Hormonal acne - what to do, how to put the skin in order? Cystic acne (acne, acne): causes, treatment Nutrition for polycystic

Very vividly described walking through the torment, so familiar to me (diet, "blue light", raw food diet ....)

The causes of acne in mature women are laid out on the shelves.
Main reason - hormonal(Almost all women have experienced skin inflammation associated with the onset of menstruation in one way or another).
Tells about polycystic ovaries, as the cause of acne (I know this).
Statistics and diagnostic methods are given.

Now about the treatment.
1. Antibiotics erythromycin series - in 81% of cases they do not help.
2.Roaccutane(accutane) - does not help in 15-30%.
(Both options, antibiotics and Accutane, are notorious for severe side effects.)
3. In case of diagnosis of the hormonal nature of acne, it is recommended hormonal treatment with antiandrogenic effect in combination with local funds(creams).
And then a surprise awaited me. In addition to listing well-known contraceptive drugs (one of them - Yarina - in America Yasmin), officially recommended by the FDA for the treatment of acne, tells about the drug spironolactone- marketed under brand names spironolactone and aldactone, the main action of which is the removal of the symptoms of hypertension through a mild diuretic. In Russia, this drug is sold under the trade name "Veroshpiron".

I read about the treatment of acne by patients with polycystic disease with great interest - my gynecologist-endocrinologist did everything exactly like that. I learned that PCOS affects up to 15% of women and that it is a metabolic disease.
In PCOS, the body secretes an excess of insulin when it metabolizes carbohydrates, which causes fat accumulation and weight gain (damn, I didn't know!).
Insulin also suppresses ovulation, in response, the ovaries secrete testosterone. Testosterone, in turn, begins to suppress insulin (that is, the body tries to solve the problem on its own, as a result, testosterone is released in such quantities that it causes acne).

In addition to birth control drugs, my doctor in Moscow prescribed an anti-androgenic drug that suppresses ovarian function.
In the case of a patient in their magazine, she also received Ziana cream, which is an antibiotic. She was also put on a low-carbohydrate diet and cured.
I want to say that I also recovered at one time and was in remission for quite a long time, which allowed me to do peelings, smooth my skin and get married (hahaha).
But constantly drinking oral contraceptives turned out to be unrealistic for me, although the skin becomes very good - I start having wild migraines. I will ask my doctor about a diuretic, but I doubt it, since I have low blood pressure.

I hope the information was useful to those who have similar problems.

Hormones play an important role in the onset and development of acne in women, and although the exact mechanism of influence is unknown, androgens have been shown to act on the follicles and cause excess sebum production. Androgens are the so-called male hormones, but are normally present in both men and women. They are produced in the testicles (in men), ovaries (in women), and adrenal glands (in men and women). The best known androgens are testosterone and dihydrotestosterone, or DHT.

WHAT HORMONES AFFECT ACNE IN WOMEN

Studies have shown that androgen receptors exist in the sebaceous glands and cells lining the pores. If a woman has high levels of testosterone and dihydrotestosterone, they will in most cases affect these receptors. Simply put, these acne-causing hormones cause the skin to produce more oil, which will further feed the bacteria. Thus, by reducing androgens and testosterone, acne can also be reduced.

In addition, the testosterone precursor hormone DHEA (DHEA) also affects the functioning of the sebaceous glands. DHEA sulfate levels begin to rise long before puberty, when the adrenal glands begin to produce it. At this time, acne begins to appear in adolescents who have a genetic predisposition to it.

Given the above, with acne, women and girls should first pass hormone tests:

• testosterone,
• DHT (dihydrotestosterone),
• DHEA (dehydroepiandrosterone sulfate).

Additionally, the doctor may prescribe to pass:

• androstenedione,
• cortisol.

One of the factors that affect the increase in hormones is the food we consume. The typical diet for most people is high in saturated fat, processed grains, meat fats, refined sugars, and low in fresh vegetables, fruits, fish, fiber, antioxidants, and seaweed.

Healthy eating is one form of natural treatment for hormonal acne in women, and not because it comes from junk food, but because the quality of food can affect hormones, especially in adolescence or when there are endocrine problems.

Another way to balance hormone levels is to take certain herbs.

ACNE IN WOMEN WITH HORMONAL DISORDERS

Very often (especially after 30 or at a later age) they appear due to hormonal failure, for example, due to polycystic ovary syndrome. is a condition in which a woman has an imbalance of hormones. Usually in this case, there is a low level of estrogens and progesterone and a high content of androgens (male hormones that are found in small quantities in women). It is still not entirely clear what causes such a violation.

Symptoms of polycystic ovaries include:

• absence or irregular menstrual cycle,
• cystic ovaries (on ultrasound),
• hair on the body, chest, face and around the nipples,
• thinning hair on the head,
• acne,
• dark patches on the skin around the neck, armpits, groin, or chest
• reduction in breast size.

An increase in male androgen hormones is responsible for these "masculine" characteristics.

You can treat hormonal failure and acne with natural and natural methods: changing the diet to one that will reduce androgens, taking herbs (for example) and other natural supplements. Although (mostly oral contraceptive pills) are perhaps the most popular way to deal with PCOS and acne, they should only be used when prescribed by a doctor and when milder methods have not worked.

If you suspect that your acne on the face, chin, chest may be caused by PCOS or another hormonal disorder, consult a doctor for testing and diagnosis.

HORMONAL ACNE IN WOMEN: NATURAL TREATMENT

1. Take vitamins and herbs

Omega-3 fatty acids can lower testosterone in women and girls. Taking EPA and DHA supplements (such as quality fish oil) and adding more Omega 3s to your diet can help balance testosterone levels and eliminate acne.

Hormonal acne in women, as a rule, appears in the chin area. If you are experiencing acne in this area during your period, vitex may help. Vitex is an herb, also known as prutnyak and Abraham tree, which can be considered a folk remedy. It has been used with great success to treat women who have low progesterone in the luteal phase (the part of the cycle that starts after ovulation and ends the day before the next period) and high estrogens. Signs of low progesterone in women:

• depression,
• depression,
• mood swings,
• hormonal acne,
• nervousness and anxiety.

Symptoms of elevated estrogen include:

• breast pain and tenderness
• bloating during menstruation.

Prutnyak acts on the pituitary and hypothalamus by increasing luteinizing hormone (LH) and slightly suppressing the release of follicle-stimulating hormone (FSH). This leads to a shift in the ratio of estrogen to progesterone, increasing the latter. Vitex's ability to increase progesterone is a side effect, as the herb itself is not a hormone. You can take it only after passing the test for the content of this hormone in the blood, in order to avoid an excessive increase in progesterone, which, on the contrary, can stimulate acne. Also, with an increased level of LH, it is undesirable to drink Vitex.

The optimal time to take vitex herb is between 7-8 o'clock in the morning, because at this time the pituitary and hypothalamus are active and regulate female sex hormones. It takes about three months to get the effect.

