Summary
A polycystic ovarian syndrome (Stein-Leventhal syndrome) is a clinical picture caused by a hormonal imbalance, which usually becomes apparent in patients between the ages of 20 and 30. Although the cause is still largely unexplained, it is assumed that the ovaries (ovaries) are made less sensitive to the hormone FSH by a hyaline layer, while the second hormone LH is still released in normal quantities. LH stimulates the production of male sex hormones, which can lead to masculinization features, such as male hair pattern, masculinization of physique, clitoral enlargement and breast reduction but also hair loss (androgenization).
However, women often also become aware of the disease through the absence of menstruation or an extended menstrual pause (between 35 and 45 days). If left untreated, Stein-Leventhal Syndrome can, under certain circumstances, prevent an intended pregnancy. In addition to a blood and urine examination, in which the hormones should be checked and detected, the ultrasound examination performed by the gynecology specialist often shows the typical cystic picture of polycystic ovaries.
Characteristically, the ovaries appear to be strung together like a string of pearls. The type and timing of the symptoms, which should be found out by the medical examination, also contribute to the diagnosis of PCO.The doctor should also rule out a tumorous cause of the symptoms and the so-called hyperthecosis ovarii before making a diagnosis of PCO. The treatment depends on whether the woman has a desire to have children or not.
If not, an attempt can be made to relieve the symptoms with ovulation inhibitors (“pill”) and the administration of glucocorticoids (cortisone). If the woman wishes to have children, treatment can be attempted with clomiphene or gonatotrope at intervals. However, there is a risk of ovarian hyperstimulation, which can result in multiple pregnancies.
If left untreated, pregnancy is difficult to impossible. Patients should be prepared for a longer treatment. The success rates are moderate and sometimes require a lifelong therapy.
Additional cosmetic treatments can be helpful in some cases and, above all, alleviate the psychological components of the disease. Recent studies have shown that patients suffering from polycystic ovarian syndrome have an increased risk of developing insulin resistance (diabetes mellitus) or cardiovascular diseases (heart disease, high blood pressure). An increased risk of malignant diseases of the endometrium due to constant and irregular hormonal stimulation was also discussed.
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