Hormonal pills for polycystic ovary syndrome. Treating hibernation at home. Drugs to restore metabolic function - gallery

Violation of the process of follicle maturation negatively affects a woman’s reproductive function.

How to treat polycystic ovary syndrome?

How to combine medications with physiotherapy?

Are there any benefits to using folk remedies? The answers are in the article.

A polyendocrine complex of negative symptoms develops against the background of autoimmune disorders, endocrine pathologies, hormonal imbalances, and problems with the functioning of the pituitary gland.

Women need to be more attentive to the health of the reproductive system if they have close relatives with type 2 diabetes, obesity, or arterial hypertension.

Polycystic ovary syndrome (PCOS) affects the hypothalamus, pituitary gland, pancreas, adrenal cortex and target organs: uterus, ovaries. The ovulation process is disrupted, tests show excess production of male hormones and decreased production of female hormones.

On ultrasound, doctors detect enlarged ovaries, inside of which there are multiple follicles, the diameter of which varies from 2 to 9 mm. During the normal course of the menstrual cycle after ovulation, unnecessary follicles undergo reverse development; with polycystic disease or other disorders of the reproductive system, the process proceeds with deviations.

What to do if the doctor makes a diagnosis? It is necessary to contact a specialist who will prescribe a course of hormonal medications that restore normal levels of hormones in the body, or he will carry out other successful treatment.

Read about large ovarian cystomas.

See what antibiotics you should take for inflammation of the ovaries.

Causes

Violation of the stages of physiological development of follicles is provoked by:

• congenital pathology against the background of health problems in the pregnant woman, when the fetus receives insufficient nutrients due to the meager diet of the expectant mother;
• deviations in the development of the organs of the reproductive system during puberty;
• endocrine pathologies;
• improper functioning of the thyroid gland, hypothalamus, adrenal cortex, pituitary gland;
• inflammatory processes in the female genital organs (development of a secondary form of the disease).

Symptoms of polycystic disease

It is worth contacting a gynecologist and endocrinologist if the following signs appear:

• menstruation became irregular, discharge became scanty or heavy, pain appeared;
• the oiliness of the skin and hair has increased, an accumulation of ulcers and white pimples is observed on the face and body, symptomatic therapy does not give a lasting result;
• in the lower abdomen with polycystic ovary syndrome, dysfunction of the reproductive system, nagging pain is periodically bothered;
• measurement of basal temperature throughout the cycle shows: the values ​​practically do not change, there is no characteristic jump on days 13-17, which indicates the absence of ovulation;
• hair is actively falling out;
• over a short period, the weight has increased by 10 kilograms or more, it is difficult to stabilize body weight;
• pregnancy does not occur, although the couple does not use contraception;
• Hair growth is more active on the face, stomach, and chest.

Effective treatments

PCOS requires a comprehensive examination and the use of several elements of therapy.

When the diagnosis of polycystic ovary syndrome is confirmed, you need to find a high-level clinic and experienced doctors: only with adequate therapy can you cope with the problem.

How to cure polycystic ovary syndrome? A clear treatment plan is developed by a gynecologist, and an endocrinologist and a neurologist must be involved.

It is important to take into account the individual characteristics of the body and find out the probable causes of deviations in polycystic ovary syndrome. Doctors should explain that eliminating PCOS requires time and the woman’s active participation in the therapy process to normalize the functioning of the reproductive system. For maximum effect, not only drugs, but also folk remedies are used.

Main stages of treatment:

1. Reducing body weight, stabilizing indicators at an optimal level. Until this condition is met, taking medications does not give the desired result.
2. Taking hormonal medications to correct disorders. If the effectiveness of oral contraceptives is low, formulations are prescribed to reduce insulin resistance.
3. Stimulation of the ovulation process to normalize reproductive function.

If conservative treatment of polycystic ovary syndrome is low, laparoscopy is prescribed - a low-traumatic endoscopic operation to remove multiple follicles.

Diet for polycystic disease

When stabilizing body weight, it is important to reduce the calorie intake to 1800-2000 calories per day. Be sure to get “slow” carbohydrates, vegetable fats, and proteins. Fasting is a bad option for losing weight; it is better to have fasting days twice a week.

Illustration of polycystic ovary syndrome

Doctors recommend getting more fiber and vitamins from fruits and vegetables, eating nuts, dairy products, vegetable oils, especially olive and flaxseed, porridge, and light vegetable soups. A useful product for losing weight and maintaining optimal body weight is turkey meat: it is richer in vitamins and minerals than chicken and is easier to digest by the body.

It is important to limit the menu:

• pickles;
• marinades;
• spicy seasonings;
• ready-made sauces and ketchups;
• canned food;
• fatty meat and fish;
• refractory fats;
• offal;
• strong black tea and coffee;
• fatty dairy products;
• red meat;
• packaged fruit juices;
• butter;
• sweet soda;
• confectionery;
• baked goods;
• mayonnaise;
• chocolate;
• sugar;
• fried foods;
• smoked meats;
• salt (up to 3-5 g per day).

Drinking regime is a prerequisite for stabilizing body weight and proper metabolism.

When treating polycystic ovary syndrome, you need to get clean water, juices, fruit drinks, green tea, compotes, milk, and other types of liquid per day - up to two liters in total. Mineral water without gas is useful: the optimal variety is selected by the attending physician.

Physiotherapy

Procedures for polycystic ovary syndrome do not directly affect hormonal levels, but have a beneficial effect on metabolic processes, neuro-reflex regulation, blood circulation in the pelvis, and activate fat burning to stabilize body weight. Physiotherapy methods provide a calming and anti-inflammatory effect, and activate the functioning of the organs responsible for the production of hormones.

Effective methods of influence:

• galvanophoresis with lidase and vitamin B 1;
• paraffin applications;
• electrophoresis;
• mud therapy;
• laser therapy;
• magnetic therapy;
• coniferous, marine, sodium chloride baths;
• circular shower or Charcot shower.

Drug treatment

After stabilizing body weight, doctors prescribe a set of drugs:

• Hormone therapy to normalize the menstrual cycle. A woman takes combined types of oral contraceptives without androgenic effects. Effective names for polycystic ovary syndrome: Janine, Marvelon. When the influence of male sex hormones is pronounced, another type of drug is prescribed - the antiandrogen Diane-35;
• Drugs to stimulate ovulation. Also to enhance the effect of using hormonal compounds in case of disruption of the reproductive system. A common treatment regimen for polycystic ovary syndrome is the use of the drug Clomiphene (days 5-19 of the cycle), in the second phase Duphaston tablets are prescribed for ten days;
• Vitamin therapy. It is important to support the body, strengthen defenses, normalize nervous regulation, and improve the condition of the vascular wall. Tocopherol has a positive effect on the production of female hormones, ascorbic acid is a powerful antioxidant, B vitamins are indispensable for the normal functioning of the central nervous system and peripheral nervous system;
• Drugs for the treatment of diabetes mellitus. Including diabetes, which often develops against the background of polycystic ovary syndrome, and malfunctions of the reproductive system. Effective agents: Pioglitazone, Metformin;
• Eflornithine hydrochloride. A drug that inhibits cell growth and polyamine production. After 1.5-2 months of use, the rate of hair growth in inappropriate places decreases;
• The drug Flutamide. It has a pronounced antiandrogenic effect. The course of therapy for problems with the functioning of the reproductive system using NSAIDs is designed for 6 months.