1. Eat right

Studies have shown that when switching from a diet high in saturated fat to a diet with less fat and more polyunsaturated fats (nuts, fish, algae, green leafy vegetables) for six weeks, there was a significant decrease in androstenedione (the precursor of testosterone). on) and testosterone in the blood. These studies have been conducted over the years, and the effect of fiber (grains, vegetables, beans) on a woman's hormonal background has also been studied. A high fiber diet has also been found to reduce blood levels of testosterone, DHT, and DHEA.

The average daily fiber intake for a typical person is approximately 13 grams. The recommended daily dose is 25 grams for women and 38 grams for men. Including fiber in your diet is beneficial for those who suffer from acne.

1. Reduce your milk intake

DHT is able to bind to receptors in the sebaceous glands and turn them on, triggering acne and increased sebum production. Milk, in turn, affects the increase in DHT levels. Doctors have found that increased consumption of meat, protein foods, coffee, alcohol, sugar, and processed grains worsens acne. On the contrary, it is useful to include fruits, vegetables and whole grains in the diet. Eating too much meat, protein, and milk leads to acidosis. The main symptom of acidosis is fatigue. Other symptoms include:

• loss of motivation
• decreased sex drive,
• poor sleep quality
• depression and rapid mental and physical fatigue.

Additional symptoms of acidosis:

• sensitivity to cold
• low Blood Pressure,
• hypo- or hyperthyroidism,
• low blood sugar.

These symptoms are caused by the body using key minerals that are needed to nourish the nervous system, such as calcium, magnesium and potassium, to neutralize acids. Stress also causes acidity in the body, as research has proven. Alkaline foods (vegetables, fruits, honey, nuts, green tea) neutralize these acids and lower levels of cortisol, the stress hormone (which is most often elevated in women with hormonal acne).

Polycystic ovaries, or Stein-Leventhal syndrome (polycystic ovary syndrome), is a benign change in the structure of the ovaries, in which many small cysts form. The disease was first described in the thirties of the last century. It occurs both in women who have given birth and in those who have not yet had children. Cysts appear both inside the ovary itself and on its surface. Most often, polycystic disease is associated with the occurrence of endocrine disorders - pathologies of the pancreas and thyroid gland, hypothalamus, pituitary gland, in violation of the function of the ovaries themselves).

Note that normally, a healthy woman grows five to six follicles per cycle, in which eggs develop. In this way, nature provided the woman with the maximum opportunity for pregnancy. At the end of the maturation of the follicles, one of them bursts - with the most viable egg. The remaining follicles undergo reverse development, that is, they fade away under the influence of progesterone, which is produced after menstruation in the second phase of the cycle. When there is not enough progesterone in a woman's body, such follicles cannot degrade and are converted into cysts. Those follicles that have not developed remain on the body of the ovary and can be collected into whole bunches of grapes.

The disease can occur in adolescence, when girls are just beginning their menstrual cycle. In adult women, the occurrence of polycystic disease is associated either with endocrine disorders or with inflammation of the reproductive organs.

Among all diseases in gynecology, polycystosis occupies a specific weight of about five percent, that is, it is diagnosed in every twentieth woman.

Symptoms and signs

Despite the fact that in most cases, polycystic ovaries are asymptomatic, women can feel problems with the genitals. These signs include:

• menstrual irregularity- most often with polycystic disease, anovulation is observed, which leads either to too long periods (more than four weeks), or to a delay or complete stop of menstruation. Against the background of a long absence of menstruation, uterine bleeding occurs in patients due to the growth of the uterine mucosa. Such signs can appear even in adolescents, which parents usually attribute to the instability of the cycle.
• increased secretion of sebaceous glands, the appearance of acne, acne - a similar symptom in polycystic is caused by increased production of androgens. It is rather difficult for the patient to cope with such manifestations, since they are not amenable to symptomatic therapy.
• excess weight gain- a typical symptom of polycystic disease, which can cause an increase in body weight by ten to fifteen kilograms. Usually this extra fat is deposited in the abdomen, hips and waist, but can be distributed throughout the body. If the metabolism of fats and carbohydrates is disturbed, patients are at risk of diabetes mellitus.
• appearance of body hair- under the influence of hormones, patients discover the appearance of hair in places where they were not there before. So, in women, hair may appear above the upper lip, on the shins and thighs, on the abdomen, in the perineum. This phenomenon is medically known as hirsutism.
• lower abdominal pain This symptom does not occur in all patients. Usually the pain is pulling in nature, the intensity of the pain is weak, as at the beginning of menstruation. Sometimes the pain radiates to the lower back or pelvis.
• constancy of basal temperature- an increase in basal temperature in women indicates that ovulation has occurred - it is on this basis that the best days for conception are determined. Patients with polycystic ovaries have a constant temperature, which indicates that the woman is not ovulating.
• inability to get pregnant- even with unprotected regular sex life, patients with polycystic cannot become pregnant, which is also an indicator of problems with the ovaries.

Causes and risk factors

Polycystic ovary syndrome is not caused by any one cause. The etiology of this disease is based on a number of factors. Doctors see the main cause of polycystosis in multiple endocrine disorders, namely:

• in dysfunction of the hypothalamus and pituitary gland, affecting the functioning of the ovaries and adrenal glands;
• in violation of the adrenal cortex, which increases the level of androgen production;
• in malfunctions in the functioning of the ovaries, manifested by problems with ovulation and an increase in estrogen levels;
• in the pathology of the pancreas, which produces insulin more than normal.

These violations lead to the fact that the follicles cease to fully mature, their immature capsules increase in size and become denser, forming multiple cysts. As a consequence of this process, a woman cannot become pregnant and have a normal cycle. The situation is aggravated by a set of excess body weight, which occurs in forty percent of women suffering from polycystic disease.

In addition to these reasons, there are risk factors that can affect the onset of endocrine disorders. Such factors include past infectious diseases, frequent stress, climate change.

Diagnosis of polycystic ovaries

In order for the doctor to begin to suspect polycystic ovaries, at least two factors must be indicated in the patient's history:

• violation of the menstrual cycle in the form of amenorrhea or oligomenorrhea, as a result - the inability to become pregnant;
• increased production of male sex hormones, manifested by oily skin, acne, excessive hair growth;
• the result of hardware studies confirming an increase in the ovaries.

During the diagnosis and evaluation of the results of the study, it must be remembered that polycystic ovaries are differentiated from a disease such as multifollicular ovaries. On ultrasound, multifollicular ovaries are quite common, but true polycystic is much less common.

Diagnosis of the disease begins with a general examination of the patient and an assessment of certain criteria.. The doctor determines the patient's body type, skin condition, the presence of acne, excessive hair growth, palpation of the abdomen is performed. The second stage is an examination on a gynecological chair, with the help of which it is possible to assess the size of the ovaries (palpation of the ovaries with simultaneous pressure on the lower abdomen). After that, the doctor prescribes an ultrasound examination of the pelvic organs. Women with polycystic ovaries are diagnosed with bilateral enlargement up to six centimeters in length and four centimeters in width, while on the monitor screen the doctor sees dark oval outlines corresponding to cysts. However, with minor cysts, it is not always possible to see them, and the ovaries may outwardly have a completely healthy appearance. Ovaries with polycystic disease have a dense structure, they contain several cysts (usually eight to twelve, each cyst can be up to one centimeter in size in size). Doppler shows an increase in blood flow in the vessels of the ovaries.

