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Polycystic ovary syndrome is a hormonal disease that affects one in ten women and is the number one cause of female infertility. What treatments are possible? How is the diagnosis made? What is hyperandrogenism? Update with a fertility doctor.
Definition: polycystic ovaries, a common cause of infertility
The ovaries are a key organ of reproduction. Under the effect of hormones, the follicles, which contain the oocytes, grow in size during the start of the menstrual cycle. Subsequently, only one continues its development to the end and releases an egg which can be fertilized. But sometimes a hormonal imbalance affects this complex process.
Polycystic ovary syndrome (PCOS) is one manifestation of this. Also called ovarian dystrophy, this hormonal disease affects 10% of women of childbearing age. It is characterized by an unusual increase in the production of androgens (male hormones) in the ovaries leading to an increase in ovarian follicles which then cause hormonal imbalance. This is called hyperandrogenism.
This causes irregularities in the menstrual cycle and ovulation disorders that complicate pregnancy. In the longer term, PCOS can also cause more serious health problems such as diabetes and heart disease. However, this syndrome remains little known to patients who sometimes take years to be diagnosed.
What are the symptoms of polycystic ovary syndrome (PCOS)?
It seems that there is a genetic predisposition to PCOS but this has yet to be scientifically proven. One thing is certain: environmental factors, including obesity, influence polycystic ovary syndrome.
Regarding the symptoms, they often appear during the first menstrual cycles and vary from one woman to another. The most common signs are difficulty getting pregnant due to an ovulation disorder. It also causes a menstrual cycle disruption, which can then be irregular, last more than 35 to 40 days, or even lead to no periods (amenorrhea).
The other symptoms of PCOS are:
- weight gain
- acne
- hyperpilosity, even hirsutism in 70% of women (excess hair on the face, chest, back or buttocks)
- hair loss, called alopecia, located on the top of the head and at the level of the frontal gulfs
- the appearance of dark spots on the skin, most often on the back of the neck, arms or groin
- depression
- anxiety
- sleep apnea
Ovulation disorders are responsible for infertility in about 50% of women with polycystic ovaries.
How to diagnose this disease and know if we are concerned?
In general, to diagnose PCOS, it is necessary to present at least two of these three criteria: an abnormality of ovulation, an excess of androgens or a high number of follicles visible during an ultrasound. A abdominopelvic ultrasound and blood test (dosage of blood sugar, insulinemia, lipid balance for cholesterol and triglyceride) are generally prescribed.
Pain treatment: how to cure polycystic ovary syndrome?
If you are suffering from any of the symptoms associated with PCOS, it is advisable first to consult a doctor who will be able to carry out the necessary checks and rule out all other possible causes.
PCOS cannot be cured, but there are a number of ways to manage symptoms effectively. You should also know that this syndrome generally subsides over time because the ovarian reserve decreases. Sometimes, weight loss can help regain an ovulatory cycle.
Studies have shown that in overweight women, a 5% drop in their body mass index (BMI) can have a positive impact on polycystic ovary syndrome. A contraceptive pill can also help regulate a cycle or alleviate acne or hyperpilosity problems.
Pregnancy: is it possible to get pregnant despite having PCOS?
Those who try to get pregnant with PCOS should see a fertility specialist who will be able to check for other problems, such as obstruction of the fallopian tubes or abnormalities on the spermogram, before recommending any medication.
Le Clomifène Citrate (Clomid) is often prescribed as a first-line treatment to stimulate ovulation. We are talking about ovarian stimulation. This treatment, which requires strict medical monitoring, is effective on ovulation disorders in 80% of cases. Other treatments such as ovarian stimulation with gonadotropins or In Vitro Fertilization (IVF) are also possible.