How to treat polycystic ovary syndrome with folk remedies and at home?

Decoctions of medicinal herbs complement drug treatment and physiotherapy, but herbal remedies cannot replace hormonal pills. Before taking formulations with phytoestrogens, it is important to consult an endocrinologist and gynecologist and obtain the approval of doctors.

To normalize metabolic processes, several folk remedies are used:

• freshly squeezed burdock juice;
• decoction of red brush;
• juice from fresh viburnum berries;
• peony tincture;
• decoction of basil leaves;
• alcohol tincture of boron uterus;
• infusion of licorice root.

With PCOS syndrome, you need to know how to treat polycystic ovary syndrome in each individual woman.

It is important to take into account the state of nervous and endocrine regulation and assess the degree of damage to the reproductive system. The combination of a complex of drugs with diet, folk remedies, and physiotherapy ensures in most cases a positive result, restoration of the physiological development of the follicles.

Video on the topic

Disorders can also affect the pancreas, which manifests itself in hypersecretion of insulin, the adrenal cortex, resulting in excess production of adrenal androgens, as well as the pituitary gland and hypothalamus.

What it is?

Polycystic ovary syndrome is a polyendocrine syndrome accompanied by dysfunction of the ovaries (absence or irregularity of ovulation, increased secretion of androgens and estrogens), pancreas (hypersecretion of insulin), adrenal cortex (hypersecretion of adrenal androgens), hypothalamus and pituitary gland.

Causes of PCOS

The development of polycystic ovary syndrome is primarily based on polyendocrine disorders, manifested by dysfunction:

• ovaries (irregularity or absence of ovulation, increased secretion of estrogen);
• pituitary gland and hypothalamus (dysregulation of the adrenal glands and ovaries);
• adrenal cortex (increased secretion of androgens);
• pancreas (increased production of insulin with tissue insensitivity to it).

Violation of hormonal regulation leads to a suspension of the development and maturation of follicles, an increase in the size and compaction of the ovarian capsule, under which multiple cystic growths begin to form from immature follicles. This entails ovulation disorder, menstrual function and infertility. Against the background of obesity (and it occurs in women with PCOS in 40% of cases), these processes are even more pronounced.

Infectious diseases, stress, and even climate change can provoke hormonal imbalances.

Polycystic ovary syndrome and pregnancy

A diagnosis of polycystic disease is not at all a reason to give up the idea of ​​having a child. It’s just that to do this you will have to go through a more difficult path than healthy women. In medicine, there are many cases where women with a similar diagnosis successfully became pregnant, carried and gave birth to a child. While carrying a child, a woman is prescribed maintenance therapy - Duphaston, Utrozhestan and other drugs that prevent miscarriage. Since pregnant patients have such a terrible diagnosis, they are closely monitored in the third trimester, when there is a threat of gestational diabetes, increased blood pressure, and weight gain. However, if all doctor's instructions are followed, pregnancy with polycystic disease is quite possible.

As a result of surgical intervention, more than sixty percent of women achieve a positive result - they successfully become pregnant and bear children. Doctors insist that couples decide to procreate as soon as possible after the operation, since the effect of the operation does not last long - about three years. In order to support a woman during the conception of a child, she is prescribed drugs that stimulate the maturation of the egg. If you miss the time of remission, it will be more difficult to get pregnant in the future.

In some cases, pregnancy itself can help cure polycystic disease, since during conception and gestation, enormous hormonal changes occur in the female body.

Symptoms

In women, the symptoms of polycystic ovary syndrome are very varied and may resemble symptoms of other diseases. Another special feature is that it is not necessary for one woman to have all the symptoms at once.

The main symptom of polycystic ovary syndrome that forces you to see a doctor is the inability to get pregnant. The most common causes and additional symptoms of polycystic ovary syndrome:

1. Oligomenorrhea - irregular, infrequent menstruation or complete absence of menstruation; those menstruation that does occur can be pathologically scanty or, on the contrary, excessively abundant, as well as painful;
2. Central obesity is “spider-shaped” or “apple-shaped” obesity of the male type, in which the bulk of adipose tissue is concentrated in the lower abdomen and abdominal cavity;
3. Elevated blood levels of androgens (male hormones), especially free fractions of testosterone, androstenedione and dehydroepiandrosterone sulfate, which causes hirsutism and sometimes masculinization;
4. Acne, oily skin, ;
5. Androgenic (significant male-pattern baldness or hair loss with bald patches on the sides of the forehead, on the top of the head, occurring due to hormonal imbalance);
6. Acrochordons (skin folds) - small folds and wrinkles of the skin;
7. Acanthosis (dark pigment spots on the skin, from light beige to dark brown or black);
8. Long periods of symptoms resembling those of premenstrual syndrome (swelling, mood swings, pain in the lower abdomen, lower back, pain or swelling of the mammary glands);
9. The appearance of stretch marks (stretch marks) on the skin of the abdomen, thighs, buttocks, as a result of rapid weight gain against the background of hormonal imbalance;
10. Depression, dysphoria (irritability, nervousness, aggressiveness), often drowsiness, lethargy, apathy, complaints of “fog in the head.”
11. Night apnea - stopping breathing during sleep, leading to frequent awakenings of the patient at night;
12. Multiple ovarian cysts. Sonographically, they may appear as a “pearl necklace,” a collection of whitish vesicles or “fruit pits” scattered throughout the ovarian tissue;
13. An increase in the size of the ovaries by 1.5-3 times due to the appearance of many small cysts;
14. Thickened, smooth, pearly white outer surface (capsule) of the ovaries;
15. Thickened, hyperplastic endometrium of the uterus is the result of a long-term excess of estrogen, not balanced by adequate progesterone influences;
16. Elevated LH levels or increased LH/FSH ratio: when measured on the 3rd day of the menstrual cycle, the LH/FSH ratio is greater than 1:1;
17. Reduced levels of sex steroid binding globulin;
18. Hyperinsulinemia (increased levels of insulin in the blood), impaired glucose tolerance, signs of tissue insulin resistance when tested using the sugar curve method;
19. Chronic pain in the lower abdomen or lower back, in the pelvic region, probably due to compression of the pelvic organs by enlarged ovaries or due to hypersecretion of prostaglandins in the ovaries and endometrium; The exact cause of chronic pain in PCOS is unknown.

