Polycystic ovary syndrome is an endocrine-metabolic syndrome, the definition of which has varied many times over time due to its complexity. It is accepted that a patient has polycystic ovary syndrome when she meets two of the following three criteria:
- Chronic anovulation (oligoamenorrhea).
- Hyperandrogenism (clinical and/or biochemical).
- Ovaries with polycystic morphology on vaginal ultrasound (at least 25 astral follicles between the two ovaries).
Symptoms
- Oligoamenorrhea: long and irregular cycles, usually longer than 40 days and sometimes with months without menstruation or with amenorrhea.
- Hyperandrogenism: whose most characteristic symptom is hirsutism, although it is also associated with acne. It is frequently associated with metabolic syndrome risk factors: obesity, arterial hypertension, hypercholesterolemia/hypertriglyceridemia and glucose intolerance or even diabetes.
It is a condition that when it includes chronic anovulation can affect fertility, since it makes it difficult to achieve gestation. It is also associated with increased risk of miscarriage and increased risk of complications such as gestational diabetes due to the tendency to increased insulin resistance and glucose intolerance.
It affects women at all ages although it is usually diagnosed in adolescence with the manifestation of menstrual irregularities and sometimes, hirsutism but insulin resistance and metabolic connotations can affect a woman’s health throughout her life subjecting her to increased cardiovascular risk.
How is it diagnosed?
The diagnosis of this syndrome, as already mentioned, is a complex syndrome with a very wide range of clinical manifestations, which make each patient manifest differently. The diagnosis will be based on a correct clinical history, a gynecological and menstrual history of the patient, together with a physical examination looking for data of hyperandrogenism and obesity, vaginal ultrasound and hormone analysis, along with lipid and glycemic profile and blood pressure control.
How to treat polycystic ovary syndrome?
The first step in treatment is to improve lifestyle, especially in women with impaired glucose metabolism, impaired lipid metabolism or overweight. In addition, the treatment approach should be tailored to the needs of the woman at any given time:
- Hormonal contraception if pregnancy is to be avoided.
- Ovulation induction or fertility treatments if the woman presents associated sterility problems.
- Hormonal treatment with progesterone if we simply want to prevent endometrial hyperplasia or neoplasia.