Diagnosis of polycystic ovary

Infertility a woman goes to a doctor for the first time and in the course of examination revealed characteristic changes in the ovaries with signs of hormonal dysfunction. In the literature, there is evidence that the disease can develop in women in their teens, though diagnosed polycystic ovarian set still much later, usually in the reproductive age when examining the infertile couple.

Not all patients are complaints of violations of the cycle, only 73% of clinical cases of violation may occur oligomenorrheic Oligomenorrhea - too short menstruation , Gipomenoreey or amenorrhea The absence of menstruation (amenorrhea) - ambiguous symptom . The most common symptom of the disease is a change in the hormonal profile (signs of hyperandrogenism), which is manifested by excessive hair growth, changes in voice, appearance on the skin of acne (acne vulgaris), showing black acanthosis and other pathological symptoms. Excess hair growth is observed on the face, trunk, limbs, this process is characterized by slow progression during the life of the patient. Brown spots and acne is most often located on the back, chest and face. These changes are the dermatological confirmation insulin resistance that develops in patients.

This applies to fat and carbohydrate metabolism. Excess weight is observed in almost half of all cases (46% women). Patients develop chronic diffuse liver disease, a natural consequence of which is to change the synthesis of protein fractions. On the basis of characteristic clinical symptoms and the appearance of morphological changes in the ovaries were invited to apply in practice a set of universal criteria. If a woman, there are two of these criteria, the diagnosis of polycystic ovary can be set. These criteria include the following indicators:

• development of chronic anovulation
• clinical and biochemical signs of elevated blood level of androgens (hyperandrogenism signs)
• characteristic sonographic changes of ovaries on the results of the ultrasound scan

The method should be complemented with ultrasound color Doppler, which will determine the state of blood flow at the level of ovarian stroma. Comprehensive assessment of ultrasonographic findings will contribute to the reliability of the established diagnosis. With regard to a hormonal test, this method can not be considered a universal criteria for the disease. This is one of biochemical markers of polycystic ovary, which complements the study of women. The most informative value of the index definition is the central hormone ratio (ratio of LH to FSH). If this ratio exceeds the index of 2 or more, the woman with the markers of the disease should be examined in greater depth and to identify what violations exist in the ovaries, polycystic exclude them.

The risk of complications

The need for timely diagnosis and treatment of polycystic ovary due to the high risk of serious complications. The presence of chronic anovulation and no signs of a full transformation of the mucosa of the uterus during the menstrual cycle is a typical manifestation of hormonal disorders. Such changes naturally cause of hyperplastic processes in the uterus. This is typical mainly for the typical forms of the disease, and when combined forms most commonly found atrophic changes in the endometrium.

This fact gives grounds to include patients with the disease to an increased risk of developing pre-cancerous and cancerous processes of the body of the uterus that is not depending on the particular clinical and pathogenetic variants of the disease.

Significantly increases the risk against the background of metabolic disorders that can occur in patients developing diabetes, hypertension, lipid disorders, and other changes. It is important to pay attention to the length of the existence of such violations of exchange that has prognostic value in assessing the prognosis of the disease. It is proved that the main links between the development of pathological changes in the polycystic ovarian and endometrial cancer there is a certain commonality. In this context, it becomes clear why the study state of the body of the uterus in women with polycystic included in a comprehensive survey.

It is necessary to conduct a survey before the course of hormone therapy to prevent existence or atypical hyperplastic processes in the endometrium. Re-control tests must be carried out in the early and late periods after completion of the treatment course. Factor in preventing the development of hyperplastic processes can be called the restoration of ovulation Ovulation - How to determine as accurately as possible? And the rate of hormone therapy is an integral part of a comprehensive treatment (appointment of combined hormonal drugs). If a woman's cycle is biphasic, it will protect the endometrium from the adverse effects of anovulation Anovulation - the cause of infertility? .

Marina Solovyov

Symptoms of polycystic ovary

Polycystic ovaries or polycystic ovary syndrome - this is very common among women of reproductive age hormonal disturbance. The disease is so named because many (but not all) of women with this disorder on the outer sides of both ovarian cysts formed a lot.

The symptoms of polycystic ovary sometimes appear very soon after menarche. Many patients, however, polycystic develops later, for example, as a reaction to an increase in weight.

Signs of polycystic ovaries, as well as their intensity, may be different for different women. To diagnose polycystic ovary need to have patient had at least two of these symptoms:

• Polycystic ovaries are clinically manifested in the form of menstrual disorders (most delays), excessive hairiness on the body, increasing the size of the ovaries, half of the patients - are overweight. The criterion for diagnosing polycystic ovary is to identify at least two of the following symptoms:
• Irregular menstruation or lack thereof. It is the most common and sure sign of polycystic ovaries. Under irregular menstruation involve menstrual irregularities, the gap between two menstrual periods for more than 35 days or less of blood eight times a year. Polycystic ovary begins at puberty Puberty child - stages of a complex path Often with the onset of menses.
• The excess of the hormone androgen. Elevated levels in the body of the male hormone estrogen Estrogen - the key to bone health   It can lead to physical symptoms such as hirsutism on the face, chest, groin, back, hands and feet, acne Acne: facial trouble   (acne) and male pattern baldness (alopecia). However, not all women with PCOS appear physical symptoms of elevated levels of androgen.
• Enlarged ovaries with multiple cysts. Ultrasound can detect polycystic ovaries. However, not all women with ovarian cysts are diagnosed with "polycystic ovaries" and vice versa - with PCOS cysts may look normal. Therefore diagnosed with polycystic ovaries, not only on the basis of the US, but also in the presence of other symptoms - irregular menstrual cycle and hormonal imbalances.

Early treatment will reduce the likelihood of developing these complications polycystic ovary as Type II diabetes, high blood pressure and heart disease.

The clinical picture is characterized by polikstoza ovarian and several other diseases, including:

• Hypothyroidism. In this case, the reduced activity of the thyroid gland, which may result in a lack of menstruation (amenorrhea).
• Hyperprolactinemia. When hyperprolactinemia pituitary gland produces too much of the hormone prolactin, which stimulates the production of breast milk and suppresses ovulation Ovulation - How to determine as accurately as possible? .
• Some tumors. Ovarian tumors or adrenal glands can be a cause to increase androgen levels.

Before diagnosing polycystic ovaries, the doctor eliminates the possibility of these diseases.

Many women with PCOS are obese. The distribution of body fat influences the severity of the symptoms of polycystic ovaries. In one study, in women who are overweight is concentrated in the central part of the body, the level of androgen, sugars and lipids higher than those in the body, whose excess weight is concentrated at the extremities.

PCOS is also associated with such diseases:

• Barrenness
• Acanthosis nigricans - a darkening of the skin on the neck, in the armpits, the inside of the thighs, groin or under the breasts
• Chronic pelvic pain syndrome