Endocrinology: Hormonal disorder in women with polycystic ovaries disease — Diagnosis and conservative treatment. Treatment
Polycystic ovary syndrome is an endocrine disease upon which an increase in the concentration of androgens is marked in a woman's body. The hormones cause the violation of ovarian function, and multiple cysts are formed on their surface. According to different authors, this pathology is detected in about 5 to 15% patients of gynecologists. Today, the cystic disease remains the most common cause of female infertility.
It is believed that the syndrome is developed in the background of decreased body sensitivity to insulin. In response, the pancreas launches the compensatory mechanisms for enhanced hormone production. Accumulating in blood, insulin stimulates the formation of excessive androgens. As a consequence, the patients report an inhibited ovulation process and disrupted menstrual cycle.
The characteristic features of the cystic disease include:
- rare periods (oligomenorrhea)
- excessive hair growth on the body,
- obesity (observed in approximately 70% patients)
- acne and oily skin.
In 30% women, the fibrocystic breast disease is developed in the background of the said disease.
The physician suggests a diagnosis based on the case history and clinical picture. To confirm the suspicions, the patient is prescribed:
- Hormonal blood test. It determines the concentration of sex hormones and hormones controlling their production.
- Transvaginal ultrasound. It allows detecting changes in the structure of ovaries. The availability of more than 8 follicular cysts is considered the sign of the cystic disease.
- Glucose tolerance test. It reveals the body's sensitivity to insulin.
- Diagnostic laparoscopy. The physician examines the ovaries using a miniature camcorder through small punctures in the abdominal wall. During the procedure, a sample of the diseased tissue is taken for subsequent histological analysis.
The treatment depend on the cystic disease flow options. Patients with obesity are primarily recommended the measures for weight normalization:
- calorie reduction,
- fasting days,
- increased physical activity.
In the absence of the effect, a drug therapy aimed at improving the insulin sensitivity is selected.
When the body weight is normal, the main goal of treatment is to restore the ovulation. For this, the woman is administered hormone therapy. If no improvement is observed, the only way out is the surgical removal of the affected ovary tissues.Hide