Syndrome of polycystic ovary
Syndrome of polycystic ovaries - ovarian hyperandrogenism; violation of the hormonal (increased formation of male sex hormones androgen) and generative (the process of egg maturation) ovarian function. The reason is a disorder of the central mechanisms regulating the function of the ovaries (hypothalamus and pituitary gland), and local, ovarian hormone formation factors. As a rule, these disorders are manifested during puberty with the onset of activation of the hormonal function of the ovaries.
The clinical picture is due to the influence of male sex hormones. It is characterized by opsomenorrhea (rare menstruation), hypertrichosis (excessive hair growth) and infertility due to anovulation (see. Anovulatory cycle). The ovaries increase in size by about 2-6 times, there is cystic atresia of the follicles (their diameter does not exceed 8 mm), located under the thickened capsule in a dense stroma. There is an increased content of testosterone in the blood and 17-ketosteroids in the urine, a violation of the ratio of gonadotropins as a result of the predominance of luteinizing hormone over follicle-stimulating. 80% of patients have obesity .
The diagnosis is established on the basis of the clinical picture, infertility, bilateral ovarian enlargement, clearly defined by ultrasound.
Treatment . In order to regulate the menstrual cycle and reduce hypertrichosis, hormonal contraceptives containing estrogens and antiandrogens are used (for example, “Diane” -35). For the treatment of infertility, ovulation stimulation (gonadotropins, clomiphene citrate) or surgical treatment - a wedge-shaped resection of the ovaries by laparoscopic method are used. Stimulation of ovulation is effective in 60%, but the pregnancy rate is lower - up to 40%, the frequency of spontaneous miscarriages - up to 20%.
Patients with polycystic ovary syndrome are at risk for developing endometrial cancer, therefore, therapy that normalizes the function of the ovaries is necessary regardless of whether the woman is interested or not in the onset of pregnancy.