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Syndrome of polycystic ovaries
The syndrome of polycystic ovaries is a disease which develops at women on condition of too intensive production of male sex hormone – an androgen. Owing to so active producing an androgen of an ovum remain in follicles. In turn there is a transformation of follicles into cysts.
The modern statistics demonstrates that the syndrome of polycystic ovaries is most often shown at the girls who entered the puberty period. However the illness can develop at women of any age. At late age – in the period of a menstrual pause – the so-called secondary polycystosis of ovaries as an effect of chronic female diseases is shown. A disease it is necessary to treat correctly as it can threaten health of the woman. Besides, formation of multiple cysts on ovaries considerably reduces ability of the woman to conception and incubation of the child. But nevertheless after competent and timely treatment of an illness and elimination of a problem such patient can take out and give birth to the healthy kid.
Causes of illness
Polycystic ovaries – a consequence of a hormonal imbalance in the woman's organism. Cysts are formed because of too high level of development of androgens and lowering of a producing progesterone. Some specialists state theories that the broken hormonal interaction between a hypothalamus and ovaries is the reason of such failure. There are also data that display of this illness is influenced by a hereditary factor. That is higher chances to ache are noted at those women at whom in a family cases of a syndrome of polycystic ovaries were observed. Therefore, in the presence of this illness at relatives the woman has to pass across the female line regularly survey at the doctor.
Symptoms of a syndrome of polycystic ovaries
At development in the woman of a syndrome of polycystic ovaries under the influence of an endocrine imbalance not only the structure, but also functions of ovaries is broken. In tissues of ovaries cysts which look as small vials of liquid inside develop. Such cysts are modified ova which ripened, however the ovulation did not occur. Thereof there is an increase in ovaries, and on their surface hillocks appear. At the same time there is a failure of a menstrual cycle. And in certain cases periods can stop completely.
In most cases cider of polycystic ovaries begins to develop at young women. Most often polycystic ovaries are shown in parallel with the first periods, the beginning of sex life, a strong and sharp increase of body weight, pregnancy. Throughout rather long period the woman can not know that she develops this disease as visible symptoms of a polycystosis of ovaries are absent. In this case irregular monthly are considered as one of the main manifestations. Periods can come irregularly, seldom, and over time to stop completely. In that case infertility in view of lack of an ovulation at which there is exit of the ripened ovum is diagnosed for the woman. The infertility which is an effect of chronic anovulation is diagnosed at polycystic ovaries approximately for a third of women. Besides, at patients perhaps periodic display of dysfunctional uterine bleedings.
There is also some other symptoms of an illness, however their manifestation takes place not at all women. In this case it is about strong pilosis of a body, an intensive hair loss on the head, reduction of a breast, emergence of spots and eels. Besides, at women who suffer from a syndrome of a polycystosis of ovaries emergence of excess weight is rather often observed. There is even a statistics which demonstrates that about 30-60% of women for whom polycystic ovaries are diagnosed suffer from obesity. At the excess weight at the woman also other symptoms of a disease can come to light more sharply. Besides, at survey at the gynecologist at part of women with a syndrome of a polycystosis of ovaries the hypertrophied clitoris is observed.
Complications of a disease
Earlier treatment of a polycystosis of ovaries practiced only at women of reproductive age who had desire to become pregnant. But today treatment of an illness is considered obligatory for all women for whom the polycystosis of ovaries as this illness can provoke a number of unpleasant complications was diagnosed. So, in view of the general hormonal imbalance of an organism in blood the long period too high content of estrogen takes place. As a result at the patient the risk of development of cancer of an endometria and a breast cancer increases. Besides owing to lack of periods the endometria is considerably thickened that also provokes development of oncological pathology in young women.
At women with polycystic ovaries high resistance to own insulin is noted. Thereof the amount of the insulin made by a pancreas increases. As a result of perhaps several types of complications. In particular, the pancreas can lose ability to produce insulin that will lead to development of a diabetes mellitus. Owing to the high level of insulin the producing androgens can become more active. Also owing to too high level of insulin the amount of "useful" cholesterol decreases. At the woman arterial pressure grows and the risk of display of atherosclerosis, development of cardiovascular diseases in the future increases. Besides, complication of an illness obesity becomes frequent.
Diagnosis of a syndrome
Unfortunately, most of the women suffering from a polycystosis of ovaries ask doctors for the help of the doctor only when already obvious is infertility. The syndrome of polycystic ovaries is considered one of the most often found infertility reasons at women. Therefore modern doctors insist on that women at whom the irregular menstrual cycle is noted or monthly in general are absent, surely passed inspection for the purpose of an exception of development of polycystic ovaries. It is especially important to exclude an illness if at the woman also other signs of a polycystosis of ovaries are shown.
