The polycystic ovary syndrome (PCOS)
Polycystic ovary syndrome, PCOS for short, is the most common hormone disorder in girls and women, and more and more women are suffering from it. Experts believe that 10% to 20% of all women in their fertile years now live with PCOS1,2,3. On the one hand, the causes are partly congenital and hereditary. On the other hand, many experts believe that environmental and lifestyle factors also have an influence - the exact relationships are still being researched. PCOS can severely affect your fertility and general well-being, but fortunately, it is treatable.
Do you suspect PCOS? Visit your doctor.
Most women are diagnosed with polycystic ovary syndrome between the ages of 20 and 40. They go to the family doctor or gynecologist because of some, or even all, of the following symptoms:
- Irregular or very long cycles (35 days or longer)
- Unfulfilled desire to have children due to missing or irregular ovulations
- skin blemishes including severe acne
- Dark skin discolorations, e.g. on the neck or under the arms
- Virilization: the physique becomes more boyish or masculine, the voice deeper
- Hirsutism: increased facial and body hair, i.e. more hair sprouts on the chin, abdomen or back
- Hair loss, receding hairline
- Psychological complaints, depressiveness
Behind all these symptoms, there may be some other causes besides PCOS. Therefore, in addition to a detailed medical history and examination of the skin and hair, the diagnosis should include an ultrasound image of both ovaries and a blood count. The blood count should include various hormone levels as well as blood glucose and lipids. This is because PCOS is often associated with insulin resistance and/or elevated cholesterol levels, some of which require treatment.
As the name polycystic ovary syndrome suggests, enlarged ovaries with many small cysts may be visible in the ultrasound image. This cyst formation occurs in about 70% of all women with PCOS. In addition, the doctor determines the concentration of androgens, i.e. male sex hormones, in the blood. This is because testosterone and the like also play a major role in women's well-being and fertility. Ovulation occurs repeatedly or even fails altogether - this is the case in 60% of all women with PCOS4. PCOS is usually diagnosed when other causes of the symptoms (e.g. thyroid disease) can be ruled out and two or all of the following criteria are met:
- An- or oligoovulation (i.e., no or infrequent ovulation)
- Virilization (the physique becomes more masculine, the voice deeper)
- Polycystic ovaries2,3
Therapeutic approaches: Eating healthier, targeted medication
Two thirds of all patients with PCOS are overweight. There is no conclusive evidence as to what was present first - the metabolic changes that promote obesity or the PCOS itself. However, there is increasing evidence that a change in diet and more exercise can help against all the symptoms at the same time4. Avoiding convenience foods and industrial sugar, including plenty of fruit and vegetables in the diet, regular walking, cycling, dancing, etc. - these can have a positive effect on blood glucose levels as well as on the menstrual cycle, blood lipids, skin condition and mental well-being. In the case of insulin resistance, treatment with drugs such as metformin is also an option to prevent the development of diabetes mellitus3.
When to use Daysy despite PCOS
Many women with PCOS who ovulate use Daysy to monitor the success of lifestyle changes or drug therapies. Daysy can help you visualize and track your cycles with your basal body temperature taken daily. It shows you if you’ve ovulated and how long your cycle was in total. This information is useful not only for you, but also for your gynecologist. Even with PCOS, Daysy reliably distinguishes between fertile and infertile days 99.4% of the time. However, in cycles without ovulation, you will see significantly more red and yellow days ("possibly fertile" and "unclear" respectively). In cycles with ovulation, Daysy will jump to green (for "infertile") after ovulation has been detected.
Even during treatment with clomiphene, you can use Daysy to see what effect this therapy is having on you. If you do not ovulate or are currently on hormonal birth control, please wait to start with Daysy until ovulation returns or you discontinue hormonal birth control.
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1) https://www.awmf.org/leitlinien/detail/anmeldung/1/ll/089-004.html
2) https://www.kup.at/kup/pdf/12148.pdf
3) https://www.rosenfluh.ch/media/gynaekologie/2019/02/Das-polyzystische-Ovarsyndrom-PCOS.pdf