Also, polycystic disease may be accompanied by signs of diabetes (weight gain, increased urination), chronic skin infections or thrush (vaginal candidiasis).

Complications

In addition to reproductive dysfunction, polycystic ovary syndrome can sooner or later trigger the development of gestational diabetes, arterial hypertension and lead to significant weight gain.

Women with polycystic ovary syndrome have an increased risk of developing coronary heart failure, peripheral vascular disease, clogged arteries and vein thrombosis, myocardial infarction and stroke. Those patients who are on long-term hormonal therapy should be wary of the development of mastopathy, endometriosis, breast cancer and cervical cancer.

Diagnostics

Diagnosis of PCOS includes a gynecological examination, ultrasound of the ovaries and hormonal examination, as well as other auxiliary techniques.

1. A blood test for hormonal status shows an increased concentration of androgens, follicle-stimulating and luteinizing hormones (as well as their ratios). Hormonal testing may also reveal impaired glucose tolerance and elevated insulin levels.
2. Ultrasound scanning. During this procedure, multiple small cysts are identified on the surface of the female reproductive glands. As a rule, the affected organs increase in size, their surface becomes lumpy, and the capsule thickens. Due to a chronic excess of estrogen, thickening of the endometrium (the inner layer of the uterus) is clearly visible on the ultrasound monitor.
3. When conducting a glucose tolerance test, high blood sugar levels indicate a violation of carbohydrate metabolism, that is, the development of hyperinsulinemia.
4. In order to be able to “see” the ovaries affected by polycystic disease, patients are shown a laparoscopic examination. Today, ovarian laparoscopy is the most informative diagnostic technique. With the development of Stein-Leventhal syndrome, the capsule of the reproductive gland thickens and smoothes, the organ acquires a pearly-whitish color, reaching a length of 5-6 and a width of 4 cm.
5. For patients suffering from mastopathy, mastography or breast thermography is indicated.
6. To identify metabolic disorders, the blood lipid profile is determined. With polycystic ovary syndrome, the concentration of low-density lipoproteins increases and the concentration of high-density lipoproteins decreases.

What does polycystic ovary syndrome look like, photos of symptoms:

How to treat polycystic ovary syndrome?

Treatment of polycystic ovary syndrome can be carried out with the involvement of several specialists at once: a gynecologist (or better yet, a specialized gynecologist-endocrinologist), an endocrinologist and a nutritionist.

It is almost impossible to completely cure polycystic disease. Gynecologists can only minimize the manifestations of the disease and thus help a woman achieve her main goal (usually the conception and birth of a healthy child). However, to get what you want, you cannot delay visiting a doctor. The sooner the diagnosis is made, the easier it will be to normalize hormonal levels and restore the proper functioning of the reproductive system.

The conservative treatment regimen is as follows:

• Drugs that stimulate ovulation.
• Antiandrogens. This is a group of drugs that reduce the amount of male hormones.
• Drugs aimed at treating diabetes mellitus. Typically, this role is played by the drug metformin, which, in addition to regulating insulin production, promotes weight loss.
• Hormonal contraceptives. Help restore the cycle and avoid the development of endometriosis. Some drugs have an antiandrogenic effect (fight acne and excess body hair). This method is not suitable for women who want to become pregnant.
• Diet. For some women, losing excess weight is enough for insulin levels to return to normal and ovulation to occur. Therefore, diet therapy plays an important role in the treatment of polycystic ovaries. The diet for polycystic ovary syndrome is aimed at eliminating large amounts of fats and carbohydrates. A combination of diet and exercise is a must.

Complex drug therapy is prescribed for up to 6 months. If the result is unsatisfactory (pregnancy does not occur), gynecologists resort to surgical treatment. Modern laparoscopic equipment allows such interventions to be carried out with the least amount of trauma for the woman - within 3-4 days after the operation the patient is discharged home, and only a few almost invisible scars remain on her body.

Nutrition rules

The vast majority of patients with PCOS are overweight.

Adipose tissue has the ability to accumulate steroids, excess fat means excess steroids and dysfunction of the hypothalamus, which “guides” the menstrual cycle. Obesity leads to amenorrhea, infertility and many other serious consequences. To successfully treat hormonal disorders, it is necessary to eliminate the negative impact of adipose tissue on the body, so treatment for polycystic ovary syndrome begins with weight correction.

As a result of observations of patients, it was possible to find out which products are most useful for women with polycystic disease:

• vegetables - lettuce, broccoli, bell peppers (red and yellow), garlic, lettuce, zucchini, eggplant, cucumbers, carrots, asparagus, celery, garlic;
• fruits - plums, oranges, grapefruit, kiwi, apples, cherries, pears;
• greens – rosemary, parsley, dill, basil;
• grains and legumes - beans, whole grain bread, beans, durum pasta, peanuts, soybeans, pumpkin, brown rice;
• vegetable oils – sesame oil, milk thistle oil, flaxseed oil, olive oil, pumpkin oil;
• dried fruits - raisins, prunes, figs, dried apricots;
• dairy products - cheese, cottage cheese, yogurt and low-fat milk;
• meat - chicken, quail, ostriches.

• reducing calorie intake to one thousand two hundred calories per day;
• switching to small, frequent meals (about five to six times a day);
• the diet should contain more low-calorie foods - vegetables and fruits;
• increasing protein consumption (primarily from fish and seafood, cottage cheese, meat);
• limiting carbohydrates (sugar, carbonated drinks, baked goods);
• eliminating animal fats and switching to vegetable fats;
• exclusion of any doses of alcohol;
• eating food without spices, seasonings, seasonings
• refusal of smoked, pickled products.

After body weight returns to normal, the number and range of foods consumed can be expanded. However, if the patient returns to her previous diet, excess weight will quickly return. To get rid of obesity forever, you need to consume foods in such quantities that your body weight remains in a stable physiological state.

Physical activity (fitness, gymnastics) is a good addition to a balanced diet. For some patients, exercising just two hours a week along with a diet gives results similar to taking special weight loss pills.

Ovulation stimulation

After the menstrual cycle is restored, they move on to the main stage of therapy - stimulation of ovulation (for those patients who want to have children). For these purposes, drugs with pronounced antiestrogenic properties are used - “Clomiphene” (“Clostilbegit”).

After discontinuation of these drugs, the synthesis of LH and FSH occurs, which, by their action, stimulate the maturation of the dominant follicle and the process of ovulation. The drug is prescribed from the 5th to the 9th day of the menstrual cycle, for a period of no more than 3 months at a dosage of 0.05 g/day. If there is no effect from therapy, the dose is increased to 200 mg. Clostilbegit has one very unpleasant side effect - the risk of developing large functional cysts in the ovaries increases significantly. If therapy with this drug does not produce results within 3 months, the issue of surgical intervention is decided.

