> Polycystic ovarian syndrome: what is it, symptoms, causes, diagnosis, and treatment

Cos’è polycystic ovary

The polycystic ovary syndrome (PCOS) is a disorder of the endocrine system common among women in età reproductive. Women with PCOS may have enlarged ovaries that contain small foci of cyst and cash equivalents – the follicles – located in each ovary as you canò see in the course of an ultrasound examination.

menstrual Periods infrequent or prolonged, reduction of hair growth, acne, and obesityà are the conditions that can occur in women with polycystic ovary syndrome. In adolescents, menstruation, infrequent or absent may give rise to the suspicion of PCOS.

The exact cause of polycystic ovary syndrome is unknown. The early diagnosis and treatment with the loss weight può to reduce the risk of long-term complications, such as the type 2 diabetes and heart disease.

Symptoms of polycystic ovary

The symptoms or signs of pcos often begin soon after the first menstrual flow (menarche). In some cases, PCOS develops later on during the reproductive years, for example, in response to a substantial increase in weight.

PCOS can; occur with different signals. All can worsen with l’obesityà, however, every woman with PCOS può to react in a different way. To be diagnosed with the doctor will look for at least two of the following elements:

    the

  • the irregular Menstruation. This is the characteristic of the più comune. Examples include intervals, menstrual più long of 35 days; fewer than eight menstrual cycles a year; failure to menstruate for four months or more; and cycles that can be limited or extended.
  • the

  • the Excess androgens. High levels of male hormones (androgens) can cause physical signs, such as excess hair on the face and body (hirsutism), adult acne or severe acne adolescent, and male pattern baldness (androgenetic alopecia).
  • the

  • the polycystic Ovaries. Become enlarged and contain many small sacs full of liquid that surround the eggs.

Complicanze

Have the syndrome of polycystic ovary può to cause the following conditions, especially if associated with obesityà:

  • type 2 diabetes
  • the

  • High blood pressure
  • the

  • Cholesterol and lipids abnormal, such as triglycerides, high, or very low lipoprotein high densityà (HDL), the “good”cholesterol
  • The metabolic syndrome, that is; a set of signs and symptoms that indicate a significantly increased risk of cardiovascular disease
  • the

  • non-alcoholic Steatohepatitis, or inflammation of the liver caused by accumulation of fat in the liver
  • the

  • Infertilità
  • the

  • sleep Apnea
  • the

  • Depression and anxiety
  • the

  • abnormal uterine Bleeding
  • the

  • Neoplasm of the uterine lining (endometrial cancer), caused by exposure to continuous high levels of estrogen
  • the

  • Gestational diabetes or high blood pressure in pregnancy

polycystic ovarian syndrome, you might first consult your family doctor. However, you canò be referred to a medical specialist of the female reproductive tract (gynecologist), a specialist in hormonal disorders (endocrinologist) or one expert in the treatment of sterilità (reproductive endocrinologist).

Causes of polycystic ovary

The doctors do not know what causes polycystic ovary syndrome, but these factors may play a role:

    the

  • the insulin excess. Insulin is the hormone produced in the pancreas that allows cells to use sugar (glucose) – primary energy source of your body. In the presence of insulin resistance, the ability to use the insulin effectively is impaired, and the pancreas must secrete more insulin to give the glucose to the cells. The insulin excess may also affect the ovaries by increasing the production of androgens, which can interfere with the abilityà of the ovaries to ovulate.
  • the

  • the Low grade inflammation. The white blood cells of your body produce substances to fight infections with a response called inflammation. Research has shown that women with PCOS have low-grade inflammation and that this type of low-grade inflammation stimulates polycystic ovaries causing the production of androgens.
  • the

  • the Inheritance. If the mother or sister have PCOS, you might have a greater probabilityà of ill. The researchers are also looking into the possibilityà that some genes are linked to PCOS.

The diagnosis of polycystic ovary

Non c’è no specific test to definitively diagnose polycystic ovary syndrome. The diagnosis is run for exclusion, which means your doctor considers all signs and symptoms, and then exclude other pathologies as possible.

During this process, you and your doctor discussing your medical history, including menstrual periods, weight changes and other symptoms. The doctor può also perform some tests and examinations:

    the

  • physical Examination. During the physical examination, the doctor detects the information, including the height, weight, and blood pressure.
  • the

  • pelvic Examination. In the course of a pelvic exam, your doctor visually and manually inspects your reproductive organs to detect any masses, growths or other abnormalities.
  • the

  • blood tests. To measure the levels of several hormones to exclude possible causes of menstrual abnormalities or excess androgens that mimic PCOS. The examination of the blood extra can; include cholesterol and fasting triglyceride levels and a glucose tolerance test, where blood glucose levels are measured while fasting and after drinking a beverage containing glucose.
  • the

  • Ultrasound. An ultrasound examination can show the appearance of the ovaries and the thickness of the lining of the uterus.

