Hormonal Disorder in Women With Polycystic Ovaries Disease. Treatment in Germany
Best hospitals and doctors for hormonal disorder in women with polycystic ovaries disease treatment in Germany
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Polycystic ovary syndrome (Stein-Leventhal syndrome) is the most common cause of irregular menstruation and infertility. This disease affects 10-15% of women. Modern medicine successfully copes with this pathology: German medical centers provide conservative treatment to eliminate a hormonal disorder in women with polycystic ovaries disease. The therapy relieves patients of most of the symptoms and successfully restores their reproductive function.
Content
Hormonal disorders can be treated with drugs. When planning a pregnancy, doctors prescribe ovulation-inducing drugs. Many patients are prescribed hypoglycemic agents to normalize their carbohydrate metabolism.
You can undergo your treatment in one of the following hospitals: University Hospital Rechts der Isar Munich, Leverkusen Clinic, or University Hospital Tuebingen.
The Booking Health specialists will take care of organizing your trip. They will help you to select a medical center and a doctor, make an appointment for the nearest future, help you to apply for a visa and come to the clinic, provide an interpreter and a personal coordinator, provide medical insurance, and take care of the favorable cost of medical services. You can contact Booking Health with any questions.
Diagnostics
To make a diagnosis of polycystic ovary syndrome, two of three criteria are required. These are as follows:
- clinical or laboratory hyperandrogenism;
- polycystic ovaries on an ultrasound scan;
- chronic anovulation.
However, doctors must rule out other causes of these signs, including thyroid diseases, hyperprolactinemia, and adrenal hyperplasia.
Chronic anovulation is diagnosed if the duration of the ovarian menstrual cycle exceeds 35 days. In adolescents, the threshold is higher and makes up 40 days. The result of ovulatory dysfunction is infertility, hyperplastic processes and an increased risk of endometrial cancer.
The main signs of hyperandrogenism are acne, increased skin oiliness, hair loss, and unwanted facial hair growth. A woman has elevated levels of androgens (testosterone, androstenedione, 17-OH-progesterone, or DHEA-s) in her blood.
Ultrasound signs of polycystic disease are the presence in the ovaries of more than 25 small follicles (up to 1 cm) and an increase in their volume to more than 10 ml.
Women with polycystic ovary syndrome often have problems unrelated to the reproductive system due to impaired metabolism. They are at a high risk of developing the following conditions:
- obesity;
- type 2 diabetes mellitus;
- cardiovascular diseases;
- non-alcoholic fatty liver disease;
- depression.
Therefore, an additional examination is required to assess the indicators of carbohydrate metabolism, cholesterol levels, and liver tests. A liver ultrasound scan, a glucose tolerance test and an individual assessment of cardiovascular risks can be conducted if clinically indicated.
Treatment
The treatment goals can be different: this may be the normalization of the hormone levels and the regularity of the menstrual cycle, the restoration of reproductive function, and the elimination of the signs of hyperandrogenism. PCOS affects young women, many of whom want to have a baby in the future, but cannot become pregnant due to chronic anovulation.
The first-line therapy for menstrual irregularities, hirsutism, and acne are oral contraceptives, patches, or vaginal rings. Patients in Germany receive contraceptives with progestins, which have direct antiandrogenic properties. They block the transformation of free testosterone into its more active form, 5-alpha-dihydrotestosterone, and therefore are very effective for hyperandrogenism symptoms and controlling the menstrual cycle.
With impaired glucose tolerance and obesity, hypoglycemic agents, a diet and exercise are prescribed. They are also used as the second-line therapy for menstrual irregularities when contraceptives are contraindicated. Contraindications to the prescription of these drugs are considered a combination of risk factors for the development of cardiovascular diseases: systolic blood pressure over 160 mm Hg, age over 35 years old, 15 or more cigarettes per day, and diabetes mellitus with severe peripheral vascular disease.
For many women, the reason for visiting a specialist is infertility. As a rule, a woman can get pregnant while taking medications for polycystic ovaries. Doctors stimulate ovulation with drugs. Selective estrogen receptor modulators are used as the first-line therapy. In recent years, aromatase inhibitors have also begun to be used.
If the main goal of treatment is to eliminate hyperandrogenism, and oral contraceptives do not work, doctors resort to antiandrogens. Some of them negatively affect the liver, so the treatment is controlled by laboratory tests. Another treatment option is non-selective mineralocorticoid receptor antagonists in combination with hypoglycemic agents.
Previously, surgical interventions were performed for polycystic ovaries. They are practically not carried out in developed countries today, since there is no convincing evidence that they have an advantage in effectiveness over conservative therapy.
You are welcome to use the Booking Health service to undergo your treatment of hormonal disorder in women with polycystic ovaries disease in Germany. On our website, you can find out the cost of diagnostics, treatment and rehabilitation in different German hospitals, compare prices and book your treatment at a favorable price. Our company's specialists will select the most suitable clinics in Germany for you and arrange your trip.
Authors:
The article was edited by medical experts, board-certified doctors Dr. Nadezhda Ivanisova and Dr. Sergey Pashchenko. For the treatment of the conditions referred to in the article, you must consult a doctor; the information in the article is not intended for self-medication!
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