Polycystic ovary syndrome is the most common hormonal disorder in women of reproductive age and the most common cause of infertility due to ovulation disorders. Typical symptoms include irregular, long or completely absent menstrual cycles. In addition, many women present with oily skin, acne and/or excessive hair growth (hirsutism). The elevated testosterone levels underlying these changes can also be detected by measuring a blood sample. Ultrasound examinations often reveal large polycystic ovaries. Especially in young women, the ovaries contain a large number of small follicles, this is normal and alone it is not sufficient to diagnose PCOS. More than half of women with PCOS are overweight and a large proportion have impaired insulin sensitivity (including an increased risk of gestational diabetes).
Weight management plays a particularly important role in the treatment of PCOS. The symptoms of PCOS may improve significantly with age, provided that the weight remains normal. In overweight women, weight loss alone may well be enough to induce ovulation, even if it not sufficient alone it sensitizes the ovaries to ovulation induction treatments and reduces the risks associated with pregnancy. In addition to actual weight reduction medication, weight management can be supported with, for example, metformin medication.
Inducing ovulation (ovulation induction) is possible with tablet treatment (letrozole, tamoxifen) or with FSH injections. The occurrence and timing of ovulation should confirmed with a urine ovulation test (LH test) or with a hCG injection (prescribed by a fertility expert). In some cases, in vitro fertilization (IVF) treatment is required.
Although PCOS is associated with impaired fertility, these women usually have the desired number of children with appropriate treatment.
