Is PCOS curable in teenage years

Polycystic ovary syndrome

A year of hope. And disappointment. When Andrea Vagt (34) was still not pregnant after twelve "months of exercise", she went to her gynecologist. He examined her for a long time and asked many questions. A hormone test confirmed his suspicions: Andrea suffers from polycystic ovarian syndrome, PCOS for short.
As a teenager she was plagued by severe acne and menstrual problems, and even then a doctor told her she had a hormonal problem. She found the fact that she was given the pill as a medication very useful. But she never really thought about it. "You probably don't ovulate at all," the gynecologist explained. He referred Andrea to a fertility clinic. Shaken, she read what it said on the transfer: Infertility / sterility from PCOS. Andrea got scared.
A few weeks later, she and her husband visited the specialist. Her hormone levels were checked again and the diagnosis confirmed. "Women with PCO can definitely get pregnant," explained the doctor. But to do this, it is first necessary for the hormonal disorder to be recognized at all. Without the help of doctors, those affected rarely have a desire to have children.
PCOS - what is it?
Polycystic means “many cysts” and it describes the condition of the ovaries. These so-called "cysts" on the ovaries are not true cysts. There are many small follicles that do not mature and so wither prematurely. This can be seen well in the ultrasound. If women have eight or more follicular cysts with increased connective tissue, one speaks of polycystic ovaries.
The polycystic ovary syndrome (PCOS) is not a uniform clinical picture, but rather different symptoms that occur individually or in combination. There is always an increase in male hormones (hyperandrogenemia).
In fact, almost all women have multicystic ovaries at some stage in their life without meeting the definition criteria for PCO. And only a quarter of women with polycystic ovary disease develop polycystic ovary syndrome.
In addition to the increased occurrence of male hormones, the PCO syndrome includes:
  • Menstrual cycle disorders (rare or absent menstrual bleeding)
  • increased body hair (hirsutism)
  • Obesity
  • unfulfilled desire to have children
  • Changes in fat and carbohydrate metabolism
  • acne
  • Hair loss (alopia)
  • PCO-typical cysts on the ovaries


How does the polycystic ovary syndrome develop?

The exact causes of PCOS are still unclear. Most likely it is caused by a combination of genetic predisposition and environment.

There is definitely a close connection with the body's own insulin production. When diagnosing PCOS, therefore, tests are carried out to determine whether the person affected is possibly insulin resistant.

It has been proven that very overweight women in particular suffer from such insulin resistance and also very often have a polycystic ovary syndrome. It is estimated that more than 50 percent of PCOS patients are overweight. It has not yet been proven whether being overweight triggers PCOS or whether PCOS is the cause of being overweight. However, new findings suggest that the disease causes the body to process food and exercise differently. One study showed that normal weight women with PCOS consumed fewer calories than normal weight women without PCOS.

Living with PCOS is not easy; symptoms such as obesity, hair loss and acne also put a strain on the psyche. In addition, there is often unwanted childlessness. A study shows that the women affected feel clearly restricted in their quality of life.


Get pregnant despite PCOS?

In women with PCOS, a number of circumstances can make pregnancy difficult. But it is also possible that they can become pregnant spontaneously.

Most people with PCOS have no or an irregular menstrual cycle. Without ovulation, however, there is no egg that can be fertilized. Often there is also a capsular contracture, a thickening around the ovary. The hormone imbalance also means that the lining of the uterus does not develop normally, making it more difficult for the fertilizable egg to implant.

Once the cause of the problem is identified, doctors can help. Ovulation can be provoked artificially. This is known as induction of ovulation. Medicines with active ingredients such as clomiphene citrate or gonadotropins are used for this purpose.

Since PCOS is often related to insulin resistance, the insulin user metformin can under certain circumstances bring success in treatment. It lowers male hormones, keeps your cycle regular, and can cause ovulation.

Those affected are particularly often advised to lose weight. This is often very difficult. There is no literature on special PCO diets on the German book market, but there are a number of publications in English. An exchange with other patients can also help a lot, there are now many self-help groups.

In Vitro Maturation (IVM) is a completely new form of treatment for infertility. Unlike IVF, only a small amount of hormonal stimulation is required. This method is still brand new and is only being tested in a few clinics - but in about five years it will probably be able to help people with PCO, for whom the previous forms of artificial insemination were not possible due to hormonal problems.

Andrea Vagt was prescribed gonadotropine injections. After five months, she took a break from treatment - and spontaneously became pregnant. Two years later she had a second child. “Today I am still happy that I was diagnosed with PCO syndrome back then. Without the medication, my body would certainly never have understood how to produce ovulation. "


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