In the course of diagnosis internal examination is surely conducted. To define a condition of ovaries, to the woman carrying out internal OUSE scannings is appointed. For this purpose the special sensor is entered into a vagina. The main criterion for establishment of the diagnosis by such method is existence more than 8 follicular cysts which diameter makes less than 10 mm. Also at a disease define an endometria hyperplasia. Sometimes also additional research is required for what to the patient the klaporoskopiya is appointed. In an abdominal wall the puncture through which the optical device is entered into an abdominal cavity is made. By means of this device the doctor examines ovaries. Besides, the analysis of urine and blood as results of such analyses allow to define surplus or a lack of hormones is appointed.
To confirm or disprove the diagnosis, excess of estrogen, an androgen, luteinizing hormone, and also a lack of follicle-stimulating hormone is considered. Also to the patient the analysis on a susceptibility to glucose allowing to define activity of own insulin is carried out. Besides, at a polycystosis of ovaries the high level of cholesterol and triglycerides is noted. Thus, the diagnosis "a syndrome of polycystic ovaries" is established in case of existence of two signs from three: anovulation (female infertility), the signs of a polycystosis of ovaries revealed at ultrasonography, the giperandrogeniya confirmed with laboratory researches.
Pregnancy at a disease
Women of childbearing age are often concerned by a question of whether the polycystosis of ovaries and pregnancy is combined. In this case it is important to consider that chances to conceive the child sharply increase at the woman who passed adequate and full treatment as conception at a polycystosis of ovaries is interfered only by lack of an ovulation. Therefore in this case regular reception of medicamentous drugs which are appointed by the doctor is very important.
Treatment of a disease
The correct treatment of a syndrome of polycystic ovaries consists not only in carrying out medical procedures and reception of medicines. It is also very important to make the procedures directed to the general improvement of the woman. If the doctor and the patient provide the correct and timely approach to therapy, then chance to cure a disease rather high. If the level of androgens in blood of the patient goes down, it has a recovery of a menstrual cycle and some external displays of an illness disappear.
For treatment of polycystic ovaries various drugs at which purpose nature of hormonal frustration, and also existence at the woman of a hypertension and a diabetes mellitus is surely considered are used. But in most cases reception of the combined oral contraceptives is shown to women with polycystic ovaries. In the absence of effect of such drugs the doctor makes the decision on purpose of medicamentous drugs which recover ability of the woman to a reproduction. Such drugs stimulate process of production of follicle-stimulating hormone which defines start of process of an ovulation.
At the increased level of insulin administration of drugs which allow to make glucose utilization process more effective is reasonable. But till today some specialists note that influence of such drugs on a fruit is up to the end not found out. Physicians claim that conservative methods are effective approximately in 50% of cases. At strong increase in the sizes of ovaries and existence in them of a large number of cysts carrying out to the patient of a surgery is possible. To recover fertility, endoscopic operative measures as they give the chance to minimize the recovery period are most often carried out. An operative measure on excision of cysts is frequent carry out with use of the laser. Besides, at polycystic ovaries the wedge-shaped resection of ovaries, decapsulation of ovaries, a demedullektomiya, electropuncture and other methods practices. In the course of such interventions the part of an ovary which develops androgens collapses or removed. As a result there is a recovery of normal communication between ovaries and the central structures. Operational treatment at a syndrome of polycystic ovaries has rather high performance in comparison with medicamentous therapy. After operation recovery of a monthly cycle is observed at 95% of patients, and at more than 80% infertility is eliminated.
Carrying out recreational procedures is recommended to those women at whom strong pilosis and excess weight is noted. In this case it is very important to adhere to active lifestyle, to receive regular moderate exercise stresses, and also to adhere to a diet which is appointed a sick diabetes mellitus. The diet has to be low-calorie (no more than 2000 kilocalories a day) If the woman suffers from severe obesity, then the additional methods of treatment directed to fight against excess weight are applied. Reduction at to norm of indicators of body weight very often allows to normalize also menstrual function, to get rid of excessive pilosis. But if pilosis nevertheless is serious cosmetic defect, then depilate, using special creams, the depilator, wax and other methods helping to eliminate unnecessary hair. All these methods allow to gain temporary effect. By means of an electroepilation it is possible to get rid of excess hair forever. In the absence of effect of the treatment methods described above carrying out extracorporal fertilization in certain cases practices.