the chances of a better quality of life. Regular gynecological examinations are recommended. PCO symptoms can improve during menopause. But they can also get worse. Why this is so is still being researched.
The existing symptomatic treatment approaches are insufficient. If there is no desire to have children, the increasing masculinization or accompanying acne can be counteracted with ovulation inhibitors. The prognosis is worse if you want to have children. PCO syndrome hits young women particularly hard.
To date, no direct preventive measures against polycystic ovarian syndrome are known. Since being overweight is an important factor in PCO syndrome, you should change your diet and do enough sport. Furthermore, the annual gynecological check-up should be used. If PCO syndrome has been diagnosed, appropriate therapy should be started as early as possible. This is the only way to positively influence the course and avoid late effects.
In most cases, follow-up care for PCO syndrome proves to be relatively difficult, so that direct follow-up care measures for this disease are relatively limited. For this reason, those affected should consult a doctor at an early stage so that other complications or symptoms that can limit the quality of life of the affected person do not occur later.
The PCO syndrome cannot heal on its own, so the patient always has to be treated by a doctor. First and foremost, medications that promote the symptoms must be discontinued. However, the medication should only be discontinued with the consent of a doctor. Regular check-ups by a doctor during treatment are also very important in order to identify and treat further damage to the body at an early stage.
However, most of those affected are also dependent on a surgical intervention. Thereafter, strict bed rest should be observed, with those affected resting and resting. The support and care of one’s own family or partner is also very important, as this can also prevent depression and other mental disorders.
You can do that yourself
In addition to drug treatment, those affected can also actively counteract the symptoms of the PCO syndrome themselves. In most cases, a change in lifestyle is necessary.
In patients who are overweight, a reduction in body weight and a change in diet usually bring about a significant improvement. Above all, belly fat should be reduced. Physical activity such as light abdominal muscle exercises, jogging or Nordic walking can help. Regardless of the body weight of those affected, high-calorie food should generally be avoided. The consumption of sugary foods and white flour products should be avoided. Instead, it’s best to eat lots of vegetables, filling protein, whole grains, and oils with omega-3 fatty acids. Excessive alcohol consumption and smoking should be avoided. During pregnancy you should pay more attention to a healthy lifestyle and dietshould be taken into account, as there are certain risks such as miscarriages or gestational diabetes if you have PCO syndrome.
If you have a lot of body hair, professional permanent hair removal can help. If affected women suffer from severe acne, laser treatment is an option. For many of those affected, the disease is primarily a psychological burden. In these cases, psychotherapeutic help can also be sought. There are also a number of self-help groups and internet forums where those affected can exchange ideas with one another.