The egg causes acne

Polycystic ovary syndrome: how medication and diet help

Status: 08/17/2020 10:40 a.m.
If polycystic ovary syndrome is suspected, the ovaries are examined by ultrasound.

The hair on the head falls out, but it grows in unpleasant places, the body becomes more masculine, acne comes along, the desire for children remains unfulfilled: Polycystic Ovarian Syndrome, or PCO syndrome for short, is one of the most common causes of infertility. And that's not the only reason why it is a psychological burden for those affected.

VIDEO: Polycystic ovary syndrome: How medication and nutrition help (6 min)

It is estimated that one million women are affected in Germany - between five and ten percent of all women of childbearing age suffer from this hormone disorder. The eponymous "cysts" in the ovaries (ovaries) are actually not at all. The small vesicles that can be seen on ultrasound are immature egg cells. And only 70 percent of women affected even have this symptom. Polycystic ovary syndrome is a disorder in the hormonal control system of women. Male hormones are overproduced, which is why PCO syndrome is associated with male body hair and a male stature for many sufferers.

The cause of PCOS is unclear, obesity is often a factor

How the disease develops is not clear. What is certain is that the genes have a say: women who are affected often have mothers with polycystic ovary syndrome or fathers who went bald early due to hormonal factors. In addition, the relationship between the syndrome and body weight is striking: three out of four people affected are overweight. Most women, including those of normal weight, also suffer from insulin resistance: their cells no longer react to the hormonal signal from insulin to absorb sugar from the blood - the blood sugar level rises. The body then produces more and more insulin. Because of this, women with polycystic ovary syndrome have an increased risk of developing type 2 diabetes mellitus. Insulin resistance, in turn, promotes obesity because the hormone causes the body to store more and more energy, and it also promotes the production of male hormones - a vicious circle. If the sensitive interaction of hormones in the female body is disturbed, the polycystic ovary syndrome can cause infertility.

Symptoms of polycystic ovary syndrome

With polycystic ovary syndrome, the following symptoms can occur in different degrees:

  • irregular or absent menstrual bleeding
  • Hair loss, similar to that in men (receding hairline, bald head)
  • oily skin, acne - even after puberty
  • Hair growth on the thighs, stomach, chest, back, chin and cheeks
  • dark discoloration of the skin on the throat, neck, under the chest or armpits
  • infertility
  • Obesity

The physical complaints often have a significant impact on the psyche of those affected.

After the menopause, the symptoms decrease significantly for many.

PCO Syndrome: Blood Tests Important For That diagnosis

The gynecologist will ask about the patient's medical history, perform a physical examination including an assessment of the skin and body hair, and examine the ovaries using ultrasound. In order to determine the hormone status and to rule out diseases of the pituitary gland and the adrenal gland, extensive blood tests are necessary: ​​for male hormones, female (cycle) hormones and the anti-Müllerian hormone, which is often elevated in those affected. Because more profound metabolic changes are associated with the PCO syndrome, the blood lipid levels are also determined and, if necessary, a glucose tolerance test (oGTT) is carried out. In addition, an examination of the thyroid hormones is advisable, since about every third person affected also suffers from an autoimmune disease of the thyroid, the so-called Hashimoto's thyroiditis. This hypothyroidism, like the polycystic ovary syndrome itself, can be the cause of an unfulfilled desire to have children.

Therapy: Diet helps to regulate hormones

Even if the disease cannot be cured, the symptoms can be significantly alleviated. If you are overweight, weight loss alone often brings about a significant improvement. However, weight loss is often made more difficult for those affected by the disrupted hormone constellation. A change in lifestyle and eating habits helps to regulate the disturbed hormonal balance again. Because when the muscles are active and, in particular, the hormone-producing belly fat melts, the cells react better to insulin, the blood sugar level drops - and with it the production of male hormones. Therefore, especially white flour products and sweets should be avoided as much as possible. Instead, more vegetables, whole grains and filling protein should be on the menu, combined with omega-3-containing oils such as walnut or linseed oil.

Diabetes medication for polycystic ovary syndrome

If insulin resistance has been proven, therapy with oral diabetes medication such as metformin may be indicated at the same time as nutritional therapy, at least temporarily. This improves the problems with the sugar metabolism, but possibly also the menstrual cycle disorders and other symptoms. If the desire to have children is unfulfilled, the doctor can also prescribe medication that stimulates the ovaries and promotes ovulation (clomiphene). If there is no desire to have children, however, the cycle can be stabilized with the help of the birth control pill. It prevents ovulation, some preparations also have an anti-androgenic effect, i.e. reduce the influence of male hormones, so that hair loss, beard growth and acne subside.

For many of those affected, their emotional hardships weigh even more heavily than the physical problems. Medical treatment may also be necessary here, if talking to other people affected does not help.

Experts on the subject

Priv.-Doz. Dr. Sabine Segerer
Specialist in gynecology and obstetrics, gynecological endocrinology and reproductive medicine
Specialist center for fertility, prenatal medicine, endocrinology and osteology
Mönckebergstrasse 10 (Barkhofpassage)
20095 Hamburg
(0800) 589 16 88

Prof. Dr. Onno Janßen, specialist in internal medicine, endocrinology and diabetology
Lornsenstrasse 6, 22767 Hamburg
(040) 30 62 82 00

Julia Schultz: Living with PCO syndrome: How to bring your hormones back into balance with the right diet Complete media 2020

additional Information
PCOS Self-Help Germany e.V.

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