Drugs for the treatment of polycystic disease. Drug treatment: Duphaston, Siofor, Regulon, Metformin, Yarina, Clostilbegit, Jess, Veroshpiron, folic acid, vitamins and other drugs. Treating hibernation at home

Among female diseases, this pathology occupies a special place in gynecology. It is not difficult to identify, but it can be difficult to cure.

We will tell you further in our article what you need to know about the diagnosis and treatment of ovaries.

How to determine pathology?

Polycystic ovary syndrome has several names. Among them, in short, PCOS (polycystic ovary syndrome), as well as Stein-Leventhal syndrome. Often on an ultrasound examination they write in the conclusion: “multifollicular ovaries,” implying polycystic disease. However, this is not entirely true.

The essence of the pathology is one - it is hormonal disbalance in a woman’s body, an increase in the size of the ovaries, the formation of many small or large cystic sacs in them.

Today medicine has big amount means and methods for determining PCOS in a patient. Diagnosis begins with listening to the woman’s complaints. The doctor pays special attention to disturbing symptoms.

Because this pathology It has clear manifestations, which can be suspected when collecting anamnesis: disruptions in the menstrual cycle, as well as uterine bleeding in the middle, lower abdomen of various types, as well as increased growth of body hair, which was not observed before.

• Conducts external and gynecological examination. It is necessary to visually assess the patient’s body type and palpate the abdomen. It can be either soft or tense, which is more common. When examined in a chair, a conclusion can be made about the condition of the ovaries;
• pelvis transvaginally.

The ultrasound picture clearly shows an increase in the appendages in size, usually more than 7 cm, a rather “heavy”, dense capsule of the ovaries, and in them a large number of follicles.

The speed of blood flow in the ovaries sharply accelerates, which is noticeable during Doppler measurements;

• Writes out directions for blood tests. As a rule, this is a study of hormones. Cholesterol and glucose levels are also determined. This is necessary to determine metabolic disorders and carbohydrate balance, which is often characteristic of polycystic disease;
• . Used extremely rarely, if there is suspicion of complex shape malignant tumor.

Sometimes laparoscopy is used for diagnostic purposes. Most often such an operation is necessary to differentiate polycystic disease from other diseases, and also if available accompanying pathologies: endometriosis, infertility unknown origin And so on.

By the way, with such a study, specialists can immediately carry out the necessary manipulations to remove or cut adhesions. It all depends on the situation and diagnosis.

Which tests must be taken:

The doctor will write all the indicators in the direction. Perhaps some other hormones will be included, but the main one the diagnosis will be clear based on these values.

The criteria by which PCOS is most likely diagnosed are:

• LH and FSH hormone values ​​are above 2.7;
• Increasing testosterone and androstenedione levels;
• Fluctuations in DEA-S numbers.

This number of examinations is necessary for successful treatment diseases.

This is especially important if a woman is planning a pregnancy.

How to treat?

Therapy for polycystic ovary syndrome depends on many factors: how old the patient is, whether diabetes is detected or absent, weight, even lifestyle plays a role. In turn, treatment takes place in two ways - conservative or surgical.

The doctor always tries to manage with medications. For example:

• Oral combined contraceptives: “Yarina”, “Jess”, “Belara”, “Diane-35” and others. OK restore the menstrual cycle, remove excessive hair growth on the body;
• "Remens", "Ovariamin". To eliminate acyclic bleeding, as well as swelling, normalize the menstrual cycle;
• Drugs that suppress the activity of the hormones LH and FSH and have an antiestrogenic effect: Dexamethasone, Inofert, Clostilbegit;
• "Zinkteral". Necessary for maintaining zinc balance in the body. This will also help get rid of skin rashes in the form of pimples and blackheads;
• Drugs that regulate metabolic processes in the body: “ASD”;
• Substances that control blood glucose. Necessary for diabetes mellitus or suspicion of it: “Metformin”, “Sioform”, “Glucophage”;
• "Veroshpiron". With a tendency to severe swelling;
• . Mandatory drug for polycystic ovary syndrome. Balances the levels of estrogens, gestagens, androgens. Improves well-being and increases immunity stability;
• Vitamin E to improve immunity.

Patients are required to be prescribed: food rich in vitamins and minerals, more vegetables and fruits. Fried and overly salty foods and smoked foods are strictly prohibited.

You cannot do without a diet, since with polycystic disease it is imperative to bring the metabolic processes in the body back to normal.

Taking pills correctly is especially important for those who who is planning a pregnancy. Because If polycystic disease disrupts the menstrual cycle, it is often necessary to resort to stimulating ovulation with hormonal agents. This gives good effect, reproductive function is gradually restored.