Surgical intervention

Surgical treatment of the disease is currently performed laparoscopically. Two surgical options are used: wedge resection of the ovaries and electrical coagulation of the brushes in the ovaries. The second method is more gentle, as it involves making incisions on the ovarian capsule and cauterizing multiple brushes. During wedge resection, the most altered areas of the ovaries (both capsule and stroma) are excised.

But it should be noted that a woman’s fertility is directly proportional to the duration of the operation, that is, the more time has passed after surgical treatment, the less likely it is to become pregnant. The maximum ability to conceive occurs in the first 3 months after surgery, and by the end of the year it decreases significantly. However, surgical treatment is indicated not only for patients with infertility, but also for diagnosing persistent hyperplastic processes of the endometrium.

IVF for polycystic ovary syndrome

The IVF program for polycystic ovary syndrome consists of 6 stages:

• stimulation of follicle growth;
• puncture (ova are obtained invasively);
• fertilization and cultivation in an artificial environment;
• embryo transfer;
• support of the luteal phase of the cycle (progesterone);
• diagnosis of early pregnancy.

If sperm quality is unsatisfactory, IVF ICSI is performed. It is necessary to dwell in more detail on the fact that in the IVF protocol for polycystic ovary syndrome, stimulation can lead to hyperstimulation syndrome. Therefore, all obtained embryos can be cryopreserved and transferred in the next cycle.

Prevention

There is currently no specific prevention of the disease.

Considering that the formation of polycystic ovary syndrome begins in girls during puberty, it is necessary to promptly pay attention to menstrual irregularities, as well as the development of obesity and manifestations of hyperandrogenism in this group of children.

Polycystic disease is a hormonal pathology that occurs as a result of a violation of the hypothalamic regulation of the ovaries. The disease entails an imbalance in the menstrual cycle, obesity, excessive hairiness (hirsutism), and can also cause infertility. Among the causes of female infertility, polycystic ovary syndrome (PCOS) occupies a leading position.

We will look in more detail about what kind of disease this is, what causes it, as well as what symptoms and treatment are most effective for a woman later in this material.

Polycystic ovary syndrome: what is it?

Polycystic ovary syndrome is a change in the anatomy and function of the ovaries against the background of impaired ovarian metabolism (steroidogenesis). The disease is associated with impaired estrogen synthesis and folliculogenesis and increased formation of androgens, which leads to the formation of multiple small cysts on the surface of the ovaries (the result of the inability of the egg to exit the follicle) and infertility.

The disease can be found under another name- polycystic ovary syndrome is a more capacious definition, as it combines several symptoms that form this pathology.

The female ovaries perform two important functions, without which the normal functioning of the reproductive system is impossible:

• The endocrine function is responsible for the normal production of progesterone and estrogens, which, in turn, prepare the inner layer of the uterus for the attachment of the fertilized egg in the event of pregnancy.
• The degenerative function is responsible for the growth and development of follicles, from which the egg is subsequently released.

The size of the ovary depends on age and phase of the menstrual cycle. The right one is usually larger and heavier than the left one. Ovaries of normal size can usually be palpated during examination only in thin women.

What happens during illness?

1. During the menstrual cycle, many follicles are formed in a healthy sex gland.
2. In the middle of a normal cycle, a mature follicle ruptures, from which an egg is released into the fallopian tube (ovulation), while other follicles are resorbed.
3. But ovulation does not occur with polycystic disease, since the egg inside the dominant follicle does not mature, and all follicles fill with fluid, transforming into small cysts.

Classification

The disease is conventionally divided into two forms, depending on the primacy of the pathology:

• primary PCOS, or true polycystic disease, which has other names - “Polycystic ovarian disease” (PCOD)”, “Sclerocystic ovaries”, “Stein-Leventhal syndrome”;
• secondary polycystic disease, which is the result of disorders of different initial mechanisms.

There are three types of polycystic disease:

Causes

Science learned about polycystic ovary syndrome more than 100 years ago, but until now, due to the fact that this pathology is characterized by multiple manifestations, its etiology and pathogenesis have not yet been fully studied.

Research shows that PCOS affects 5 to 10% of all women of childbearing age, regardless of race or ethnicity.

The following factors predispose to the development of the disease:

• genetic predisposition;
• excess body weight;
• constant stress;
• presence of chronic infections;
• a large number of abortions (lead to hormonal imbalances);
• complicated course of pregnancy and childbirth;
• irregular sex life;
• endocrine pathology (diseases of the thyroid gland, adrenal glands, pancreas and others);
• disturbed ecology;
• gynecological problems (both inflammatory and endocrine in nature).

Polycystic ovary syndrome occurs in both teenage girls and adult women who have given birth. The impetus for the development of the disease can be severe stress, a serious infectious disease, an autoimmune process, or a sudden change in climate.

Symptoms of polycystic ovary syndrome

The symptoms of polycystic disease are incredibly varied, most of them are nonspecific, as they can be present with any dyshormonal disorder. They may appear with your first period or several years after a period of normal menstruation.

The most common symptoms of polycystic disease in women:

• Menstrual irregularities – long delays and prolonged menstruation.
• Increased greasiness of hair and skin, the appearance of acne, pimples, seborrhea. In polycystic disease, they develop due to hypersecretion of androgens, are permanent in nature, and do not respond to symptomatic therapy.
• Significant increase in body weight. Fat deposits appear mainly in the waist area (apple-type). The development of obesity in polycystic ovary syndrome is associated with impaired glucose tolerance and excess insulin in the blood.
• The appearance of dark spots on the skin (often in the neck area), acne, wrinkles and skin folds, increased oily skin, male pattern hair growth (hirsutism).
• Pain in the abdominal area. The pain symptom may be constant. This is explained by enlargement of the ovaries and pressure on the pelvic organs.
• constancy of basal temperature - an increase in basal temperature in women indicates that ovulation has occurred - it is by this sign that the best days for conception are determined. Patients with polycystic disease have a constant temperature, which indicates that the woman is not ovulating.
• Infertility. It is explained by chronic anovulation or rare ovulation (during the rupture of the follicle and the release of the egg, it cannot break through the too dense lining of the ovary).
• Depression and dysphoria. The manifestations of these conditions are expressed in nervousness, irritability and aggressiveness. Quite often lethargy, apathy, and drowsiness are also noted.

Diseases that can mimic polycystic disease:

• Pathological processes associated with hypofunction of the thyroid gland;
• Tumors of the ovaries and adrenal glands;
• Increased secretion (hyperprolactinemia of the pituitary gland).

I would like to emphasize that the symptoms of the above diseases are very similar to the signs of PCOS, and therefore great attention should be paid to the diagnosis of the pathological process.

Complications

Polycystic ovary syndrome is a very insidious disease, which, in addition to infertility, entails a lot of undesirable consequences for a woman’s health.

