If Stein-Leventhal syndrome doesn’t speak to you, surely you’ve heard of polycystic ovaries, an increasingly common problem among young women. We should always monitor for changes and deviations in the menstrual cycle and not ignore the signals sent by our body that something is wrong. What if you notice you have irregular periods? Dysfunctional uterine bleeding is any bleeding – the result of disturbed activity of the hypothalamus-pituitary-ovary axis (HPH) and can be a manifestation of various diseases. After a gynecological examination, you may come across different terms and diagnoses. Let’s clarify some of them. Normal menstruation is monthly bleeding from the uterus during 28 days (with physiological deviations from the 21st to the 35th day) with an average duration of 5 days (from 3 to 7 days). Bleeding is accompanied by mild dixomfort, preceded by ovulation and adequate progesterone production. Absence of bleeding for more than six months is called amenorrhoea. Amenorrhea can be primary – when the girl has never had menstruation and secondary – after regular or irregular menstruation, a period of amenorrhea occurs. In any case, we must look for reasons for these deviations. With an interval of menstruation between 40 and 90 days (infrequent bleeding), the deviation is called opsomenorrhoea or oligomenorrhoea. Continuous bleeding from the uterus is called menometrorrhagia. Stein-Leventhal syndrome was known more than 100 years ago, but in 1935, Stein and Leventhal described seven women with sterility, mild obesity, and pronounced body hair. Women almost always have amenorrhoea (absence of menstruation) or opsomenorrhoea. Today, Stein-Leventhal syndrome is also known as ovarian hyperandrogenemia – increased release of male sex hormones in women and infrequent or absent ovulation, or also as polycystic ovary syndrome (PCOS). In fact, ovarian hyperandrogenemia includes Stein-Leventhal syndrome. It is believed that the predisposition to the disease is transmitted through the X-chromosome from the girls’ fathers. The fathers of the sick are hairier. It is assumed that childbirth traumas, inflammatory processes in the small pelvis, immune factors, environmental factors and others are important for the occurrence of the disease. What are the symptoms? Most often, a doctor’s consultation is sought because of increased body hair, expressed to varying degrees. Usually the onset of the disease is slow, gradual, around or after puberty. Other symptoms are: Menstrual disorders (most often secondary amenorrhoea or opsomenorrhoea, in 10 to 20% of the diseases proceed with menometrorrhagia). Keep in mind that an irregular menstrual cycle does not always mean polycystic ovaries! Preserved female features (developed mammary glands, female-type distribution of subcutaneous fat, etc.), i.e.virilization (the appearance of male genital marks in a woman) is expressed only and only in increased hair growth to varying degrees; Infrequent ovulation or lack of ovulation; Sterility; Tendency to gain weight (to varying degrees), stretch marks, acne; Tendency to develop diabetes, insulin resistance; Polycystic ovaries (ultrasound data of enlarged ovaries, most often bilaterally, with a thickened shell and rosary-like follicles arranged in the ovarian cortex with a size of 6 mm to 12 mm). It is important to note that polycystic ovary syndrome does not always mean the presence of ovarian cysts. Dimensions of the uterus at the lower limit; Characteristic of the disease are the changed ratio of hormones or their levels at this stage of the menstrual cycle. Your gynecologist will ask for hormone tests. Laboratory tests are done on certain days of the menstrual cycle – between the 3rd and 7th and around the 20th day of the menstrual cycle. It is also important that progesterone production, determined between day 20 and 24 of MC, is always reduced. Low LH levels or an anovulatory cycle are present. With normal progesterone production – with a normal ovulatory cycle, the existing hair is treated as a skin disease – hirsutism (increased response of the hair follicle to the normally produced androgens). Be sure to do your research to find out exactly what it is all about! What is the treatment? In addition to the right approach, patience is needed. After making the diagnosis, which in some cases requires monitoring over the course of months, a method of treatment must be chosen. Contraceptive preparations, preparations containing estrogens and powerful anti-androgens, gonadoliberin and others are used in order to block the hypothalamic-pituitary-ovarian axis for a certain period of time or to stimulate it in order to regulate its activity. Another method is surgical treatment, but always combined with conservative treatment for a better effect. Also, the treatment should include a hygienic-dietary regimen to normalize body mass, mandatory consultations with an endocrinologist and possible cosmetic procedures (electroepilation of hair, etc.) And in conclusion – in patients with this disease, pregnancy is absolutely possible with adequate therapy and change in the way of life. Do not give up!Your gynecologist will ask for hormone tests. Laboratory tests are done on certain days of the menstrual cycle – between the 3rd and 7th and around the 20th day of the menstrual cycle. It is also important that progesterone production, determined between day 20 and 24 of MC, is always reduced. Low LH levels or an anovulatory cycle are present. With normal progesterone production – with a normal ovulatory cycle, the existing hair is treated as a skin disease – hirsutism (increased response of the hair follicle to the normally produced androgens). Be sure to do your research to find out exactly what it is all about! What is the treatment? In addition to the right approach, patience is required. After making the diagnosis, which in some cases requires monitoring over the course of months, a method of treatment must be chosen. Contraceptive preparations, preparations containing estrogens and powerful anti-androgens, gonadoliberin and others are used in order to block the hypothalamic-pituitary-ovarian axis for a certain period of time or to stimulate it in order to regulate its activity. Another method is surgical treatment, but always combined with conservative treatment for a better effect. Also, the treatment should include a hygienic-dietary regimen to normalize body mass, mandatory consultations with an endocrinologist and possible cosmetic procedures (electroepilation of hair, etc.) And in conclusion – in patients with this disease, pregnancy is absolutely possible with adequate therapy and change in the way of life. Do not give up!Your gynecologist will ask for hormone tests. Laboratory tests are done on certain days of the menstrual cycle – between the 3rd and 7th and around the 20th day of the menstrual cycle. It is also important that progesterone production, determined between day 20 and 24 of MC, is always reduced. Low LH levels or an anovulatory cycle are present. With normal progesterone production – with a normal ovulatory cycle, the existing hair is treated as a skin disease – hirsutism (increased reaction of the hair follicle to the normally produced androgens). Be sure to do your research to find out exactly what it is all about! What is the treatment? In addition to the right approach, patience is required. After making the diagnosis, which in some cases requires monitoring over the course of months, a method of treatment must be chosen. Contraceptive preparations, preparations containing estrogens and powerful anti-androgens, gonadoliberin and others are used in order to block the hypothalamic-pituitary-ovarian axis for a certain period of time or to stimulate it in order to regulate its activity. Another method is surgical treatment, but always combined with conservative treatment for a better effect. Also, the treatment should include a hygienic-dietary regimen to normalize body mass, mandatory consultations with an endocrinologist and possible cosmetic procedures (electroepilation of hair, etc.) And in conclusion – in patients with this disease, pregnancy is absolutely possible with adequate therapy and change in the way of life. Do not give up!
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