Has proven itself well in the treatment of PCOS hirudotherapy. It's all about the leech's saliva, which contains healing substances and when used as a course, it normalizes a woman’s hormonal levels. In addition, a leech bite (see photo) stimulates the immune system, thus increasing protective forces body.

The course of treatment depends on the degree of damage, but on average it lasts 7 days, lasting 60 minutes.

You need to understand that treatment with leeches is helper method therapy, an addition to the main treatment.

If conservative scheme treatment does not help, then you will have to go under the surgeon’s knife. The doctor removes the dense part of the ovary using a method, thus allowing the mature egg to be released later.

IVF and pregnancy

According to statistics, more than 30 percent Infertility patients who came for IVF were faced with a diagnosis of polycystic ovary syndrome.

In general, the IVF procedure is nothing not a prerequisite with diagnosed PCOS. She is designated as " last chance", in cases:

1. If no other treatment is effective within a year;
2. With prolonged attempts (more than 8 times) to stimulate ovulation in polycystic disease;
3. If the patient has other diseases leading to infertility;
4. When it is confirmed that a woman’s eggs do not fulfill their function, that is, they are not viable.

IVF is also prescribed if a woman has more than 8 miscarriages. Her increased level LH affects the ability to bear children in such a way that spontaneous interruption becomes a “habit” of the body.

Before the IVF procedure, the patient is prescribed a set of measures to combat overweight. These are the above-mentioned drugs “Siafor”, “Metformin” and others. They also try to correct hormonal levels, normalize the hormones LH and FSH. After which IVF is prescribed.

The probability of successful fertilization is the same as with other forms of infertility. Sometimes even higher.

Therefore, if you have been diagnosed with PCOS, you need to calm down and understand that it can be treated. You just need to come to the inspection on time and get correct therapy . And don’t forget about your health: maintain a normal weight, regularly visit a gynecologist and lead a healthy lifestyle.

The doctor will tell us what to do with polycystic ovary syndrome and how to treat it:

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. You just have to go through more to do this. difficult path than healthy women. In medicine, there are many cases where women with 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, 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 manage to 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 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 in the 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 dark spots on the skin, from light beige to dark brown or black);
8. Long periods of symptoms resembling symptoms 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; exact reason chronic pain in polycystic ovary syndrome is unknown.

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

Complications

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

Women suffering from polycystic ovary syndrome have an increased risk of developing coronary heart failure, diseases peripheral vessels, blockages of 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, and cancer mammary glands 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. In a blood test for hormonal status, it is noted increased concentration 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 performing a glucose tolerance test high performance blood sugar signals a violation 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, it is determined lipid profile blood. 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 the woman achieve main goal(this is usually conception and birth 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 proper functioning. 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 intended for treatment 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, it is enough to lose excess weight so that insulin levels return to normal and ovulation occurs. 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 physical exercise.

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 polycystic ovary syndrome have 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 others serious consequences. For successful treatment hormonal disorders needs to be eliminated Negative influence 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, linseed 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;
• change to fractional 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) serves good addition to rational nutrition. For some patients, exercising just two hours a week along with a diet gives results, similar to technique special pills for weight loss.

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 functional cysts large sizes in the ovaries. 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. At 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 period of limitation of the operation, that is, the more time has passed after surgical treatment, the more less likely get 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 indicated not only for patients with infertility, but also for diagnosing persistent hyperplastic processes 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 in puberty, it is necessary to promptly pay attention to menstrual irregularities, as well as the development of obesity and manifestations of hyperandrogenism in such a contingent of children.

Infertility is a disease familiar to many families. Increasingly, difficulties with conceiving are occurring in young girls, and the cause of this is polycystic ovary syndrome. With this disease, many small cysts - unruptured follicles - form on the paired glands. Normal ovulation does not occur in the body, which means there is no mature egg necessary for conception. That is why information on how to treat polycystic ovary syndrome is necessary for many women of reproductive age.

Treatment with drugs of various groups

In order to treat polycystic ovary syndrome, competently selected hormonal agents. Many women are afraid to take hormonal pills. There is an opinion that in the process of such treatment you can gain a fair amount of weight, however, if the drug is purchased on the recommendation of the attending physician, undesirable side effects will be minimal. It is advisable to continue conservative therapy for 6 months. If there is no desired result, they choose another way to solve the problem.

Hormones and their antagonists are successfully used to eliminate cystic formations from the affected ovaries. In accordance with the hormonal imbalance, the doctor can select drugs that stimulate the maturation and release of the egg. In other cases, therapy with antiandrogen drugs, oral contraceptives, progesterone or dexamethasone is necessary. If necessary, the woman is prescribed other hormone-containing medications.

