- amenorrhea (absence of menstruation),
- hirsutism (increased hairiness),
- obesity.
A family history of the syndrome is also observed in some women.
The symptoms of the polycystic ovary are due to a situation of chronic anovulation, ie a constant absence of ovulation, associated with an increase in the production and secretion of androgens (hyperandrogenism) in variable quantities.
PCO can occasionally be associated with a number of other hormonal alterations that cause hyperandrogenism: Cushing's syndrome, congenital hyperplasia of the adrenal gland, ovarian and adrenal cancers.
The excess of androgens is due to a series of hormonal alterations that characterize PCO and which are an increase in LH levels - which show wide fluctuations in relation to an exaggerated and irregular secretion by the pituitary (which produces LH) - and the enhanced production of estrogen and androgenic hormones by the ovary. In particular, it is precisely the irregular - and often exaggerated - secretion of LH that "overstimulates" the ovary to produce these hormones in abundance.
In polycystic ovary syndrome the concentration of FSH, also produced by the pituitary, is instead reduced. Furthermore, the secretory variations of LH and FSH linked to an ovulatory menstrual cycle are abolished.
In about 30% of affected patients there is also a modest increase in prolactin, with values about double those observed in normal subjects.
What do hormonal changes in polycystic ovary syndrome cause?
The high quantities of androgens present in the circulation are converted into estrogens at the level of peripheral tissues, in particular at the level of adipose tissue, rich in enzymes whose task is precisely this conversion. The LH released in excess causes an increase in the volume of the ovary with overproduction of androgens, which increase the processes of peripheral conversion of androgens into estrogens, perpetuating the vicious circle responsible for the polycystic ovary syndrome.
The inadequate secretion of FSH and the high concentration of androgens inside the ovaries, where the follicle maturation takes place, cause its incomplete maturation. The incomplete maturation of numerous follicles, in turn, determines the formation of small cyst. The ovaries are usually, but not necessarily, enlarged. More rarely, the increase in prolactin can cause milk secretion from the nipples (galactorrhea).
Ovarian polycystosis is characterized by a marked variability of clinical manifestations. The syndrome therefore differs considerably from one patient to another both for the presence or absence of certain symptoms, both for their intensity and for the hormonal alterations detectable with common laboratory tests. In a significant number of patients it is discovered that some important clinical manifestations of this disease appeared already during puberty: the menarche (first menstruation) usually occurs at the physiological age, but is immediately followed by menstrual irregularities. Excessive development of the hair system occurs just before or around the age of the menarche. Excess weight is present in a number of patients even before the menarche.
Menstrual cycle disorders are one of the symptoms of the polycystic ovary that most often lead the patient to consult the doctor: anovulatory cycles, oligomenorrhea (few menstruation, "delayed cycles"), abnormal uterine bleeding, amenorrhea, infertility and alterations may occur of basal temperature, which reflect the lack of ovulation. Ovulatory cycles can spontaneously occur at any time due to a fluctuation in the level of estrogens. Among women with polycystic ovary, hirsutism is almost constantly present, but it is generally , relatively mild. Sometimes acne is present, while what are called signs of virilization are rarely observed, and which are hirsutism, receding hairline, recession of the attack line of the hair on the forehead, acne and increased production of sebum (oily skin), increased mass muscles, low-pitched voice, increased volume of the clitoris and labia majora, increased sexual desire, enlarged breasts and loss of female silhouette. Obesity is present in less than half of patients with polycystic ovary syndrome.
Other articles on "Polycystic Ovary"
- Polycystic ovary: diagnosis and therapy
- Drugs for the treatment of Polycystic Ovary Syndrome
- polycystic flow, insulin resistance and nutrition
- Polycystic ovary: does it make you fat? Diet for the polycystic ovary
- Example diet for the polycystic ovary