The next stage of the study is laboratory tests. With polycystic ovaries in the blood of women, the level of hormones of the pituitary gland, adrenal glands and ovaries, luteinizing hormone, androstenedione, testosterone, cortisone and others is assessed. Additionally, analyze the level of glucose, insulin and lipids in the blood. In order to exclude tumor processes in the ovaries, magnetic resonance imaging is performed.

If all the signs indicate polycystic ovaries, but ultrasound diagnosis is doubtful, then in such cases diagnostic laparoscopy is performed - a special device is inserted into the abdominal cavity with a small incision, which displays a picture of the state of the internal organs on the doctor's screen. Thus, it is possible to establish 100% whether this diagnosis takes place.

Complications in polycystic

Polycystic ovary syndrome is caused primarily by hormonal causes, which means that the disease can cause complications, also associated with hormonal imbalances. The most severe complication of the disease is the inability of a woman to become pregnant.

If a woman does not respond properly to the symptoms of the disease and does not seek medical help within the first two years of the onset of the disease, then she is at increased risk of cervical and breast cancer.

Metabolic disorders, and primarily fats, lead to the development of vascular atherosclerosis, stroke, myocardial infarction, fatty liver hepatosis.

In order to avoid complications with polycystic disease, it is necessary to identify the disease at an early stage and immediately begin treatment.

Treatment of polycystic ovaries

All treatment of polycystic disease should be aimed at restoring the natural menstrual cycle, ovulation, and the level of female sex hormones. All these goals are interconnected and should be achieved in a comprehensive manner. The basis of the treatment of polycystic ovaries is hormonal therapy, but if it is impossible to cure the disease with conservative methods, doctors resort to surgical intervention.

Women suffering from polycystic are prescribed drugs that gently act on the body. The trial therapeutic course is six months. Until a few decades ago, for the treatment of polycystic, drugs were prescribed that led to severe weight loss. For those who were not overweight, this became a serious problem. Now there is an opportunity to prescribe a remedy that does not have side effects. One of the most popular medicines among doctors is Clomiphene. This drug successfully stimulates ovulation in seventy percent of patients, and another forty percent, after taking Clomiphene, conceive a child without any problems. Similarly to Clomiphene, the drugs Horagon, Metrodin, Menagon also act. Additionally, drugs such as Diane-35, Marvelon, Janine, Metformin are prescribed.

For conservative treatment, drugs that inhibit the production of estrogens and androgens are used. These funds will help to remove male features - hair, acne, overweight. In parallel with this, gonadotropins that stimulate ovulation are widely used.

Also, you can not ignore your attention and taking vitamins. For the normalization of metabolism, vitamins are of great importance. In particular, they normalize the concentration of androgen and insulin. For the treatment of polycystic, vitamin C, E and group B are prescribed. Among the trace elements, selenium, calcium, magnesium, zinc and chromium are prescribed. All of the above elements are contained in multivitamin complexes, which are widely represented in the pharmacy chain.

If these methods do not lead to an improvement in the state of health, there is a need for surgical intervention. Modern techniques make the operation less traumatic. Such techniques are called minimally invasive, sparing. Laparoscopy is performed under anesthesia, there are no scars after it, and after three to four days after the operation, the woman can go home. With polycystosis, it is possible not to completely remove the ovary, but to remove only the part affected by cysts. This technique is called wedge resection. With a wedge resection, as a rule, about two-thirds of the organ is removed. Otherwise, doctors may resort to cauterization - cauterization of the affected tissue and preserving the ovary completely. Cauterization is done in a hospital under general anesthesia. A small hole (about 1 centimeter) is made in the area near the navel, through which a trocar, a special metal tube, is inserted into the cavity. The trocar allows the insertion of a flexible laparoscope. Then, in the iliac region, two small incisions are made on both sides for the introduction of surgical instruments. The ovary is fixed in a position convenient for the doctor, and with the help of a coagulator or a laser, notches of one and a half to two centimeters are made on the surface of the ovary. The depth of the notches is five millimeters, the width is two to three millimeters. Similar manipulations are carried out on two ovaries. At the end of the operation, both ovaries are already significantly reduced in size. A significant plus of cauterization is that the ovary is completely preserved, and pathological formations are removed.

As a result of such interventions, the level of androgen production decreases, and ovulation normalizes. After cauterization, pregnancy can occur already at the first full cycle. On average, the restoration of normal hormonal levels and the resumption of ovulation may take from six months to one year.

Polycystic ovaries and pregnancy

The diagnosis of "polycystic" is not a reason to abandon the idea of ​​having a baby. It's just that for this you have to go through a more difficult path than healthy women. In medicine, there are a lot of cases when women with a similar diagnosis successfully became pregnant, carried and gave birth to a child. During the bearing of a child, a woman is prescribed maintenance therapy - Duphaston, Utrozhestan and other drugs that prevent miscarriage. Since pregnant patients have such a formidable diagnosis, they are also closely monitored in the third trimester, when there is a threat of gestational diabetes, high blood pressure, and weight gain. However, if all the doctor's prescriptions are followed, pregnancy with polycystic disease is quite possible.

As a result of surgical intervention, more than sixty percent of women manage to achieve a positive result - they successfully become pregnant and bear children. Doctors insist that couples decide to continue the family as soon as possible after the operation, since the effect of the operation is not long - about three years. In order to support a woman during the conception of a child, she is prescribed drugs that stimulate the maturation of the egg. If you miss the remission time, then it will be more difficult to get pregnant in the future.

In some cases, pregnancy itself can help cure polycystic disease, since during the conception and gestation of the fetus, tremendous hormonal changes occur in the female body.

Diet for polycystic

When treating a disease, it is very important that a woman helps her body overcome the disease, so doctors insist on sufficient daily physical activity and diet.

• reducing the level of calorie intake to one thousand two hundred calories per day;
• switching to fractional frequent meals (about five to six times a day);
• the diet should contain more low-calorie foods - vegetables and fruits;
• increase in protein intake (primarily from fish and seafood, cottage cheese, meat);
• restriction of carbohydrates (sugar, carbonated drinks, pastries);
• the exclusion of animal fats and the transition to vegetable;
• exclusion of any doses of alcohol;
• eating food without spices, seasonings, spices
• refusal of smoked, pickled products.