Medicines that have the effect of lowering blood sugar levels help cure polycystic disease.

Most promising drug In this regard, today the drug “Metmorphine” is considered. The need to supplement the main therapy with glucose-lowering drugs is due to their ability to increase tissue resistance to the protein hormone of the pancreas - insulin. During treatment, the level of insulin concentration in the blood decreases, which means its negative impact on appendages.

Restoring healthy hormonal levels is impossible without a sufficient supply of vitamins and minerals to the body. To regulate the functional ability of the gonads, patients with fertility problems are prescribed vitamin complexes. Special attention in case of polycystic ovary syndrome, it is necessary to pay attention to the intake of vitamins B, C and E. Good therapeutic effect It helps to achieve this by taking Myo-inositol, a nutraceutical that is included in some vitamin and mineral complexes, for example, Vitrum Beauty.

If during the diagnosis of polycystic disease it turns out that the pathology is accompanied by a lack of function thyroid gland, correction of this condition is necessary with the help of exogenous L-thyroxine in a dosage selected by a gynecologist-endocrinologist.

Despite the measures taken, ovulation may not occur without medication assistance. In order to induce it, clostilbegit or tamoxifen is used approximately in the middle of the cycle.

When pregnancy occurs, hormone therapy is canceled because... successful conception means that the patient has recovered

Is surgery always necessary?

It happens that polycystic ovary syndrome is not the only gynecological disease that is diagnosed in a woman. An examination may show that there is active growth and thickening of the epithelium lining the uterus. In such a situation it is necessary surgical intervention. The operation is also performed on women who do not have positive results from conservative therapy.

State of the art modern medicine allows you to treat gynecological pathologies with low-traumatic interventions. This method of access to the site of the disease is called laparoscopic. During the operation, the surgeon can not only eliminate the identified disease, but also diagnose other possible pathological processes. Elimination of cyst accumulations from the surface of the ovaries is carried out using wedge resection. Such intervention implies partial removal or cauterization of the affected epithelium of the appendages.

The result of laparoscopy in this case is a decrease in the production of male sex hormones and, as a consequence, the restoration of normal ovulation. This effect, however, is short-lived. After 1–3 years, many patients experience a relapse of polycystic ovary syndrome. Families wishing to have children are advised to plan to conceive in the first 6 months after wedge resection. It is during this period that the likelihood of pregnancy is highest.

Will traditional medicine help?

Polycystic ovary syndrome is a disease that has virtually no symptoms. This is why many women believe that they can get rid of the disorder quickly enough using only prescriptions. herbal decoctions and tinctures. PCOS is a serious hormonal disorder that can lead to infertility, so the approach to treatment must be competent. Any adjustments to therapy must be agreed with your doctor. It is not recommended to start taking herbal medicines without the approval of a specialist.

Recipes traditional medicine in the treatment of polycystic disease can be used for the following purposes:

• to strengthen immune defense body;
• to activate the function of the liver and thyroid gland;
• to cleanse the body of toxins.

Completely restore ovarian health folk remedies it won't work, because The pathogenesis of the disease is based on hormonal imbalance.

Patients diagnosed with polycystic disease are advised to increase physical activity

What should the diet be like?

It will be possible to normalize fertility in women suffering from polycystic ovary syndrome if normal metabolism and hormonal synthesis are restored. Due to metabolic disorders, PCOS is often accompanied by obesity, so diet therapy is an important point in eliminating polycystic disease.

If problems with reproductive function are caused by many cysts on the appendages, you should eat foods with the least glycemic index. Those that are not quickly absorbed by the body and do not provoke sharp jump blood sugar levels.

Meals must be divided into fractions. It is recommended to reduce the usual portion size, but increase the number of meals to 5 or 6 times a day. The total caloric content of the diet during the treatment of polycystic disease should vary between 1200 - 1800 kcal. During the day, meals should be structured as follows:

• have a hearty breakfast, preferably no later than 1 hour after waking up;
• have a snack between the morning meal and lunch (have a lunch);
• at lunchtime, eat the first and second courses;
• for dinner (3 or 4 hours after lunch) choose easily digestible foods;
• Have a small snack an hour before going to bed (do not fall asleep on an empty stomach).

In order to permanently get rid of the formation of cysts on the ovaries, it is necessary not only to maintain normal hormonal levels in the body, but also to monitor your lifestyle. In women with ovarian cysts, dysfunction of the liver and kidneys is often detected, so it is recommended to remove foods with high percentage animal fats.

Such an unbalanced diet contributes to an increase in cholesterol levels in the blood, and also provokes the production of androgens, which is undesirable for PCOS. As heat treatment It is better to choose stewing or steaming; it is recommended to avoid fried foods. Successful treatment of polycystic disease at home involves some limitations.

