VERIFIED CONTENTConsultation: dr Tadeusz Oleszczuk, gynecologist-obstetrician
Do you have problems with the regularity of your cycles or have you gained weight or have noticed excessive hair or acne? Maybe you have polycystic ovary syndrome, which also affects your mental he alth. We talked about PCOS with the gynecologist Dr. Tadeusz Oleszczuk.
Patrycja Pupiec: Polycystic ovary syndrome is a common problem?
Tadeusz Oleszczuk:Yes, it cannot be said that it is rare, because it is estimated that it affects about 6-13 percent of the population. women of childbearing age.
Is it true that the ultrasound image alone is not sufficient confirmation that you suffer from this syndrome?
Half of women have normal ovaries, and for those ultrasound results that show polycystic ovaries, this doesn't mean it's actually PCOS. For this, blood tests are needed and only they will show what the reality is. There are also symptoms of excess testosterone and obesity related to insulin resistance.
I have heard the opinion of a doctor who said that PCOS is overdiagnosed.
The reason for this state of affairs is diagnosis only on the basis of ultrasound image examinations. On the other hand, it is easy to exclude it precisely by the results of certain blood tests - then it will turn out if everything is okay. Certainly, in the case of this particular ensemble, the regularity of the cycles is also a good source of information.
Does a family history of PCOS increase the risk of developing the disease?
This may be the case when, for example, both mother and daughter have problems with PCOS or with the thyroid gland, and therefore related to genes as well as environmental conditions. Another correlation is diet. High glucose levels resulting from the insulin resistance that often accompany this disorder, or high testosterone levels, prolactin spikes, all of these may have an impact on the appearance of PCOS symptoms.
It's good to always have an ultrasound of the thyroid gland, breasts and blood tests, because as you can see it is a complex of hormonal and metabolic disorders. They are connected vessels. Hence the variety of symptoms.
Polycystic ovary syndrome is a diseasemultidimensional - will the gynecologist take care of the problem? Is the cooperation of other specialists, e.g. an endocrinologist, and sometimes a diabetologist or a dietitian, inevitable?
Of course, this is a complex of hormonal and metabolic disorders. In addition to those listed, you may need to consult and help other specialists, such as a dermatologist, who will carefully look at high levels of testosterone, which may aggravate the symptoms of acne.
A diabetologist will rule out insulin resistance if obesity is difficult to overcome. The dietitian will draw up appropriate dietary recommendations.
The whole body suffers from PCOS - would you agree with this claim?
I think so, that's why you need to approach the patient holistically, not only in terms of the level of one of the hormones, or even through the aforementioned ultrasound examination of the reproductive organ. Hormone levels and their impact on the functioning of the thyroid gland are one thing, but metabolic disorders and the related deficiency of certain vitamins, trace elements and minerals are also involved.
It disrupts the functioning of the thyroid gland, which affects hormone levels. Genetic and environmental factors are decisive.
Is treatment just about getting rid of symptoms because PCOS can't be cured, right?
Not necessarily, because by taking hormonal contraception, many things can be regulated and everything returns to normal, and the cycle itself is regulated. For example, you can take hormonal pills for six months and then stop taking them, and it is often observed that the cycle is already regular. Indeed, in many cases, certain disorders can be corrected by hormonal contraception. During this time, the volume of the ovaries decreases and the excess production of testosterone decreases.
This type of contraception, apart from the fact that it serves its main purpose, blocks ovulation, i.e. the maturation of ovarian follicles, reduces the risk of cysts and PCOS development. When taking hormonal pills, the ovary shrinks, as does the number of follicles, and after its withdrawal, some women with this disorder become pregnant naturally.
Pregnancy itself has a positive effect on the ovaries. Then everything returns to normal, because during these 9 months and during breastfeeding, the ovaries rest. You also need to remember about your diet. Balance it, that is, give up sugar, lose weight, restore normal testosterone levels if it is inappropriate. An endocrinologist's consultation is helpful.
Exactly - many women find out that they suffer from disorders only when they try to get pregnant.
Yes, womanshe tries to get pregnant at the age of 31, for example, and then performs a series of tests to see if everything is fine, but some premises should already catch her attention. For example, irregular cycles that occur every 2 and sometimes every 3 months - such situations should be clarified, ideally as soon as possible when this occurs.
In the fight against PCOS, diet and the possible loss of unnecessary kilograms are important, but this is not only a disease of overweight women. Women with a normal BMI also get sick.
Yes, indeed women with normal weight also get sick, but more often this disorder is associated with overweight or obesity. Excessive adipose tissue disrupts the hormonal balance and increases the risk of insulin resistance.
Many women quit treatment and ignore disturbing symptoms.
Let's start with the fact that one of the treatment methods that does not require the intervention of doctors is simply weight reduction, because then the testosterone level decreases, and all this makes it easier to get pregnant.
These weight losses don't have to be huge, sometimes only a few kilos are enough, right?
Of course, I myself had patients who, weighing a lot of about 105 kg, lost weight to 92 kg without any medications, just by removing sugar from the diet, and they became pregnant without any problems.
Can PCOS lead to cancer?
Of course, that's why you should get interested in the symptoms as soon as possible, because the sooner the better. The emerging extra hair, weight gain, anovulatory cycles, and disturbances in the regularity of the cycles are signals that should be alarming.
Many women use herbs such as chamomile, peppermint or turmeric for treatment. Is that enough?
Herbs primarily have a good effect on the digestive tract, so it is very good that these people pay attention to it. Certainly, it will also have a good effect on calming stress, which has a very negative effect on the entire body. However, it is best to perform appropriate tests and apply adequate and effective treatment.
Why should smokers be afraid of PCOS?
Smokers often have nodules in the thyroid gland, and this can cause hormonal disorders, so this group especially should monitor the thyroid gland - perform blood tests and an ultrasound of the thyroid gland and the reproductive organ with an assessment of the size of the ovaries.
In your practice, have you ever had a patient that is resistant to treatment?
It all depends on your determination and expected results. If appropriate changes are made,performs the required tests and heals disorders that may affect the symptoms of PCOS, you can always see an improvement. Sometimes you need to use hormonal contraception, but with a proper diet, everything should return to normal. Comprehensive treatment is effective.
gynecologist-obstetrician Tadeusz OleszczukGynecologist-obstetrician with over 30 years of experience. Author of the books "What the gynecologist will not tell you" and "Calm your hormones".
www.tadeuszoleszczuk.pl
fb.com / drtadeusz
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