As a result of observations of patients, it was possible to find out which products are most useful for women with polycystic disease:

• vegetables - lettuce, broccoli, bell peppers (red and yellow), garlic, lettuce, zucchini, eggplant, cucumbers, carrots, asparagus, celery, garlic;
• fruits - plums, oranges, grapefruit, kiwi, apples, cherries, pears;
• greens - rosemary, parsley, dill, basil;
• grains and legumes - beans, whole grain bread, beans, durum pasta, peanuts, soybeans, pumpkin, brown rice;
• vegetable oils - sesame oil, milk thistle oil, linseed oil, olive oil, pumpkin seed oil;
• dried fruits - raisins, prunes, figs, dried apricots;
• dairy products - cheese, cottage cheese, yogurt and low-fat milk;
• meat - chicken, quail, ostriches.

It is very important for polycystic not only to stick to a diet, but also to give the body moderate physical activity. This will not only contribute to getting rid of excess weight, but also to consolidate the result for a long time. At least two hours a week of intensive training is enough for the body to get rid of two to three kilograms per month.

Disease treatment prognosis

It should be noted that it will not be possible to completely cure polycystic ovaries, however, it is quite possible to minimize its manifestations and achieve lasting improvements for some time. The main goal that women with polycystic ovaries achieve is the onset of pregnancy. Therefore, in order for a woman to become pregnant, it is necessary to conduct a complex of hormone therapy. In most cases, doctors manage to achieve their goals.

It should be taken into account that the disease progresses with age and is less and less amenable to conservative treatment. Therefore, the issue of pregnancy should be raised as early as possible in order to succeed.

Prevention

It is quite difficult to predict polycystic ovaries or, moreover, to take any measures to prevent the disease. For women of all ages, it is important to monitor the menstrual cycle, visit a gynecologist with scheduled examinations at least once a year. It is also worth paying attention to the use of hormonal contraceptives - such drugs are prescribed only by a doctor after an examination and obtaining the results of laboratory tests. In all other cases, self-medication can lead to hormonal imbalance and polycystic ovaries.

What is polycystic ovaries

Polycystic ovary syndrome can be found, on average, in one in fifteen women. Often the symptoms of the disease are already present in adolescence. Treatment of the syndrome helps control unwanted symptoms and prevent more serious possible health problems in future.

Hormones and associated processes in the body

Hormones are chemical messengers that drive many different chemical reactions in our bodies, including growth cells and energy production. Very often the role of one of the hormones is to notify organism about the production of another hormone.

For reasons that are not entirely clear, hormone levels in this syndrome are outside the normal range. And thus, one hormone can change the production of another, which in turn will change the level of the third. For example:

• violation of the content of sex hormones. Small amounts of male sex hormones (androgens) are produced by the ovaries. With polycystic ovaries, the production of a little more androgens begins. This can lead to the cessation of ovulation, the formation of acne, the growth of additional hair on the body and face;
• the body can "resist" the use of insulin, causing insulin resistance. When our body is unable to use insulin efficiently, there is an immediate rise in blood sugar levels. Over time, this can lead to diabetes.

Symptoms of polycystic ovary syndrome

Signs at the beginning of the development of the disease are mild. Some or most of the following symptoms may be present:

• appear acne ;
• body weight increases, and there are problems with its reduction;
• additional hair grows on the face and body. In very common cases, women are faced with the growth of thicker and darker hair on the face and hair on the back, chest and abdomen;
• hair falls out on the head;
• there are irregular intervals between periods. Often, women with this syndrome have fewer than 9 cycles per year. Some do not have periods at all, others have heavy bleeding;
• infertility problems. Many women fail to conceive (are infertile);
• depressive state.

Most women with this condition develop many small cysts in their ovaries. It was this fact that determined the name of the disease - polycystic ovary syndrome. The presence of cysts is not harmful in itself, but at the same time leads to hormonal imbalance.

Causes of polycystic ovary syndrome

All causes of the syndrome are associated with changes in hormonal levels in the body. There are one or more reasons for this.

Very often, the disease is inherited, so the chance of getting sick is higher for those who have women in the family who had polycystic ovaries or diabetes, had irregular menstruation. Polycystic can be transmitted through both the female and male lines of relatives.

Diagnosis of polycystic ovary syndrome

To diagnose, the attending physician will perform the following procedures:

• ask questions about health status, symptoms and menstrual cycle;
• Examine carefully for signs of PCOS, such as being overweight and having high blood pressure. Be sure to measure height and weight to calculate BMI (body mass index);
• send for blood donation for analysis to determine the level of hormones, sugar and insulin. A hormone test can help rule out issues related to the endocrine system that can cause similar symptoms.

In addition, there may be ultrasound procedure pelvis for ovarian cysts. If the doctor is able to diagnose the syndrome without conducting ultrasound, it can be done in order to exclude other diseases from the causes of symptoms.

Treatment of polycystic ovary syndrome

Regular exercise, healthy food and weight restriction are the keys to treating this syndrome. In addition, to balance the level of hormones, you can carry out drug treatment associated with taking medications. Treatment can reduce unpleasant symptoms and possible health problems in the future.

The first step to treatment is regular exercise and a healthy food. This helps lower blood pressure and cholesterol levels, reduce the risk of heart disease and diabetes, and will also allow lose weight :

• food must be healthy. Include in your diet an abundance of fruits and vegetables, nuts and legumes, and whole grains. Limit your intake of high-fat foods such as meat , cheese and fried products. If you have problems with high sugar levels, try to eat the same amount of carbohydrates every day. A qualified dietitian will be able to prepare an appropriate daily meal plan;
• regularly alternate between moderate and heavy stress on the body. Walking- magnificent an exercise which most people can afford;
• most women with PCOS can benefit from weight loss. Even the loss 4.5 kg can help balance hormone levels and normalize the menstrual cycle. The syndrome usually makes it difficult to effectively weight loss, therefore, a prerequisite is a consultation with a doctor to draw up individual weight loss plans and create the most favorable conditions for weight loss;
• be sure to stop smoking. Women who smoke have an increased level of androgens, which contribute to the further development of this syndrome. In addition, smoking increases the risk of heart disease.

In the treatment, the doctor may also use the following means:

• contraceptives tablets. Taking these drugs will help normalize menstrual cycles and reduce unpleasant symptoms, such as male pattern hair growth and the presence of acne. For even greater effect, spironolactone can be used along with birth control pills, which stimulates a decrease in the level of androgens in the blood. Of course this therapy not used if the patient is trying to become pregnant;
• in the presence of diabetes - metformin. This therapy can help normalize menstrual cycles and fertility;
• when the patient tries to get pregnant - technologies for artificial conception of a child or surgical intervention.

It is very important that the doctor monitors the effectiveness of treatment in a timely manner and, if necessary, makes the necessary adjustments. As part of your treatment, you may need to have regular blood sugar tests, measure your blood pressure, and monitor other parameters that may indicate problems in your body.

It may also be necessary to treat unwanted symptoms of the disease, for example, growth of hair on the face and body, the appearance of acne, for which they use:

• special drugs, which can be purchased without a prescription, or prescribed by a doctor, effective in combating the problem of acne;
• methods of hair removal by pulling with glued wax, medical tweezers or shaving. laser or electrolysis depilation allows you to permanently get rid of them, but is more expensive. In addition, the doctor may prescribe recipe a special cream to slow down hair growth, if used on a regular basis.

