Polycystic ovary
Polycystic ovarian syndrome must be differentiated from an ultrasound with the visualization of polycystic ovaries, which contain small cystic images inside. Polycystic ovaries are a diagnosis that is made by ultrasound and that may not be accompanied by any symptoms, it simply refers to the presence of multiple follicles in the ovaries. Polycystic ovary syndrome is characterized by an endocrinological alteration that can have a very diverse gradation of symptoms. The name can be confusing, but it should be noted that it is not a problem of cysts in the ovaries but a hormonal alteration that gives rise to multiple follicles in the ovary.
The regulation of hormonal production in the ovary is done through the secretion by the pituitary of two hormones, LH and FSH. In PCOS, the pituitary gland produces an abnormally high amount of LH which causes the ovaries to produce more testosterone than usual. This elevation of testosterone, called hyperandrogenism, has several symptoms: acne, hirsutism and ovulation disorders, in addition to insulin resistance, which is considered a prediabetic state.
Therefore, the classic polycystic ovary syndrome describes obese, infertile women with acne and hirsutism and a history of menstrual disorders. On ultrasound, ovaries are observed with the presence of a large number of small follicles, in a much greater number than in a normal ovary. All of these symptoms can present to a very variable degree and frequently not all coexist.
Polycystic ovary syndrome has short-medium-term consequences that are: the absence of regular periods, excess hair and acne. On the other hand, it can lead to sterility due to an alteration of ovulation. In the long term they can have obesity problems with insulin resistance (so they need to produce more insulin to have the same effect). Obesity is accompanied by a greater appearance of arterial hypertension and an alteration in the metabolism of cholesterol and triglycerides, thus increasing cardiovascular risk.
In women with anovulatory cycles, the hormonal balance tends towards unbalanced estrogen and progesterone production, which is a risk factor for endometrial cancer, especially in women with obesity.
The short-term treatment in the woman who does not want to become pregnant is usually oral contraceptives since they regulate the rules and control the symptoms of acne and hirsutism. In addition, complementary treatments can be done for skin symptoms, such as permanent hair removal, dermatological acne treatments and nutritional control and physical exercise to control weight. In women who want to become pregnant and have a difficulty in ovulation, treatment can be given to facilitate it and achieve pregnancy. In women with impaired glucose tolerance, the doctor may prescribe medical treatment to help control sugar metabolism.
(Updated at Apr 14 / 2024)