About one million women in Germany suffer from the so-called polycystic ovarian syndrome (PCO): Your body produces too many male hormones (androgens). PCO affects up to 15 percent of all women of childbearing age - often accompanied by an unfulfilled desire to have children. Previously, PCO was also called Stein-Leventhal syndrome.
Symptoms of PCO
The polycystic ovarian syndrome PCO is characterized by irregular cycle, increased body hair, acne or hair loss noticeable. As late effects, cardiovascular disease or uterine cancer can occur. The risk of diabetic women being affected is up to seven times higher.
"As the condition manifests itself in many different symptoms, gynecologists, specialists in internal medicine, endocrinologists, dermatologists and dieticians must work closely together in the treatment of the disease", emphasizes Professor Dr. med. med. Ludwig Kiesel. Only in this way could individual complaints, secondary diseases and the quality of life of the affected women be improved, says the director of the Clinic for Obstetrics and Gynecology at the University Hospital Münster.
What treatment options are there?
Therapies are mainly based on the respective signs of the PCO: Cycle disorders are treatable with birth control pills. This also has a beneficial effect on blemishes, hair loss or increased hairiness of the male type. Sometimes it makes sense to treat the ovaries with laser beams.
If you want to have children, a hormonal stimulation of the ovaries is promising. As an alternative to the "hormone injection", insulin-lowering drugs are now being used.
PCO therapy for children
If there is a desire to have children for women with PCO, long-term treatment will not be possible with birth control pills. Especially in overweight women then offers a treatment by a change in diet and increased physical activity. For some women, these measures can already lead to a regular cycle.
In addition, drug treatment with metformin may be effective because PCO often occurs in conjunction with insulin resistance. Metformin improves the uptake of glucose into the cell and insulin levels up again. Also from this form of therapy results in many PCO women again a regular cycle.
Often, however, women with children for a certain period, the contraceptive pill is first prescribed to let the hormone balance to settle down. Subsequently, the women are then often given clomiphene - the drug triggers an ovulation and can lead to a pregnancy.
If therapy with Clomiphene is not successful, one part of the ovarian tissue can be removed by surgery. The surgery reduces androgen concentration and can lead to spontaneous ovulation. Otherwise, a re-treatment with Clomifen is possible. On the other hand, a pregnancy can also be brought about by an artificial insemination.
Strong suffering of those affected
Women suffering from PCO almost always have a mental illness: their altered appearance and frequent infertility make them feel unwanted. "Attending self-help groups can make a decisive contribution to improving your personal life situation and well-being, " emphasizes Dr. med. med. Susanne Hahn from the University Hospital Essen. Here the patients would find support and could exchange information and experiences.
Causes of the disease
Although PCO has been known since the 18th century, the causes are still unclear. As the disease is more common in the family, experts also discuss genetic causes: Recently, a working group of the Department of Gynecology and the Institute of Reproductive Medicine at the University Hospital Münster, Germany, showed that the expression of PCO syndrome is influenced by a genetic modification of the receptor molecule for male hormones.