Possible consequences:

• The most serious complication of the disease is the woman’s inability to become pregnant.
• If a woman does not respond appropriately to the symptoms of the disease and does not seek medical help within the first two years after the onset of the disease, then her risk of developing cervical and breast cancer increases.
• Metabolic disorders, and primarily fats, lead to the development of vascular atherosclerosis, stroke, myocardial infarction, fatty liver hepatosis and type 2 diabetes mellitus.
• Severe form due to massive uterine bleeding.

Polycystic disease is a disease that has a favorable prognosis. Timely and high-quality treatment leads to the restoration of the ability of a representative of the weaker half of society to conceive and bear a fetus in 75-90% of cases.

Diagnostics

It's no secret that a timely diagnosis will help to begin effective treatment in a timely manner and help avoid surgical intervention. Diagnostics will help to establish the true causes that provoked the disease.

Polycystic ovary syndrome is diagnosed only based on a combination of several signs (the main ones are infertility, increased androgens and related symptoms).

Basic methods for diagnosing polycystic disease:

1. General examination, including assessment of body type, hair growth pattern, condition of the skin and mucous membranes, palpation of the abdomen, etc.
2. Gynecological vaginal-abdominal examination on a chair, revealing enlargement and hardening of the ovaries on both sides.
3. Ultrasound transvaginal examination. The volume of the ovaries is increased and amounts to 8 or more cubic cm. Directly under the capsule, 10 or more atretic follicles are found. The stroma is thickened, hyperplastic and can account for 25% of the ovarian volume.
4. Magnetic resonance imaging (MRI) to exclude tumor lesions.
5. Pelvic laparoscopy is an examination of the abdominal organs using an endoscope inserted through the anterior abdominal wall. Indications for laparoscopy are suspicion of a tumor of the uterus or ovaries, chronic pelvic pain, suspicion of tubal pregnancy, ovarian apoplexy, tumors, rupture of a cyst.
6. A glucose tolerance test (insulin resistance), elevated insulin levels, and high blood sugar indicate a disorder in carbohydrate metabolism.

It is also necessary to conduct a study of hormonal status.

• A pathognomic sign of polycystic ovary syndrome is an increase in the ratio of luteinizing hormone to follicle-stimulating hormone to 3:1.
• The testosterone content in the blood is increased, a decrease is noted in the second phase of the cycle, and an increase in 17-KS is detected in the urine.

Note: in case of hormonal imbalances, the basal temperature remains unchanged throughout the menstrual cycle. Deepening of the voice, defeminization and hypertrophy of the clitoris are usually not observed with PCOS.

Pregnancy

In the vast majority of cases (85%), infertility with polycystic ovary syndrome is primary and may be its only symptom. The number of spontaneous pregnancies with polycystic disease does not exceed 3–5%, and the likelihood of a successful outcome is negligible.

Most experts say that it is quite possible to get pregnant with PCOS. In clinical practice, there are many cases of successful pregnancy in patients suffering from polycystic disease. However, for this purpose, maintenance drug therapy is recommended throughout pregnancy.

Attention! During pregnancy with such a diagnosis, there is a high risk of fetal death, miscarriage and premature birth.

How to treat polycystic ovary syndrome?

Treatment of polycystic ovary syndrome is a rather lengthy and complex process. The main thing is to be patient and tirelessly pursue the goal.

Treatment goals:

• normalization of the menstrual cycle;
• restoration of ovulation and subsequent pregnancy;
• elimination of cosmetic problems;
• weight correction.

Considering the fact that polycystic ovaries can act as a side manifestation of another type of disease (chronic adnexitis, diabetes, liver disease, etc.), treatment should be aimed not only at eliminating the symptoms (polycystic ovaries themselves), but also at eliminating the underlying disease , which provoked the pathology in question.

Treatment consists of:

1. Mandatory weight loss in the presence of obesity. In these patients, this stage is the first. To do this, correction of nutrition and lifestyle is carried out. Losing weight can help treat hormonal changes and improve health conditions such as diabetes, high blood pressure or high cholesterol.
2. Oral contraceptives reduce the concentration of androgens in the blood. If you take the drugs for 2-3 months, it is possible to restore the ability to ovulate. The method is effective only for polycystic disease caused by hyperandrogenemia.
3. If you have insulin resistance- reduced ability of cells to respond to insulin, which helps absorb glucose, metformin drugs are prescribed: Glucophage, Siofor.
4. Ovulation stimulation. Minimum doses of hormones are prescribed that will “start” the ovaries and make it possible to get pregnant as naturally as possible.
5. Non-hormonal therapies polycystic ovary syndrome, for example, physical therapy or non-steroidal antiandrogens are usually used as adjuncts.
6. It is necessary to take ascorbic acid and vitamins of the following groups: E, B12, PP, B1, B9, B6.

Operation

The indication for surgical treatment of polycystic ovary syndrome is the lack of effect of conservative therapy. The method of operation is determined depending on the picture of the disease. In women with infertility, surgical treatment is an analogue of hormonal stimulation of ovulation.

Methods of surgical intervention are aimed at achieving the following goals:

• remove affected parts;
• destroy some areas of the ovary;
• activate the synthesis of androgens in order to normalize the relationship between the ovaries and the central parts of the brain structure.

The main advantage of laparoscopy is that this procedure does not harm the patient. She comes to her senses within a couple of hours after the operation, and full recovery occurs within a few days.

But surgical methods are resorted to in extreme cases, when the medicinal methods described above do not help. Laparoscopy may also be prescribed for women over 30 years of age who have pronounced disorders of hirsutism and the menstrual cycle, as well as those who are found to have developed endometrial hyperplastic processes.

If treatment for polycystic disease is prescribed in a timely manner, it can be eliminated at the earliest stages. If you follow all medical recommendations, the prognosis of the disease is favorable, and only when planning a pregnancy can certain difficulties arise.

Pregnancy after surgical treatment occurs within 6-9 months, but the more time passes after surgery, the less chance of getting pregnant.

Diet

Nutrition provides the body with substances to produce the energy necessary for metabolic processes, for the restoration and synthesis of new cells in order to store reserve substances (fat in adipose tissue, glycogen in the liver).

• a hearty first breakfast approximately 30-40 minutes after waking up;
• light second breakfast;
• full lunch;
• multi-course dinner;
• light snack before bed.

If you have polycystic ovary syndrome, you will have to once and for all eliminate foods that contain large amounts of carbohydrates and cholesterol from your diet. This requirement is very categorical - the foods listed below cannot be eaten even sometimes and even if you really want to.

Diet rules for polycystic ovary syndrome:

• The calorie content of food is no more than 1800 - 2000 kilocalories per day.
• Fractional meals 5-6 times.
• Combine protein foods with vegetables.
• Do not combine fruit intake with other foods.
• Cooking methods - boiling, stewing, baking, steaming.
• Drinking regime: up to 2 liters of water per day.
• Fasting days no more than once every 7-10 days (kefir, curd, fruit).
• Reduce the consumption of salt and foods where Na is contained in large quantities (crackers, nuts, canned food).
• Limit carbohydrate intake after 6 pm.

