VM Medical Park Ankara Hospital Gynecology and Obstetrics Specialist Prof. Dr. İkbal Kaygusuz warned about Polycystic Ovary Syndrome (PCOS).
Emphasizing that the syndrome is one of the most common endocrine disorders affecting 5 to 10 percent of women of reproductive age, Prof. Dr. İkbal Kaygusuz said, “As there is no ovulation every month in those with PCOS, the chance of pregnancy decreases and infertility is also an important problem. PCOS can also cause long-term health problems, including hyperlipidemia, type 2 diabetes (diabetes mellitus), cardiovascular disease, uterine cancer. Therefore, early diagnosis and treatment is required.
Stating that menstrual irregularity typically begins in adolescence in patients with PCOS and the first menstrual period may be delayed, Prof. Dr. Prof. Dr. İkbal Kaygusuz said, “Menstrual irregularity should generally be in the form of oligomenorrhea (less than 9 in a year) and less frequently amenorrhea (absence of menstruation for three or more consecutive months). Dr. İkbal Kaygusuz said, “After the age of 40, menstrual cycles improve, but metabolic diseases come to the fore. Women who develop oligomenorrhea after the age of 30 are less likely to have PCOS.
Stating that the increase in obesity both increases the incidence of polycystic ovary disease and aggravates its clinical findings, Prof. Dr. Ikbal Kaygusuz said:
“The diagnosis of PCOS should be suspected in every woman of reproductive age presenting with menstrual irregularities and symptoms of hyperandrogenism (acne, hirsutism (hair loss), male pattern hair loss). Some women present with either oligomenorrhea alone or with hyperandrogenic symptoms. Also, those with hyperandrogenism (as most women with hirsutism have PCOS) should also be evaluated for PCOS.”
Pointing out that the Rotterdam criteria are used to diagnose PCOS, Prof. Dr. İkbal Kaygusuz emphasized that two out of three of the following criteria are necessary for diagnosis:
Oligo and/or anovulation (menstrual irregularity).
Clinical and/or biochemical manifestations of hyperandrogenism (impaired hormone tests).
Polycystic ovaries on ultrasound.
Underlining that the polycystic appearance of the ovaries in the patient is not accompanied by other findings, it does not mean that he has PCOS. Dr. İkbal Kaygusuz said, “These ultrasonography findings can be seen in 25 percent of normal women and 14 percent of women using birth control pills. The diagnosis of PCOS is confirmed by exclusion of androgen excess or other conditions that cause ovulation disorders (thyroid disease, non-classical congenital adrenal hyperplasia, hyperprolactinemia and androgen-secreting tumors).
prof. Dr. İkbal Kaygusuz listed the general goals of the treatment of women with PCOS as follows:
“Improvement of hyperandrogenic properties (hirsutism, acne, hair loss on the scalp).
Management of underlying metabolic abnormalities, reduction of risk factors for type 2 diabetes and cardiovascular disease.
Prevention of endometrial hyperplasia (thickening) and cancer that may occur as a result of chronic anovulation (lack of ovulation).
Methods of contraception for those who do not want pregnancy, as women with irregular periods ovulate intermittently and unwanted pregnancies can occur.
Ovulation treatments for those seeking pregnancy.”
Underlining that PCOS treatment requires the treatment of individual components of the syndrome, Prof. Dr. İkbal Kaygusuz made the following suggestions:
“The choice of treatment depends on whether the patient wishes to become pregnant or not, and with which complaint he or she applies to us. The first step in treatment is lifestyle changes. The first step for overweight and obese women is diet and exercise to lose weight. Current evidence suggests that lifestyle changes (diet, exercise, and behavioral interventions) are effective in improving insulin resistance and hyperandrogenism. "Beyond improving metabolic risk factors, even losing a pound or two can induce ovulation without the need for further treatment."
Stating that birth control pills are the first choice as drug treatment for a woman with PCOS who is not planning a pregnancy, Prof. Dr. İkbal Kaygusuz said, “Medicine therapy is the main treatment used to correct menstrual irregularity, treat hair growth and acne problems, and also provide birth control. However, those who are overweight, smokers over the age of 35, those who have had embolism (clot) before or those with a family history cannot use birth control pills. Sometimes patients do not prefer to use birth control pills. In this case, we recommend cyclic progestin therapy as a menstrual regulator and for endometrial protection. "With metformin therapy, which is used to correct insulin resistance, it may be possible to induce ovulation in approximately 30 to 50 percent of women with PCOS."
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