Care and treatments

The treatment of polycystic ovarian syndrome generally focuses on management of the main concerns of the individual, such as infertilità, hirsutism, acne or obesityà.
lifestyle Changes

As a first step, the doctor may; recommend weight loss through a low calorie diet combined with activitiesà moderate exercise. Even a modest reduction in your weight – for example, losing 5% of body weight – may help improve your condition.

Farmaci

The doctor can; prescribe a medication to:

    the

  • the Regulate the menstrual cycle, the doctor può you like to recommend the pill that contains both oestrogen and progestin. In this way, you get a decrease in the production of androgens, with a break for your body from the effects of estrogen, reducing the risk of endometrial cancer, and correcting the abnormal bleeding. As an alternative to the contraceptive pill, it is possible to use a patch or vaginal ring containing a combination of estrogen and progestin. Of course, for the period of treatment you willà to remain pregnant. If you’re not a good candidate for the contraceptive pill, an alternative approach is to take progesterone for 10 to 14 days every 1-2 months. This type of therapy regulates the cycles and offers protection against endometrial cancer, but does not improve androgen levels and does not prevent pregnancy.
    The doctor può also prescribe the metformin (Glucophage, Fortamet, others), an oral medication for type 2 diabetes that improves insulin resistance and lowers insulin levels. This medication può help with ovulation and lead to regular menstrual cycles. Metformin also slows the progression of type 2 diabetes if you è già in the condition of prediabetes and aids in weight loss, if you follow a program of diet and exercise.
  • the

  • the Help ovulation. If you’re trying to get pregnant, you may need a medication to help ovulation. The Clomiphene (Clomid, Serophene) is a medication anti-oral estrogen, which you take during the first part of the menstrual cycle. If the clomiphene is not effective, the doctor may add metformin to induce ovulation.
    If you do not it is pregnant with clomiphene and metformin, your doctor may; recommend gonadotropins – follicle-stimulating (FSH) and luteinizing hormone (LH) medications that are administered by injection. Another medication that your doctor can use is the treat breast cancer (Femara). It is not known exactly how it works treat breast cancer to stimulate the ovaries, but canò help with ovulation when other medicines fail.
    In taking any kind of medication to help ovulation, it is important that you be followed by a specialist in reproduction with regular ultrasound scans to monitor the improvements and avoid problems.
  • the

  • the to Reduce the excessive hair growth. The doctor may; recommend birth control pills to decrease the production of androgens, or another drug called spironolactone (Aldactone) that blocks the effects of androgens on the skin. Sinceé spironolactone può cause birth defects, it is necessary to have a contraception effective when you are using the drug, and not is recommended if you are pregnant or planning a pregnancy. Eflornithine (Vaniqa) is another possibilityà pharmacological; the cream slows down the growth of facial hair in women.

Natural remedies

To help offset the effects of PCOS:

    the

  • the Keep your weight under control. Obesityà worsens insulin resistance. Weight loss can reduce both insulin levels and androgens and may restore ovulation. No single dietary approach specific is the best, but losing weight by reducing the amount; of calories consumed each day can help with polycystic ovary syndrome, especially if one is overweight or obese. Use dishes for smaller, reduce the size of your portions and resist the temptation. Ask your doctor to recommend a weight control program.
  • the

  • the Take into account the changes in the diet, on low-fat diets high in carbohydrates may increase insulin levels, then you may want to consider a diet low in carbohydrates, if your doctor recommended it. No need to limit the carbs, instead, better to choose complex carbohydrates that are rich in fibers. If a food is rich in fiber, the more slowly it is digested and più slowly increase the levels of sugar in the blood. Carbohydrates rich in fiber are whole grain breads and cereals, wholemeal pasta, bulgur, barley, rice, and beans. Limit less healthy, simple carbohydrates such as beverages, fruit juices in excess, cake, candy, ice cream, cakes, cookies and doughnuts.
  • the

  • the Be active. Physical exercise helps to keep the più low levels of sugar in the blood. If you have PCOS, by increasing the activitiesà daily and participating in a regular exercise program, you può to treat or even prevent insulin resistance and keep the weight under control.

IN ARGOMENTO:

Pill and polycystic ovarian syndrome, what other contraception?

Diseases of women. Ovary micropolicistico

the Ovary micropolicistico treated with the contraceptive pill

ovarian Cysts: causes, symptoms, diagnosis, and treatment

Source: Mayo Clinic

23 maggo 2015

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