In moral terms, it is quite difficult to realize the presence of this syndrome in oneself. You can feel the sudden sadness or become depressed, in which case talking to a qualified counselor or another woman who also suffers from it can help. Check with your PCP for availability of local consultants, or find online groups on the Internet yourself. With this disease, it is very important to realize that you are not alone.

Causes of polycystic ovary syndrome

The causes of the disease are not well understood, but it is believed that the occurrence of the disease is largely due to heredity. If you have polycystic ovaries, then 50% of your sister or daughter will have similar problems.

It is known that the syndrome is associated with a change in the level of hormones in the body. One hormone can affect the production of another, which in turn affects the third.

Problems associated with PCOS include:

• Imbalance of hormones produced by the ovaries. If the level of hormones that “trigger” process ovulation, does not meet the required level, the egg is not produced every month. In some women, cysts form directly on the ovaries and produce androgens.
• An increase in the content of androgens (male sex hormones) causes problems with male-type hair growth and acne, and also contributes to the complete cessation of the ovulation process.
• Elevated levels of insulin and blood sugar. About half of women with this syndrome suffer from insulin resistance. organism- the inability of the body to fully use the hormone insulin produced to process sugar. If your body can't use it effectively, your blood sugar will always rise to unacceptably high levels. If insulin resistance is left untreated, it can lead to the development of type 2 diabetes.

Symptoms of polycystic ovary syndrome

The symptoms of the disease develop gradually over time. Often, the change in hormone levels associated with the development of the disease begins in early adolescence after the first menstruation. especially noticeable symptoms become after the acquisition of excess body weight.

Several or many symptoms may be associated with the disease. The general symptomatology of the syndrome often leads to diagnostic errors, since it is similar to the symptoms of other diseases.

Symptoms in the initial stage of the development of the syndrome

Early symptoms include:

• a reduced number or complete absence of menstrual cycles, which can range from 9 cycles per year (with more than 35 days between them) to no menstruation at all. Some women with the syndrome have regular periods, but ovulation does not occur monthly, which means that ovaries do not release an egg every month;
• severe irregular bleeding from the vagina. Almost 30% of all women with the syndrome have this particular symptom of the disease;
• hair loss on the head, accompanied by their growth on the face, chest, back, abdomen, thumb arms or on the toes (hirsutism). Nearly 70% of all American women suffering from PCOS complain of similar hair problems caused by elevated levels of androgens in the blood;
• the appearance of acne and oily skin also occurs as a result of an increase in the content of androgens in the blood;
• depression or sudden mood changes.

Living with the symptoms of the syndrome can go a long way in determining overall well-being, sexual satisfaction and, in general, affect the quality of life. These symptoms can also lead to severe depression.

Symptoms that appear over time

Symptoms of the disease, manifested over time, include:

• baldness male type hair. Perhaps the appearance of thinning hair (alopecia). The reason is also associated with an increased content of androgens in the blood;
• weight gain or obesity in the upper part of the body (more around the abdomen than around the hips). The effect is associated with a high level of androgens in the blood;
• recurring miscarriages. The exact causes of miscarriages in the presence of the syndrome are not known. May be related to high blood levels of insulin, delayed ovulation, or other causes such as the quality of the egg produced or the quality of its attachment to the uterine wall;
• signs of excessive insulin levels in the blood (hyperinsulinemia) and insulin resistance, which may include weight gain and changes in the surface of the skin, such as the appearance of moles, warts, dark spots, velvety areas in the armpits, groin and genitals;
• sleep breathing problems (obstructive sleep apnea) are associated with both obesity and insulin resistance;
• high blood pressure is the most common symptom among women with the syndrome, especially those with increased body weight.

The common reasons women go to the doctor are:

• problems with menstruation;
• infertility;
• male pattern hair growth (hirsutism) on the face and body;
• excess body weight or obesity of the upper part of it.

Consequences for a woman

This syndrome belongs to a group of diseases caused by an imbalance of hormones. Common symptoms include irregular cycles between periods, infertility, recurrent miscarriages, hair loss on the head and appearance of hair on the face and body in a male pattern, acne and obesity. The disease increases the risk associated with the development of serious diseases, including hypertension (high blood pressure), heart disease, diabetes, and endometrial crayfish uterus.

Problems with the reproductive function of the body

The hormonal imbalance associated with the syndrome causes typical pregnancy problems and some associated problems:

• inability to become pregnant (infertility) is a consequence of the absence of ovulation;
• recurring miscarriages. The exact causes of miscarriages in the presence of this disease are not known. May be related to high blood levels of insulin, delayed ovulation, or other causes such as the quality of the egg produced or the quality of its attachment to the uterine wall;
• development gestational diabetes during pregnancy. The risk of acquiring diabetes during pregnancy is significantly higher among women with the syndrome compared with women who have regular ovulation cycles;
• high blood pressure during pregnancy and childbirth, birth a child with excessively high or low body weight or the birth of a premature baby;
• precancerous condition of the uterus (endometrial hyperplasia). May be due to the lack of regular menstruation, which usually "remove" the endometrial thickening in the uterus every month. Contraceptive use tablets or other hormonal agents are effective in reducing the risk of endometrial hyperplasia;
• uterine cancer, the risk of its development during the reproductive periods of life in women with this disease is 3 times higher than in women with regular monthly ovulation cycles.

During menopause, the frequency of menstruation may return to normal. The reason for this phenomenon is not known. But despite this, having PCOS in the future still increases the risk of high blood pressure (hypertension), diabetes, heart disease, or endometrial cancer.

Problems with insulin and sugar metabolism

Insulin is a hormone that helps the cells in our body get sugar needed to generate energy. Sometimes the cells do not respond properly to the production of insulin and cannot absorb sugar. This phenomenon is called "insulin resistance". Insulin resistance can lead to high blood sugar levels and diabetes.

By age 40, up to 40% of women with PCOS have insulin resistance and up to 10% have type 2 diabetes. People with insulin resistance have elevated levels of insulin in their blood. This condition contributes to the production of male sex hormones, further aggravating the course of the underlying disease.

The most likely health problems associated with insulin resistance are:

• increased blood pressure;
• increase in triglycerides;
• low cholesterol level;
• increased blood sugar;
• excess body fat (usually in the abdomen).

Heart and circulatory problems

It is quite possible with elevated insulin levels to exacerbate problems associated with the functioning of the heart and circulatory system. These problems include:

• blockage of blood vessels (atherosclerosis);
• increased blood pressure;
• cordial attack and coronary artery disease;
• elevated cholesterol;
• stroke.

Sleep breathing problems

Women with this syndrome have a higher risk of sudden cessation of breathing during sleep. Possible respiratory arrest is associated with obesity and insulin resistance.

Factors that increase the risk of developing polycystic ovaries

The main risk factor for the occurrence and development of the disease is heredity. Experts believe that a combination of genes is responsible for the development of the disease. If you have this syndrome, then 50% of your sisters or daughters will have it.

