Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women of reproductive age (between 15 and 44 years of age). It is estimated that it affects 10-15% of women, and according to Finnish research, even 25% of women. Every fourth woman met on the street, young or middle-aged, or even a teenager, has this disease, even if she does not know about it!
The name of this disease is misleading because the most important criterion for the diagnosis of PCOS is the excess of androgens (i.e. male hormones) in the blood. The diagnosis is made when at least 2 of the 3 criteria are met:
It is worth emphasizing - criterion 2 is necessary.
In practice, the first criterion comes down to infrequent or absent periods. The ovary of a woman with PCOS does not release the egg necessary for sperm to fertilize it. The second criterion is an excess of androgens (that is, sex hormones) in the blood.
Polycystic ovaries are ovaries that contain at least 20 follicles 2-9 mm in diameter and / or the ovary is at least 10 cm2 in size.
The ultrasound picture is decisive in the diagnosis.
Symptoms that may suggest PCOS include:
The first 6 symptoms indicate that the level of androgens (male sex hormones) in the blood is too high.
As already mentioned, the basic criterion for the diagnosis of PCOS is a high level of androgens. The endocrinologist orders the determination of the level of free testosterone, and if the level is normal, also of other androgens: androstenedione and dehydroepiandrosterone sulphate (DHEA-S). In order to find out whether the patient is ovulating, the level of progesterone is checked in the second phase of the cycle (i.e. after ovulation). The inside of the ovaries shows an ultrasound.
The recommended additional tests ordered by an endocrinologist include: TSH and fT4 (indicate the function of the thyroid gland), PRL (prolactin, one of the superior hormones regulating the work of other hormone-secreting organs), glucose level and lipid profile.
A patient suspected of PCOS should be under the care of an endocrinologist; it is good if the treatment team also includes a gynecologist and, if necessary, an internist or a psychiatrist.
PCOS in a woman with this condition leads to:
British research shows that women with PCOS are more likely to have mental health problems. They often become depressed, have anxiety states and have bipolar disorder (depression alternating with mania or its milder form, i.e. hypomania).
Scientists believe that genetic factors are responsible for PCOS, although no single gene has been found to support this theory.
PCOS occurs more frequently in women whose family (parents or siblings) are people with type II diabetes or whose fathers were hairy; perhaps it is not PCOS that leads to insulin resistance but, conversely, insulin resistance to PCOS.
Higher levels of substances responsible for inflammation have been found in women with PCOS.
Polycystic ovary syndrome is a complex disorder, both in terms of its clinical picture, causes and effects. A woman suspecting PCOS should first go to an endocrinologist who will order appropriate tests and conduct treatment, if necessary, referring to doctors of other specialties for additional consultations.
Do you want to know what the treatment of PCOS looks like? Read our article - CLICK HERE.