Polycystic ovary syndrome is common. Its cause is unknown, although genetic and non-genetic factors are known to intervene: It affects 5%-10% of women of childbearing age. Abnormal levels of androgens (male sex hormones) affect the activity of the ovaries; Ovarian follicles do not grow properly and do not ovulate; Many small follicles accumulate in the ovaries, giving them the appearance that many cysts are present (polycystic). These changes also cause imbalance of other hormones: Estrogens and progesterone produced in the ovaries; Follicle stimulating hormone (FSH) and luteinizing hormone (LH), produced in the pituitary. The first symptoms related to polycystic ovary syndrome usually begin at puberty. However, they can also occur later. Symptoms of polycystic ovary syndrome The symptoms of polycystic ovary syndrome are not the same in all women and does not have always the same intensity. Usually, the first symptoms are: Irregular menstrual cycles and sometimes absent menstruation; Acne and oily skin. In adolescence, changes in the skin and menstrual cycle due to polycystic ovary syndrome can be confused with normal changes in this phase. Other early symptoms may be: Hair thinning and alopecia with a male pattern; Facial hair in excess (for example on the upper lip) and hair in typically male parts of the body (hirsutism), for example on the chin, neck, chest, abdomen, arms and thighs. Subsequently, the disease may also be associated with: Difficulty getting pregnant and infertility; Overweight and obesity; Higher risk of type 2 diabetes, sleep apnea, cardiovascular diseases, depression and anxiety, sexual dysfunction, and eating disorders. Higher prevalence of endometrial cancer at an early age. The symptoms of polycystic ovary disease after menopause are not as well-known but are known to be less important after age 70. Diagnosis There are no specific tests to diagnose polycystic ovary syndrome. The diagnosis is based on: In the medical evaluation, that is, in the physical exam and personal and family health history; Hormonal analysis results; Pelvic ultrasound. When at least two of the symptoms or signs listed below are present, a polycystic ovary syndrome may be suspected: Changes in ovarian function; Excessive androgen production with clinical or laboratory evidence; Polycystic ovaries identified in imaging tests; Due to the impact that polycystic ovary syndrome has on women health and well-being, an early diagnosis is important so that a more effective treatment is possible. Regular gynecological follow- from puberty and throughout adult life helps with early diagnosis and more effective intervention. Treatment of polycystic ovary syndrome Treatment of polycystic ovary syndrome is symptomatic: It is directed to the symptoms of the disease, in order to minimize it as well as their impact. It also considers the particularities that the disease has in each woman and her stage of reproductive life. It usually includes: Lifestyle modification, with regular exercise, healthy eating and body weight control; Do not smoke; Oral contraceptives to control ovulation changes and some consequences of androgen excess production; Specific drugs to limit the excess of androgens or their action. Consequences of polycystic ovary syndrome on fertile life This syndrome is one of the main causes of female infertility. In addition, women with this condition who become pregnant are at a higher risk of the following complications: Miscarriage; Gestational diabetes; Hypertension during pregnancy; Pre eclampsia. However, it is possible for a woman with polycystic ovary syndrome to have a term pregnancy with success and without complications. For this, regular medical follow-up and appropriate treatment are very important. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