An additional risk factor is family history of diabetes. A significant association has been established between diabetes and this disease. Research on this topic is still ongoing.

Time to see a doctor

Given that the disease is chronic, the symptoms appear gradually. The symptoms of polycystic disease are similar to other diseases, so the disease can be mistaken for something else.

He has a wide range of symptoms, ie. it is unequivocally difficult to determine the need to visit a doctor. However, it is with the help of early diagnosis and treatment of the syndrome that serious health problems can be prevented, including heart disease, diabetes and others. Therefore, visit a doctor if you find yourself with signs of the syndrome, which are described below.

For teen girls:

• if at the age of 14 years menstruation has not yet begun and hair is growing on the back, chest, abdomen or face (hirsutism);
• if at the age of 15 years menstruation has not yet begun or menstruation does not begin within 2 years after the appearance of breasts and hair growth in the genital area;
• if there are less than 8 menstruations per year and this condition lasts for 2 years after the appearance of the first menstruation;
• if a lot of acne appeared on the body;
• if head hair loss is noted;
• if excessive hair growth is noted, or hair grows on the back, chest, abdomen or face;
• if menstrual cycles last less than 21 days and more than 41 days;
• if any signs of diabetes are present, such as constant thirst, frequent urination (especially at night), an unexplained increase in appetite, fatigue, incomprehensible weight loss, blurring of the image in the eyes, tingling or numbness in the hands and feet;
• if any skin problems, namely the frequent formation of acne, oily skin, dandruff, new moles and warts (acrochordons) in the armpits and neck or dark patches of skin (acanthosis nigricans, black acanthosis, pigmented papillary cutaneous degeneration) in skin folds, on the neck, in the groin or armpits;
• excessive obesity or obesity is greater in the abdomen than in the waist. This effect is associated with an increased content of androgens;

For women aged 20 to 40:

• if menstrual cycles last less than 21 days and more than 35 days;
• if there are regular menstrual cycles, but attempts to get pregnant have been unsuccessful for 12 months;
• if for more than 8 days there is vaginal bleeding, heavy bleeding or the release of large blood clots;
• if there is pain in the pelvic area for more than 4 weeks;
• if excessive hair growth is noted or hair grows on the back, chest, abdomen, or face (hirsutism);
• if any signs of diabetes are present, such as persistent thirst, frequent urination (especially at night), unexplained weight loss, unexplained increased appetite, fatigue, blurred vision, tingling or numbness in the hands and feet;
• if you have skin problems, namely, frequent acne, oily skin, dandruff, new moles and warts (acrochordons) appear in the armpits and neck, or dark patches of skin (acanthosis nigricans, acanthosis nigricans, pigmento-papillary cutaneous degeneration) ) in skin folds, on the neck, in the groin or armpits;
• if there is a tendency to frequent depression and mood swings. Many women with the syndrome have emotional problems due to excessive hair growth, obesity, or infertility;
• excessive obesity or obesity is greater in the abdomen than in the waist. This effect is associated with an increase in testosterone (male sex hormone) and is known as android obesity;
• if there is a desire to quit smoking with a long smoking experience.

For women over the age of 40:

• if there is vaginal bleeding, heavy bleeding or the release of large blood clots for more than 8 days;
• if there is pain in the pelvic area for more than 4 weeks;
• if any signs of diabetes are present, such as persistent thirst, frequent urination (especially at night), an unexplained increase in appetite, unexplained weight loss, fatigue, blurring of the eyes, tingling or numbness in the hands and feet;
• if any signs of heart disease are present, such as pain or heaviness in the chest, rapid shortness of breath, unusual tiredness, increased blood pressure (hypertension);
• if there is a tendency to frequent depression and mood swings. Many women with the syndrome have emotional problems due to excessive hair growth, obesity, or infertility;
• if there is a desire to quit smoking with a long smoking experience.

Using watchful waiting

A wait-and-see approach when this problem is suspected is unacceptable. Early diagnosis and treatment of the disease can prevent future complications with reproductive function, metabolism or heart disease.

Who to contact

Health care providers who can help both diagnose and treat PCOS include:

• gynecologists;
• obstetricians;
• family doctors;
• nurses;
• laboratory assistants, physician assistants;
• therapists;
• endocrinologists (pediatric and general practice);
• reproductive endocrinologists;
• nutritionists.

Diagnostic procedures

If there are signs of the syndrome, such as problems with the frequency of menstrual cycles or the inability to become pregnant for a long period, it is necessary to visit a doctor. As already mentioned, the syndrome increases the likelihood of infertility, uterine cancer, heart disease and diabetes. If you have already been diagnosed with this syndrome, regular health checks are necessary to prevent serious complications in the future.

Several diagnostic procedures will be required. The doctor will ask about the present symptoms, conduct an examination and send for laboratory tests. They may also ask for a pelvic ultrasound.

The usual sequence for diagnosing:

• Questioning – Your doctor may ask you about changes in your weight, skin, hair, and menstrual cycles. Additional questions may relate to medications used, food preferences, physical activity, problems conceiving a child. Be sure to tell us if you have had severe hair loss on your head or vice versa - excessive male-pattern hair growth on the body or face. You should also report any hormonal (endocrine) problems, including diabetes, that members of your family have had;
• physical examinations - blood levels of thyroid hormones will be checked, skin, hair, breasts and abdomen will be visually checked, blood pressure will be measured, and the pelvic area will be examined to detect enlarged or abnormal ovaries. Your doctor may also report your BMI after measuring your weight and height.

In addition to these procedures, often for the diagnosis of "polycystic ovaries" use the definition of indicators indicating the development of the disease. Such indicators are the high content of androgens, sugars and fats (lipids) in the blood. Additionally, you may need to:

• a test for the presence of the hormone human chorionic gonadotropin - to determine the fact of pregnancy;
• test for the content of testosterone, androgen. Androgens at high levels can completely stop the ovulation process and cause acne, male-type hair growth on the body and face, and hair loss on the head;
• a test for the content of the level of prolactin, the imbalance of which can negatively affect the delay in menstruation or the appearance of infertility;
• a test to determine the level of cholesterol and triglycerides in the blood, usually outside the normal range in the presence of polycystic ovaries;
• determining the content of thyroid-stimulating hormone to determine the excessive or insufficient work of thyroid hormones;
• biochemical blood tests to determine the content of cations, anions, biologically active substances and blood glucose levels;
• an adrenal hormone test, such as DHEA-S hormone or 17-hydroxyprogesterone. Adrenal problems can cause symptoms similar to those of PCOS;
• blood glucose and insulin test, which can be used to determine the presence or absence of insulin resistance.

An ultrasound examination of the pelvis will help determine the enlarged ovaries or an increased, compared with the normal content, the content of eggs in the ovaries, which, in fact, are signs of the presence of polycystic ovaries. However, many women suffering from polycystic ovaries do not show these signs.

