Polycystic ovary syndrome (PCOS)
PCOS is not a death sentence or an obstacle to happy motherhood, but a hormonal condition with which modern gynecology can work effectively.
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Why does PCOS occur?
- Heredity: if your mother or sister had PCOS, the patient is at higher risk
- Insulin resistance: cells respond less well to insulin, the body produces more of it compensatory, and excess insulin stimulates the ovaries to produce more androgens
- Excessive production of luteinizing hormone (LH), which prevents follicles from maturing and provokes their transformation into small cysts
- Chronic low-grade inflammation and features of the adrenal glands, thyroid gland and hypothalamic-pituitary system
PCOS Phenotypes: Why It’s Different for Everyone
| Phenotype | Hyperandrogenism | Ovulation | Ultrasound signs of polycystic disease |
|---|---|---|---|
| A (classic) | Present | Absent | Present |
| B (anovulatory) | Present | Absent | No |
| C (ovulatory) | Present | Present | Present |
| D (non-androgenic) | No | Absent | Present |
What are the dangers of PCOS without treatment?
Without correction, the risk of type 2 diabetes, high cholesterol and cardiovascular diseases increases, hyperplasia and endometrial cancer due to chronic anovulation, obstructive sleep apnea syndrome, as well as anxiety and depressive disorders.
Symptoms: what to look out for
- Irregular menstruation or its complete absence, sometimes heavy uterine bleeding
- Hirsutism - excessive growth of dark, coarse hair on the face, chest, abdomen, inner thighs
- Acne, oily skin, seborrhea
- Male pattern hair loss
- Abdominal type weight gain with stretch marks
- Difficulty conceiving due to lack of ovulation
- Irritability, anxiety, low mood, loss of energy
General information
How to make a diagnosis
The diagnosis of PCOS is established according to international (Rotterdam) criteria if at least two of three signs are present:
- Clinical or laboratory signs of excess male sex hormones
- Irregular ovulation or its complete absence
- A characteristic picture of the ovaries on ultrasound: enlarged organ, more than 10–20 small follicles along the periphery, thickened capsule
Hormonal profile
Blood is donated for hormones on days 2–4 of the cycle: LH, testosterone, DHEA, estradiol, as well as TSH, prolactin and AMH.
How to distinguish PCOS from other conditions
It is important to differentiate PCOS from adrenogenital syndrome. To clarify the diagnosis, tests with glucocorticoids are performed and, if necessary, genetic testing of the CYP21A2 gene, as well as assessing glucose tolerance and lipid profile.
FAQ: we answer frequently asked questions from patients
Is it possible to get pregnant with PCOS?
Yes. Infertility in PCOS is reversible in most cases. With proper therapy, pregnancy occurs in most patients within a year.
Is PCOS inherited?
Hereditary predisposition plays a role but does not guarantee the development of the disease in the daughter.
Can PCOS be cured permanently or is it for life?
This is a chronic condition, but symptoms are well controlled with treatment, and with age, the clinical picture often becomes milder.
Is it necessary to have surgery?
No, surgery is a reserve method if therapy is ineffective for 3–6 months.
Will losing weight really help with PCOS?
In overweight patients, a 5-10% weight loss often restores ovulation.
What tests are needed to diagnose PCOS?
Hormonal profile (LH, testosterone, DHEA, estradiol, AMH, TSH, prolactin), pelvic ultrasound, assessment of carbohydrate metabolism.
Is PCOS dangerous if I don't plan a pregnancy?
Yes, without treatment, the risks of diabetes, cardiovascular disease and endometrial hyperplasia increase.
Where to go if you suspect PCOS?
See a gynecologist or gynecologist-endocrinologist.
PCOS is a barrier, but a temporary one. With properly selected treatment, most patients normalize their cycle and become mothers.
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What is polycystic ovary syndrome
Polycystic ovary syndrome (PCOS), or Stein-Leventhal syndrome, is one of the most common hormonal disorders in women of reproductive age: according to various sources, it occurs in 8–21% of patients. With PCOS, the conversion of male sex hormones into female ones is disrupted in the ovaries, which is why the follicles do not mature, ovulation does not occur, and a dense, thickened membrane is formed around the ovary. These changes are often based on increased insulin activity and dysregulation of the pituitary gland - its hormones FSH and LH.
It is important to understand: PCOS is not the same thing as just “cysts on the ovaries” that are sometimes accidentally found on an ultrasound. This is a systemic endocrine condition that affects not only reproductive function, but also metabolism, skin, and emotional background.