Polycystic Ovary Syndrome (PCOS): Causes, Symptoms and Personalized Treatment

Polycystic Ovary Syndrome (PCOS), now also referred to as Poly-Endocrine Metabolic Ovary Syndrome (PMOS), is a common condition in women characterized by a hormonal imbalance in the ovaries. With accurate diagnosis and personalized treatment, both a regular menstrual cycle can be restored and a high success rate can be achieved in patients who wish to conceive.

What Is Polycystic Ovary Syndrome (PCOS)?

Polycystic ovary disease or syndrome is an endocrine (hormonal) problem that progresses with a hormonal imbalance in the ovaries and difficulties with ovulation. The main cause is a communication problem between the ovaries and the hormones secreted by the pituitary gland that stimulate them, and it is evaluated across a wide spectrum.

On ultrasound, the ovaries have a polycystic appearance; however, there is an important point that should not be misunderstood: there are no cysts in the ovary. In fact, the number of small follicles — the beginnings of eggs — is high, meaning there is no ovarian insufficiency. However, in the subgroup that experiences ovulation problems due to a disrupted organization, the follicles cannot grow at a normal rate, develop an egg, and complete the ovulation function.

As a result, menstrual irregularities and ovulation problems occur, and patients who wish to conceive may experience difficulties in achieving pregnancy.

A High Chance of Pregnancy with Treatment

With treatments planned specifically for each patient and couple — regulating and balancing ovulation — the ovulation problem can be easily resolved and high pregnancy rates can be achieved. If other accompanying conditions are present, further step treatments such as insemination (IUI) and IVF may be applied depending on these factors.

Treatment of PCOS Must Be Personalized

This condition, which is fundamentally a hormonal imbalance, is examined across a broad spectrum. Sometimes the most correct strategy is to manage the process without giving additional hormones, by treating accompanying metabolic problems such as insulin resistance and thyroid disorders.

Not every patient necessarily has menstrual irregularity; in some cases the hormonal disorder is more pronounced, while in others it follows a milder course. Ultrasound findings also differ from patient to patient.

In addition, the patient’s age and whether she is single or married require different management strategies. For example, the treatment of a 14–16 year-old case still in adolescence differs from that of a single patient over the age of 18. Likewise, each patient differs according to their complaints and clinical condition; follow-up should be tailored after determining which subgroup the patient belongs to.

Prescribing birth control pills containing strong hormones routinely and for many years is not the right approach. If our patient is married and does not wish to have children, a different strategy is followed; if she is married and wishes to have children, regulating ovulation together with a thorough analysis and organization of all other factors is required.