Regular check-ups for diabetes, heart disease, and uterine cancer

Diabetes. In the presence of the syndrome at the age of 30, doctors recommend that women undergo a test for blood glucose levels to diagnose diabetes. The study can be performed at an earlier age if the syndrome is accompanied by other causes of diabetes, i.e. obesity, sedentary Lifestyle, poor heredity for diabetes or the development of gestational diabetes during pregnancy. The doctor will determine the frequency of testing depending on the specific situation.

Heart diseases. Cholesterol and triglyceride levels, blood pressure and body weight should be checked regularly. These actions are necessary due to the fact that the syndrome contributes to an increase in blood pressure, cholesterol levels in the blood, the development of obesity, heart disease, blockage of blood vessels (atherosclerosis), cardiac seizures and a heart attack.

endometrial cancer of the uterus. Regular menstrual cycles allow you to normally rid the body of endometrial thickening in the uterus. If this does not happen, the endometrial thickening in the uterus becomes larger and larger, provoking a precancerous condition. If you have had irregular menstrual cycles for at least 1 year, your doctor will order a transvaginal ultrasound and/or endometrial biopsy to look for signs of precancerous conditions or cancer.

An Overview of Treatment Options for Polycystic Ovarian Syndrome

The problem belongs to the group of diseases caused by imbalance of hormones. The disease is often accompanied by irregular menstruation, beginning at puberty, or difficulty conceiving a child.

Important factors necessary for the treatment of this syndrome are regular exercise, a healthy diet, abstinence from smoking and tight control of body weight. To stabilize the hormonal level, sometimes medications are also indicated.

There are no specific treatments for this disease, while at the same time, with strict control, it is possible to reduce the risks of developing other problems (infertility, diabetes, heart disease, uterine cancer).

Initial treatment for polycystic ovaries

Treatment of the syndrome should begin with regular exercise, healthy eating, and smoking cessation. This approach is not only a way of life, but a medical procedure. Additional treatment depends on the symptoms of PCOS and plans to have a child in the future:

• if body weight is greater norms, then even a small loss of it will most likely help to balance the hormonal level and stabilize menstrual cycle and ovulation. Exercising on a regular basis and limiting your food intake to a healthy diet to lose excess weight is the first big step towards healing. This is especially important if pregnancy is planned in the future;
• if you smoke, try to quit. Women who smoke have higher androgen levels than non-smokers. And it also increases the risk of heart disease;
• if you are planning a pregnancy, and weight loss does not have a positive effect on the conception of a child, the doctor may use medications aimed at lowering insulin levels. With weight loss, your body's ability to ovulate and become pregnant greatly improves. Fertility drugs may also promote normal ovulation;
• if pregnancy is not in your plans, hormone therapy can be used to control ovarian hormones. Contraceptives that help reduce the layer of endometrial thickening in the uterus help in correcting problems associated with the menstrual cycle. This greatly reduces the chance of uterine cancer. Taking hormonal drugs will help to solve the problem with unwanted hair growth and acne. The use of birth control pills and vaginal rings is prescribed for hormone therapy. Spironolactone (aldactone) is often used in combination with progestin- and estrogen-based contraceptives to lower androgenic hormone levels. Lowering androgen levels will help resolve issues with hair loss, acne, and hirsutism.

At the same time, taking hormonal drugs will not solve problems with heart disease, blood pressure, blood cholesterol, and the risk of diabetes. That is why sports and a healthy diet are very important, which are the main part of the treatment of the syndrome.

Complementary treatment to bring the menstrual cycle back to normal, solve problems with hair growth and acne on the skin

Additional treatments for problems associated with PCOS include:

• hair removal by laser, electrolysis, wax, chemicals, pulling out with medical tweezers;
• medical treatments for the skin. Acne medications can be sold with or without a prescription. Some of them should be taken orally, others are only applied to the skin. There is no need to remove pigments on the skin if it is missing irritation. In general, such problems are easily solved even in ordinary hospitals.

Teenage girls. Early diagnosis and timely treatment can help prevent subsequent long-term complications of PCOS, such as excess body weight, diabetes, and infertility.

Continuous Treatment

To be able to control body weight, ensure normal metabolism for a long time, exercise regularly, eat healthy diets. This will reduce the risk of diabetes and heart disease, as well as hirsutism, skin problems caused by hormones.

To bring the cycle back to normal, hormone therapy is needed, which will reduce the duration of the endometrial thickening in the uterus and prevent uterine cancer. When conducting hormone therapy, it is mandatory to use birth control pills, suppositories or vaginal rings.

Spironolactone (aldactone) is often used in combination with progestin and estrogen birth control pills to lower androgenic hormone levels.

Visit regularly a gynecologist's office in order to promptly diagnose any complications associated with PCOS, such as high blood pressure, excessive blood cholesterol, uterine cancer, diabetes, heart disease. To all women for 30 years suffering from this syndrome should be regularly checked for diabetes.

Treatment of infertility in polycystic ovaries, primarily associated with the normalization of the process of ovulation:

• in the presence of this syndrome and excess body weight, its reduction may be exactly the means that is necessary for the process of ovulation. Losing weight by 5-7% or less within 6 months will help reduce the level of cholesterol and male sex hormones in the blood. This will normalize the course of the ovulation process and the ability to conceive in more than 75% of women who have experienced the syndrome;
• if ovulation is not achieved through weight loss (or if you are not overweight and do not need to reduce it), your doctor may use medication, prescribe non-steroid drugs metformin or clomiphene. Reception of drugs must be carried out for several months. The combination of these two methods of treatment often leads to the launch of processes that cause ovulation;
• if metformin or clomiphene are not effective, they may prescribe a hormonal preparation of gonadotropin, which is very similar to the human hormone that ensures the flow of ovulation. However, taking such drugs increases the risks associated with the development of an unwanted pregnancy with two or even more embryos.
• Until the time of treatment with gonadotropin, it is necessary to check the formation of follicles in the ovaries daily by conducting blood tests or ultrasound to rule out the development of a problem such as ovarian hyperstimulation syndrome.

If the treatments associated with weight loss and medication have not been effective, as an option, treatment may include:

• extracorporeal fertilization. The egg is fertilized by sperm in the laboratory, the embryo is grown in a few days, and then implanted into the walls of the uterus to ensure pregnancy. This method is complicated, difficult, and expensive, but may improve your chances of getting pregnant.
• drilling of the ovaries or partial destruction of the walls of the ovary. It is a surgical method to stimulate ovulation. It is sometimes used for women with PCOS who have failed medical hormone therapy and weight loss.

For women who become pregnant with this syndrome, the risks increase during pregnancy. So, the use of metformin can reduce the chances of bearing a baby, as well as provoke the development of type 2 gestational diabetes. However, the negative impact of metformin on the course of pregnancy itself is not known.

Methods for the prevention of polycystic ovary syndrome

There is no method known to exist that can prevent its development. However, through early diagnosis and treatment, it is possible to reduce the risks and possible subsequent complications associated with infertility, metabolism, obesity, heart disease and diabetes.

