What is polycystic ovary syndrome?

MADRID, 26 July. (Vilma Rosa Bustos Acuña/University of La Sabana) –

Between 4% and 20% of women of reproductive age suffer from this hormonal disorder, which affects the normal functioning of the ovaries and causes a wide range of symptoms.

For Laura Maria Arias, a 23-year-old girl from Bogota, it was a day like any other day she lived with such a disease. It was a morning when he wanted to sleep a little more than usual and not even pay attention to the alarm clock, but the pain in his stomach simply did not allow him to fulfill his desire. Even in very cold conditions, she was sweating, bedridden, and eventually waking up early involuntarily with pain that even ibuprofen 800 could not soothe.

After excruciating cramps at various times of the menstrual cycle and other unpleasant symptoms such as hormonal acne, constant migraines and constant fatigue, Laura decided to visit a gynecologist. On a gynecological ultrasound, they were able to see the presence of some cysts, and this, along with her incredibly painful menstruation, was a sign that she was suffering from polycystic ovary syndrome (PCOS).

For strangers, this condition represents a hormonal imbalance that occurs when the ovaries produce an excess of hormones, in particular androgens, which are responsible for the development of male qualities. There are no associated symptoms, which vary from woman to woman.

According to the World Health Organization, approximately 116 million women in the world suffer from this syndrome. For Colombia, there are no specific statistics or censuses that are indicative of prevalence in the country, but the National Academy of Medicine estimates that it affects between 4% and 8% of women of childbearing age.

Hair loss, lack of a menstrual cycle, hormonal acne, diabetes, and depression are some of the symptoms that a woman with PCOS may experience.

“The physical part that affects PCOS should also be evaluated in the laboratory. These people have changes in their hormonal levels, their cholesterol, triglycerides and cardiovascular risk are elevated, they have altered insulin as well as thyroid and prolactin.

Depending on the target of the hormones that are affected, there will be accompanying symptoms, ”says Dr. Viviana Russi, an obstetrician-gynecologist, specialist in gynecological endocrinology and ultrasound.

At the age of 14, Camila Cobos, a medical student at the University of La Sabana, began notoriously irregular menstrual cycles, she could spend about 6 months with amenorrhea, that is, the absence of menstruation. Then the opposite happened to her, about 3 periods in just a month. This caused him general discomfort as he lost a large amount of blood in a short time. In addition, his weight increased dramatically, and when he consumed sugar, he began to experience dizziness, a disorder that he had not had before. “I went to the gynecologist and she sent me a pelvic ultrasound and some sugar tests.

As a result, it turned out that she had an ovary full of follicles, and we also realized that she had a clear insulin resistance.” It was then that Camila’s diagnosis was confirmed.

Although it is one of the most common hormonal disorders among women, its causes are not clear, but it is believed that genetic and environmental factors may play a role in predisposing to it, as well as lifestyle.

Patricia Barrera, a nutritionist and dietitian with the Colombian Diabetes Association for 15 years, says that 50% of this condition is genetic and latent, but it can show up when a person gains weight, eats a lot of sugar, you don’t exercise or drink enough water.

“The idea is to come to an agreement with the patient and use a contraceptive that does not gain weight that works well so that her menstrual cycles come and the pain and discomfort decrease. In addition, if necessary, she should lose weight and when she reaches her respective goal, contraceptives can be gradually withdrawn and her cycles are likely to be regulated, ”says Dr. Barrera. This goal is achieved through a diet plan that consumes the appropriate amount of fruits and vegetables, fiber, and water to keep organs lubricated, eat at the right time, and get a good dose of exercise.

Hirsutism is a condition that occurs in many women with PCOS and can cause self-esteem issues. This causes an overgrowth of black and thick hair like in men; It can be found in various parts of the body, such as the back and perineum, but is also very common on the face.

Sarah Pineda, now 24, has noticed hirsutism since she was a child. As his body began to develop and he reached adolescence, he grew a lot of facial hair. It didn’t look like a normal thin woman and it intrigued her so she decided to go to the doctor and find out about her condition. “I have always been told that I have to be very careful about my weight, because the moment I start to gain weight, hair growth immediately rampages. There were times when I shaved in the morning, and at night I already had hair, and I felt sorry for my teammates.”

“From the moment I was diagnosed, I started taking oral contraceptives because the estrogen load (female hormones) helped me a lot to regulate my menstrual cycle, my skin and hirsutism,” confirms Sarah, who no longer follows this treatment.

“Usually, women with this disorder have high levels of male hormones such as testosterone circulating in their bloodstream, or their hair follicles are hypersensitive to androgens. This results in their bodies being covered in thick, pigmented hair. occur in men at the end of puberty.

The Importance of a Good Diagnosis

It should not be assumed that in the absence of symptoms from the very beginning of development or those that are considered “usual”, there is no syndrome. It is important to remember about reproductive health. “I developed at 13, I never had a problem with hormones, acne or being overweight. I have always had a regular cycle and normal cramps,” confirms Giuliana Escarraga, who was diagnosed with PCOS at 19 when she suddenly began to feel cramps that prevented her from moving, eating and even made her feel sick. He was prescribed contraceptives, which coped very well with the pain, but for about a year he could not get them, since the Ministry of Health regulated the prices of these drugs.

Edmundo Mora, gynecologist-oncologist, head of the department of gynecological oncology at San José Hospital and Fundación Universitaria de Ciencias de la Salud and founding member of the Society of Gynecologist-Oncologists, notes that “there are diseases that can be confused with polycystic ovary syndrome, especially those which are adrenal endocrine tumors or central brain tumors that may also cause these signs or symptoms.” For this reason, Dr. Mora stresses that an accurate diagnosis is vital to avoid negative consequences; a physical examination is necessary, as well as a good history with information about menstruation and the presence of abnormalities.

“Some doctors can minimize this condition. They diagnose it with an ultrasound and tell you to take these birth control pills for a while, and when you want to get pregnant, they will give you another treatment. differential diagnosis, ovarian functional tests, testosterone tests.

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