Traditional methods of treatment

Before using folk remedies for polycystic ovary syndrome, be sure to consult a gynecologist.

1. Tampons with mumiyo. Mummy in the amount of 150 grams is poured with 3 dessert spoons of warm water. After the main component swells, stir the mixture. A tampon formed from a bandage is placed in the composition and inserted into the vagina before going to bed at night. The course of treatment is 10 days. The procedures are not used during menstruation.
2. Stem and leaves Wash, dry and chop the young celandine. Mix in equal parts with vodka and leave in a dark place for 10 days. Drink a teaspoon of infusion mixed with 50 ml of water thirty minutes before meals.
3. Place 5 g of milk thistle in a glass of boiling water. Let cool and filter. Drink 100 ml in the morning on an empty stomach and in the evening before bed.
4. You will need 40 g of dry oregano per 300 ml of boiling water. After an hour, filter and drink 20 ml three times a day.
5. Peppermint can be used to reduce androgens. Mint tinctures, mint tea can be drunk without restrictions (within reason). To quickly achieve the desired effect, you need to brew mint together with milk thistle and take one glass twice a day.

Prevention

Prevention of polycystic disease includes:

• regular visits to the gynecologist - twice a year;
• weight control, regular exercise, diet;
• taking hormonal contraceptives.

Now, you know what kind of disease this is. But, despite serious pathological changes in the reproductive system, reasonable, correct and step-by-step treatment of polycystic ovary syndrome makes it possible to restore its normal hormonal functioning and achieve a full pregnancy and childbirth.

Polycystic ovary syndrome is a syndrome whose morphological manifestation is numerous cystic formations in the gonads.

Thus, the functioning of the female reproductive system is ensured by the coordinated work of the hypothalamus, pituitary gland, ovaries, adrenal glands and thyroid gland. In the case of polycystic ovaries, this mechanism fails, ultimately leading to infertility.

The result of polycystic disease is the formation of numerous cysts on the surface and inside the ovary, which can be either single or merge into intricate “clusters”.

The formation of such benign neoplasms on the body of the ovary leads to the fact that the dominant follicle does not mature in it, and as a result, anovulatory cycles predominate in the woman, which makes pregnancy impossible.

Causes

Why does polycystic ovary syndrome develop, and what is it? Polycystic ovary syndrome (PCOS) is a very common gynecological disease in which a woman's body the following violations occur:

1. The maturation of eggs in the ovaries is disrupted, as a result of which a woman may experience significant difficulty conceiving a child.
2. Numerous cysts (fluid-filled blisters) may form in the ovaries.
3. Menstruation comes rarely with long breaks or stops altogether.
4. A woman's body produces a large amount of male sex hormones (androgens).

The exact reason is still under investigation. There are several theories trying to explain the mechanism of development of polycystic ovary syndrome, but they do not have a sufficient evidence base, so we will not present them below.

It is believed that the following factors predispose to the development of this condition in the ovaries:

• inflammation of the reproductive organs;
• hereditary factors (if such a pathology was observed in women in the family);
• genital injuries (especially ovaries);
• obesity;
• frequent abortions;
• complicated and difficult labor.

There is also a distinction between primary polycystic ovary syndrome (Stein-Leventhal syndrome) and secondary polycystic ovary syndrome. Secondary polycystic ovary syndrome develops against the background of adrenal hyperplasia, thyroid disease, diabetes, and obesity.

Is it possible to get pregnant with polycystic ovary syndrome?

The hormonal disorder that causes polycystic ovary syndrome is observed in women of reproductive age. Due to disruption of the natural process of follicle maturation, a mature egg does not leave the ovary.

An additional “obstacle” is the thickened ovarian capsule that forms with polycystic disease. Thus, ovulation occurs much less frequently than a healthy cycle would suggest (oligo-ovulation) or does not occur at all (anovulation). Outwardly, this is manifested by the absence or irregularity of menstruation and infertility. Women often learn about polycystic ovary syndrome when they are already starting treatment for infertility. Sometimes such patients manage to get pregnant, but often due to hormonal imbalance, the pregnancy ends in the early stages.

However, in most cases, after a course of treatment for polycystic disease, it becomes possible to become pregnant and successfully carry and give birth to a healthy child. In most cases, polycystic disease interferes with conceiving a child more than with bearing it. If a pregnant woman has already been diagnosed with polycystic disease, she should undergo a course of hormonal and drug therapy to maintain normal health and successful pregnancy.

First signs

Initial signs polycystic ovary syndrome:

1. Menstruation disorders;
2. Overweight;
3. Increased amount of body hair.

It is difficult for doctors to identify the primary signs of polycystic disease. Women play a significant role in verification. If your periods are irregular or prolonged, consult your doctor immediately.

Symptoms of polycystic ovary syndrome

There are several symptoms characteristic of polycystic ovary syndrome, which can be observed in different combinations and have different severity:

1. Irregular menstrual cycle: characterized by long breaks (more than 35 days) between menstruation; Occasionally, in polycystic ovary syndrome, vaginal bleeding is observed 2-3 times a month.
2. Scanty (more often) or heavy (less often) cyclic bleeding.
3. The duration of menstruation varies: from 2-3 to 7-10 days.
4. The growth of noticeable dark hair on the face, chest, and abdomen is hirsutism. The symptom occurs due to an excess amount of androgens in a woman’s blood.
5. Rough (male) voice.
6. Obesity. The distribution of excess adipose tissue occurs according to the male pattern (in the lower abdomen and abdominal cavity, while the arms and legs remain of normal size).
7. Oily skin plus acne or pimples on the body.
8. . Male pattern baldness of the scalp is typical (bald patches on the forehead and crown).
9. Fibrocystic mastopathy.
10. Hyperinsulinemia. Increased insulin levels in the blood due to tissue insulin resistance.
11. Infertility. It is explained by chronic anovulation or rare ovulation (during the rupture of the follicle and the release of the egg, it cannot break through the too dense lining of the ovary).

As you can see, polycystic disease manifests itself differently depending on the reasons that caused it. Most often, this disease is characterized by symptoms such as an increase in the size of the ovaries and an irregular menstrual cycle. A woman who takes care of herself should be wary of long delays. This is already a serious reason to see a doctor. It is worth paying attention to the basal temperature, which normally should increase in the second half of the cycle, but with polycystic disease it remains the same all the time.

Diagnostics

The diagnosis of polycystic ovary syndrome is made on the basis of ultrasound, but this is not enough for a correct diagnosis. Polycystic ovaries give a peculiar characteristic picture on ultrasound, but sometimes the same picture can be observed in a completely healthy woman. In this regard, it is incorrect to diagnose polycystic disease only on the basis of ultrasound.