Treatment of polycystic ovary syndrome at home

Treatment of the disease at home will help to cope with negative symptoms and live a healthy life.

Weight control or weight loss help reduce the chances of diabetes, high blood pressure (hypertension), and high blood cholesterol. Regular weight loss can help to normalize androgen and insulin levels in the blood, in the treatment of infertility. Weight loss in 6 months of only 5-7% can reduce the content of androgens and restore the body's ability to ovulate, will allow to conceive a child for more than 75% of women suffering from a symptom of polycystic ovaries.

At home, for treatment, you can use:

• weight loss. Achieving optimal body weight will improve well-being and prevent possible subsequent health problems. Being active and eating healthy are the keys to weight loss. Of course, the process of losing or gaining weight is strongly influenced by age, metabolism, a woman's genetic predisposition; hunger and reduce the desire to overeat. Healthy food will make you feel more energetic, improve your well-being;
• maintaining a healthy body weight. Healthy weight refers to a weight that will ensure good health while receiving sufficient energy for games and work and control the negative symptoms of the syndrome;
• for smokers - stop smoking. In women who smoke, an increase in the content of androgens in the blood was noted, compared with non-smoking women. It increases the risk of heart disease.

Treatment acne may include the use of prescription and over-the-counter products that are applied to the surface of the skin or taken by mouth. Some of the women notice a significant reduction in the number of acne on the skin after taking hormonal drugs based on estrogen and progestin.

Excessive hair growth(hirsutism) slows down as androgen levels decrease. Can be deleted unwanted hair using the following methods:

• laser hair removal, in which the hair follicle is destroyed by a laser beam;
• electrolysis, in which you can get rid of them forever with an electric current acting directly on the hair roots;
• means for chemical removal applied to the skin;
• wax depilation, allows you to remove hair roots;
• shaving;
• plucking;
• oxidation, bleaching of hair.

These techniques differ in cost and duration of the removal effect. Before trying one of them, you should consult your doctor about the possible risks associated with infection and skin damage.

Drug treatment of polycystic ovary syndrome

Medication may be used, as part of a general treatment, to control reproductive hormones and blood insulin levels.

Choice of medicines

To treat a woman's reproductive function and metabolic problems, use:

• a combination of the hormones estrogen and progestin in the form of birth control pills, vaginal rings, or by applying to certain areas of the skin. These hormones help normalize menstrual cycles. They will also help with problems associated with increased levels of androgens, such as acne, growth or male pattern hair loss. Progestin allows normal growth and removal of the endometrial thickening in the uterus, as occurs with normal menstrual cycles. This monthly removal of the endometrial layer helps prevent precancerous conditions and uterine cancer;
• synthetic progestin. If you are unable to use estrogen, you will need to talk to your doctor about the possibility of injections or progestin-only pills. Progestin allows normal growth and removal of the endometrial thickening in the uterus, as occurs with normal menstrual cycles. This monthly removal of the endometrial layer helps prevent precancerous conditions and uterine cancer;
• three types of progestin, which allow not to increase the content of androgens and are the best for the treatment of the syndrome: norgestimate, desogestrel and drospirenone. Side effects are possible, including headaches, fluid retention in the body and mood changes;
• spironolactone (aldactone) - a drug, which lowers the level of androgens and is a diuretic. It is often used along with estrogen and progestin. The therapy reduces hair loss on the head and its excessive growth on the body and face (hirsutism);
• metformin (glucophage). The drug is a means of controlling the content of insulin, sugar and androgens. Regular use helps reduce the risk of developing heart disease and diabetes, helps to normalize the frequency of menstruation and solve the problem of infertility;
• clomiphene citrate (Clomid, Serophene) and gonadotropin injections (LH and FSH). Used to treat infertility. Clomiphene may be combined with metformin if metformin alone does not induce ovulation. When taking two drugs, the effectiveness of treatment with clomiphene increases.

The drug eflornithine (such as vanica) is a special cream that can reduce hair growth if used on a regular basis. Be sure to consult your doctor before using it.

Acne treatment includes the use of both prescription drugs and over-the-counter drugs. They are applied to the skin or taken orally.

The use of combined hormonal drugs can significantly reduce the formation of acne, since their appearance is associated with a high level of androgens in the blood.

What to think about

Metformin is indicated in the treatment of many of the problems associated with this syndrome. In particular, its positive effect on the ability to conceive and bear a fetus, a decrease in the likelihood of premature birth and gestational diabetes, and the prevention of possible health complications are noted. The use of metformin during pregnancy is quite controversial, although the risk seems to be quite small. It should be noted that Metformin is approved by the Food and Drug Administration. USA only for the treatment of diabetes, so you should discuss with your doctor the appropriateness of its use for the treatment of polycystic ovaries.

Due to some funds for restrictions Hair growth can increase your chance of developing insulin metabolism problems, so be sure to discuss side effects with your healthcare professional.

Surgical treatment of polycystic ovary syndrome

Surgical methods are used to treat infertility only if medical treatment is ineffective. With surgery, the improvement in ovarian function is achieved by reducing the number of small cysts in them.

Choice of surgical methods

Surgical methods include:

• wedge-shaped resection of the ovary - surgical removal of its part. The operation is done to help regulate the frequency of menstrual cycles and start the normal process of ovulation. This method is currently being tried not to be used due to the possibility damage ovaries and increase in additional fabrics at the site of the cut (scar formation);
• laparoscopic drilling of the ovaries - surgical operation, which stimulates the start of the ovulation process in women with this problem who have not been helped by previous treatments, including weight loss and infertility drug treatment. For operations using electrocautery or laser. An analysis of the results of surgical intervention for treatment, carried out by some researchers, showed that the operation to drill the ovaries leads in 80% of cases to the onset of the ovulation process and in 50% of cases to pregnancy. However, there are other reports of researchers, indicating less success. With a high degree of probability, we can say that for young women and women with an optimal BMI value, laparoscopic ovarian drilling can lead to a positive result.

What to think about

There is no single prescription for the treatment of polycystic ovaries. Surgery is only recommended if other treatments have failed. You should discuss the risks and possible benefits of surgery with your doctor. It is unlikely that surgical methods contribute to multiple pregnancies, in contrast to the treatment of infertility with medical methods. No one knows how long the effect of surgical treatment will be. There are also some concerns that surgery may contribute to the formation of additional tissue in the area of ​​incisions, i.e. to the formation of scars, which can also exacerbate problems associated with difficulty getting pregnant.

Other methods of treatment of polycystic ovary syndrome

All methods of its treatment are aimed at combating the consequences of the disease, such as infertility, irregular menstrual cycles, unwanted hair growth, or at preventing possible subsequent health complications. There is no one remedy for the treatment of the disease, however, there are opportunities for effective treatment of each individual symptomatology. So, for women with excess body weight, there is no more effective therapy than weight loss and a healthy diet. In general, adherence to a healthy lifestyle is of great importance for the treatment of this complex syndrome.