• bakery products made from premium flour;
• starchy foods (for example, potatoes and semolina);
• animal fats, including butter;
• milk chocolate;
• foods high in sugar, such as jam and cream desserts;
• refined oils;
• food prepared with the addition of trans fats (chips, etc.);
• alcoholic and caffeinated drinks;
• canned food and sausages;
• herbs, hot sauces and spices.

The weight loss of women suffering from PCOS should be monitored by a nutritionist. Fasting for this disease is strictly contraindicated.

Can PCOS be prevented?

Polycystic disease is a disease that both appears and is not cured in one day. Many girls turn to a doctor only when attempts to become happy parents remain unsuccessful. In order to answer the question of whether polycystic ovary syndrome can be cured in advanced stage, has not become relevant, it is recommended to visit a gynecologist at least once every 12 months. From the moment of the first menstrual bleeding(menarche) it is also necessary to monitor the health of a teenage girl. This measure will make it possible to identify the disorder in the early stages of its development, when it is much easier to treat the disease.

Women who do not plan to become mothers should use contraception to avoid unwanted pregnancy and abortion. In addition, inflammatory processes in the genitourinary system that can lead to ovarian dysfunction should be eliminated in a timely manner.

Summary

In order to cure polycystic ovary syndrome, it is necessary A complex approach. It is impossible to achieve tangible results with herbal medicine alone. The main emphasis in the treatment of the syndrome is on hormonal drugs, which the doctor must select based on the patient’s test results.

Polycystic ovary syndrome is a syndrome whose morphological manifestations are 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”.

Formation on the body of the ovary of such benign neoplasms leads to the fact that it does not ripen dominant follicle, and as a result, women have a predominance anovulatory cycles, 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 rarely comes with long breaks or stop 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 sufficient basis evidence base, so we will not list them below.

It is believed that predisposing for the development this state in the ovaries there are such factors:

• 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?

Hormonal disorder causing syndrome polycystic ovary syndrome, 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 disorder pregnancy ends early.

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, then she should undergo a course of hormonal and drug therapy to maintain normal health and successful pregnancy fetus

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. With irregular or long menstruation consult a doctor immediately.

Symptoms of polycystic ovary syndrome

There are several symptoms characteristic of polycystic ovary syndrome that can be observed in various combinations, have different expressions:

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 type (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 content insulin 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. It's already 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 for correct diagnosis This is not enough. 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 cortisol;
• androgenital syndrome - increased testosterone levels;
• hyperprolactinemia - excess prolactin;
• - decreased thyroid function.

In general, the diagnosis of polycystic ovary syndrome will only be reliable if it is based on the results of laboratory and ultrasound examinations and takes into account the whole complex of symptoms, that is clinical manifestations diseases. 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 gynecological disease, therefore, treatment should 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). These 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 per evening time 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 you should take precautions when using this drug. effective contraception. 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 consumption fat 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 case when hormone therapy within six months it turns out to be ineffective, 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 formation of adhesions is minimized.

Sometimes the choice of surgical method occurs during diagnostic laparoscopy, which allows surgery immediately after examining 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.

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.

Polyendocrine complex negative symptoms develops against the background of autoimmune disorders, endocrine pathologies, hormonal imbalances, 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 males, decreased production 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. At normal course During 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? You need to contact a specialist who will prescribe a course hormonal drugs, restoring normal level 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 stages physiological development follicles provoke:

• 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 basal temperature throughout the cycle it 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 comprehensive examination, the use of several elements of therapy.

If the diagnosis of polycystic ovary syndrome is confirmed, you need to find a clinic high level And experienced doctors: Only with adequate therapy can the problem be overcome.

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

Important to consider individual characteristics body, find out probable reasons abnormalities 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. With low efficiency oral contraceptives compounds are prescribed to reduce insulin resistance.
3. Stimulation of the ovulation process to normalize reproductive function.

With low efficiency conservative treatment polycystic ovary syndrome, laparoscopy is prescribed - low-traumatic endoscopic surgery 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, cereals, light vegetable soups. Useful product for losing weight and maintaining optimal body weight - 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, correct exchange substances.

When treating polycystic ovary syndrome, you need to receive per day clean water, juices, fruit drinks, green tea, compotes, milk, other types of liquid - up to two liters in total. Useful mineral water without gas: the optimal type 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, improve condition vascular wall. Tocopherol has a positive effect on the production of female hormones, ascorbic acid — 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 means: 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. A course of therapy for problems with the functioning of the reproductive system with use of NSAIDs designed for 6 months.

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

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

For normalization metabolic processes Several folk remedies are used:

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

At 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 the nervous and endocrine regulation, 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.

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