Therefore it is necessary take a blood test for such hormones:

• luteinizing (LH);
• follicle-stimulating (FSH);
• testosterone;
• insulin;
• cortisol;
• 17-OH-progesterone;
• DEA sulfate;
• thyroxine (T4);
• triiodothyronine (T3);
• thyrotropin (TSH).

The diagnosis of polycystic ovaries cannot be made until diseases that give exactly the same clinical picture have been excluded:

• Cushing's syndrome - increased amount of cortisol;
• androgenital syndrome - increased testosterone levels;
• hyperprolactinemia - excess prolactin;
• - decreased thyroid function.

In general, the diagnosis of polycystic ovary syndrome will be reliable only if it is based on the results of laboratory and ultrasound studies and takes into account the entire range of symptoms, that is, the clinical manifestations of the disease. Polycystic ovary syndrome is a set of symptoms that includes menstrual irregularities, infertility and androgenic dermatopathy.

Treatment of polycystic ovary syndrome

When diagnosed with polycystic ovary syndrome, treatment is a complex multi-stage process of sequential restoration of the physiological parameters of the whole organism. Polycystic ovary syndrome is not only a gynecological disease, so treatment should also be aimed at eliminating those disorders that led to the development of ovarian pathology. The scope of treatment measures is determined taking into account the severity of the process and the woman’s desire to become pregnant.

Polycystic ovary syndrome requires treatment in which the following points are taken into account:

• regulation of metabolic processes in the brain (that is, therapy affecting the hypothalamic-pituitary system);
• suppression of androgens excessively produced by the ovaries;
• normalization of weight, elimination of current metabolic disorders;
• therapy aimed at restoring the menstrual cycle, as well as eliminating infertility caused by polycystic disease.

How to treat? As for medications, today the first-line drugs for the treatment of polycystic ovary syndrome are metformin and glitazones (pioglitazone, rosiglitazone). They may be supplemented, if necessary, with antiandrogenic drugs (spironolactone, cyproterone acetate), estrogens (ethinyl estradiol as a separate drug or in birth control pills), progestins, small doses of dexamethasone (0.5-1 mg in the evening to suppress the secretion of adrenal androgens) .

Treatment of excess hair growth

Your doctor may recommend birth control pills to reduce the production of androgens, or a drug called Spironolactone (Aldactone), which blocks the action of androgens in the skin. However, spironolactone can cause birth defects, so effective contraception is necessary when using this drug. Spironolactone is not recommended if you are pregnant or planning to become pregnant.

Eflornithine (Vaniqa) cream is another option for slowing facial hair growth in women. There are options for hair removal without the use of drugs: electrolysis and laser hair removal. Laser hair removal works best on very dark hair and covers large areas.

Normalization of body weight

Women suffering from polycystic ovary syndrome due to obesity should combine physical activity with a certain diet and diet:

• limiting the calorie content of food to 1500 - 1800 kcal per day with 5-6 meals a day;
• eating low-calorie foods (fruits, vegetables);
• increasing the protein content in the diet (fish, seafood, meat, cottage cheese);
• limiting carbohydrate foods (baked goods, sugar, jam, honey, sweet drinks);
• exclusion of animal fats and their replacement with vegetable ones. Daily fat intake is no more than 80 g;
• exclusion of spices, herbs, sauces, smoked and pickled foods;
• complete exclusion of alcohol;
• fasting days 2-3 times a week (apple, kefir, cottage cheese, vegetable).

Particular attention should be paid to sweets, that is, exclude them from your diet altogether. Along with following a diet, it is necessary to engage in physical exercise (gymnastics, visiting the pool, jogging, Yoga).

Regulation of menstrual function

For this purpose, COCs (combined oral contraceptives) that do not have an androgenic effect are used. For example, Marvelon, Janine, etc., 1 tablet from day 5 to day 25 of the cycle, for three months. Then a break for one month.

They effectively restore the cycle, and at the same time protect against the “accumulation” of non-exfoliating endometrium. If the influence of androgens is significant, then it is better to use an antiandrogen (in combination with estrogen) instead - the drug.

Operation

In the event that hormonal therapy is ineffective for six months, the patient is indicated for surgical intervention. It can also be prescribed if there is a risk of developing endometriosis.

The two most common types of surgery are:

1. Wedge resection– consists of removing a certain part of the ovaries on both sides. This method is highly effective - in 85% of cases it is possible to achieve ovulation.
2. Laparoscopic electrocoagulation of the ovaries– special notches are made in several places using a needle electrode. Compared to resection, this method is much more gentle, since the likelihood of adhesions is minimized.

Sometimes the choice of surgical method occurs during diagnostic laparoscopy, which allows surgical treatment to be performed immediately after examination of the ovaries. Another advantage of laparoscopic operations is the ability to eliminate adhesions and/or restore patency of the fallopian tubes.

Traditional methods of treating polycystic ovary syndrome

Treatment of polycystic ovary syndrome with folk remedies is not recommended due to the low effectiveness of the latter. Considering the number of hormonal disorders in the body of a woman with polycystic ovary syndrome, herbal treatment cannot bring the same effect that occurs with proper hormonal or surgical treatment.

Treatment prognosis

It is impossible to completely cure PCOS, so the goal of therapy is to create favorable opportunities for conception. When planning pregnancy, women diagnosed with polycystic ovary syndrome need to undergo a course of treatment to restore and stimulate ovulation.

Polycystic ovary syndrome progresses with age, so the issue of pregnancy should be resolved as early as possible.

Endocrine disorders in polycystic ovary syndrome affect not only the sexual sphere. With a long course of this disease and in the absence of adequate treatment, serious complications often arise from other organs and systems of the body.

A pathological formation, consisting of a wall and contents, formed in various organs and tissues of the body. The cyst can be acquired or congenital. The structure of the cyst wall and its contents depend on the mechanism of cyst formation and on the organ or tissue in which the cyst is located.

If the parenchyma is already sufficiently reduced, the patient begins to feel constant thirst. This occurs because the kidneys cannot concentrate urine and all the fluid received by the body is passed out as urine. The urine resembles water.

Polycystic ovary syndrome is an endocrine disease that is characterized by disruption of the endocrine and reproductive functions of the ovaries.

Polycystic ovary syndrome occurs in approximately 15% of women of reproductive age and accounts for more than 65% of all cases of endocrine infertility.

Often the disease occurs during adolescence and begins to manifest itself during the appearance of the first menstrual cycles. In the pathogenesis of this disease, it is important to note the role of stressful situations suffered in childhood, trauma and infections. Hereditary predisposition to this type of disease also plays a certain role. For a woman whose relatives suffer from type 2 diabetes, obesity or hypertension, the risk of developing this disease is slightly higher than in the general population.

The main manifestations of polycystic ovary syndrome are: menstrual irregularities, acyclic uterine bleeding, infertility, obesity, hirsutism, acne.

Treatment of polycystic ovary syndrome using alternative medicine

As mentioned above, polycystic ovary syndrome is an endocrine disease. However, it is important to note that hormonal disorders that occur with polycystic ovary syndrome affect not only the organs of the reproductive system, but also all other organs and systems of the body. It is also known that primary metabolic disorders play a certain role in the development of polycystic ovary syndrome.

Tianshi methods and preparations used in alternative medicine help normalize the body's metabolic processes (metabolism of fats, proteins, carbohydrates), restore hormonal balance and have a beneficial effect on the centers regulating the autonomic functions of the body.

It is important to note the beneficial effects of dietary supplements and other supplements of alternative medicine during the recovery period. Their use along with traditional medications increases the effectiveness of treatment and reduces recovery time. Tianshi preparations are highly effective in the prevention of polycystic ovary syndrome, due to the rich content of natural vitamins and biologically active substances in them.

Treatment of polycystic ovary syndrome with traditional methods

Treatment of polycystic ovary syndrome has the following goals:

• Normalization of menstrual and reproductive function;
• Weight normalization;
• Normalization of metabolic processes in the body;
• Treatment of endometrial hyperplasia and concomitant breast diseases;
• Correction of dermatological manifestations of increased androgen levels – hirsutism.

Treatment of polycystic ovary syndrome is carried out in several stages
At the first stage, if obesity is present, measures are taken to reduce the patient’s weight. A low-calorie diet is prescribed (up to 2000 kcal per day). The composition of food should be selected in such a way that carbohydrates account for half of the total energy content of food, a third - fats, and a fifth - proteins. Vegetable fats should make up at least one third of the total fat. The consumption of salty and spicy foods is limited, and the consumption of salt and water is also reduced.

In parallel with the diet, daily moderate physical activity is prescribed. Weight loss has a beneficial effect on the general condition of the patient, reduces tissue insulin resistance and blood pressure. The diet and exercise regimen is selected strictly individually. It is important that diet and exercise do not exhaust the patient.

At the second stage treatment of polycystic disease or cysts, therapy is prescribed to reduce insulin resistance (especially if the results from the first stage of treatment are unsatisfactory). For this purpose, the drug Metformin (a group of biguanides) is used. Metformin reduces the resistance of peripheral tissues to insulin, normalizes glucose metabolism in adipose tissue, liver and muscles, and also has a positive effect on the blood lipid profile: reduces the concentration of atherogenic fractions of lipoproteins (LDL, LDL). The duration of taking the drug varies from 3 to 6 months.

When positive results are achieved from the first and second stages of treatment of cysts or polycystic ovaries (weight loss and insulin resistance), they move on to the third stage - stimulation of ovulation. Stimulation of ovulation is carried out using the drug Clomiphene. The drug is prescribed for 5 days (from the 5th to the 9th day of the menstrual cycle). The dose of the drug is gradually increased over 3-4 months. Positive results from the treatment of polycystic disease with Clomiphene include the restoration of regular menstruation, an increase in body temperature in the second half of the menstrual cycle, an increase in the concentration of progesterone in the blood, as well as determination of the dominant follicle using ultrasound. If these signs are absent after 3 months of treatment with Clomiphene (maximum dose 200 mg/day), treatment of polycystic disease with this drug is stopped.

When treating polycystic disease with Clomiphene, its antiestrogenic effect should be taken into account. Under the influence of this drug, the production of cervical mucus and the growth of the functional layer of the endometrium are reduced. Therefore, in parallel with Clomiphene, drugs containing estrogens are prescribed. Estrogen drugs prepare a woman's reproductive system for fertilization and implantation of a fertilized egg. If the function of the corpus luteum is insufficient in the second half of the menstrual cycle, progestin drugs are prescribed to support the development of pregnancy. The effectiveness of this treatment method reaches 65%.

If pregnancy does not occur against the background of restored menstrual function, it is necessary to exclude other causes of infertility (for example, tubal infertility), as well as male infertility.

If there are no positive results from treating infertility with Clomiphene, drugs containing gonadotropin (Pergonal, Humegon) are prescribed. Drugs in this group directly stimulate ovulation. The disadvantages of treatment with gonadotropic drugs include the high risk of multiple pregnancies, as well as the high cost of the treatment itself.

To maintain regular menstrual function and reduce the effect of androgens, combined estrogen-gestagen drugs with the addition of antiandrogen drugs are prescribed. The most famous representative of this group is the drug Diane-35, containing the antiandrogenic component Cyproterone acetate. Combination drugs help not only restore menstrual function, but also serve as a means of preventing breast and uterine cancer, the risk of which is significantly increased with polycystic ovary syndrome.

The antiandrogenic component Diane-35 reduces the manifestations of high levels of androgens - hirsutism, acne, seborrhea. For severe hirsutism, treatment with Androcur is prescribed. Additional methods of treating hypertrichosis are also used - hair removal.

Surgical methods for treating polycystic ovary syndrome

There are a large number of surgical methods treatment of polycystic ovary syndrome(wedge resection of the ovaries, decortication of the ovaries, subtotal resection of the ovaries, etc.) however, a common disadvantage of these methods is the development of postoperative adhesions in the pelvis, which can cause infertility. Recently, minimally invasive laparoscopic treatment methods (electropuncture and electrocoagulation of the ovaries, laser vaporization, microresection of the ovaries, etc.) have become increasingly popular, the advantages of which are reduced trauma, rapid postoperative recovery, as well as the ability to eliminate adhesions in the pelvis. Indications for surgical treatment are the ineffectiveness of drug therapy for 6 months, the patient’s age over 29 years, the presence of severe menstrual irregularities and hirsutism, as well as the development of endometrial hyperplastic processes. A negative impact of surgical treatment of polycystic disease on further ovarian function has been noted - rapid decline of ovarian function.

Treatment of polycystic ovary syndrome

Polycystic ovary syndrome adrenogenital syndrome is characterized by increased secretion of male sex hormones by the adrenal cortex. In the treatment of this pathology, glucocorticoid drugs (prednisolone, dexamethasone) are used. To further stimulate ovulation, Clomiphene is prescribed. Combined estrogen-gestagen drugs are also used to normalize the menstrual cycle. Surgical operation (wedge resection of the ovaries) is not effective in this case, since it does not eliminate the cause of polycystic disease (increased secretion of androgens by the adrenal cortex).

With polycystic ovary syndrome of central origin, there is a dysfunction of the nerve centers that regulate the reproductive function of a woman. Treatment begins with weight loss measures. To normalize menstrual function, oral contraceptive medications are indicated. Wedge resection of the ovaries is indicated only in the presence of hyperplastic changes in the endometrium.

Bibliography:

• Garcia Celso-Ramon Current therapy of infertility, Dubin, Toronto, Philadelphia: Decker inc., 1988
• Akunts K. B. Operative gynecology: A guide for doctors and a manual for students of medical universities M., 1996
• Baisova B.I. Gynecology, M.: GEOTAR-Media, 2006