The polycystic ovary syndrome is the most common hormonal disorder among women and every third woman with fertility problems responsible for the fertility problem. It also increases the risks, inter alia, for diabetes, heart attacks and tumors. How to recognize it and how can it be treated?

Polycystic ovary syndrome: No normal cycle

Woman ultrasound PCO

Photo: © Stefan Merkle

The term polycystic ovary syndrome (PCOS) heard Anastasia for the first time when she was 13 at the gynecologist - with textbook symptoms: After a single period she had already received no bleeding for a year, also she suffered from excessive hair growth on the face and Upper body. A blood test showed an excess of androgens, that of male hormones, a later ultrasound many small bubbles on the ovaries.

No ovulation, no pregnancy

The latter phenomenon is the suffering that occurs in about five to eight percent of all women of childbearing potential, its name: "polycystic ovary syndrome" it is entirely derived from the fact that they inhabit the many bubbles that the ovaries in the affected women (ovaries) and this zoom often, formerly thought to be cysts. Today we know the better, says "At the beginning of a normal cycle with any woman stand ready about 30 to 40 eggs, one of which is to come to mature," Prof. Christoph Keck, including a specialist in gynecological endocrinology and reproductive medicine at Endokrinologikum Hamburg. "In polycystic ovary syndrome maturity mechanism is prevented by an excess of androgens. The follicles do not develop and remain trapped as bubbles on the ovary. "Because ovulation and a period rarely occur if ever, a spontaneous pregnancy is impossible with 75 percent of women.

Polycystic ovary syndrome: skin problems, body hair, obesity

And that's not all: The polycystic ovary syndrome symptoms affect the body internally and auaßen. Androgens are often responsible for a rather manly appearance, excessive body hair, acne and hair loss. In addition, the hormone can have other imbalances, such as an underactive thyroid or insulin resistance. The PCOS occurs more often in diabetic patients and is often associated with obesity. Overall, the syndrome is a complex conglomerate of various factors. Because the complex play together on the principle of the chicken and egg problem, a causal release can hardly notice the symptoms can vary widely in their severity. Only one thing you know for sure, says Prof. Keck: "The genes play a role. There are families who in every generation women with PCOS "The syndrome is not curable, but treatable -. And that is necessary even without fertility.

Many gynecologists overlook the PCOS

Firstly, the polycystic ovary syndrome symptoms burden the majority of women was enormous: "I was very ashamed of the hair and do not feel as a woman," said Anastasia recalls. This is typical, confirmed Prof. Keck: "The women have problems with their own bodies, with sexuality in their relationships and prone to depression." Many thus remain alone. Whether it is because gynecologists despite striking physical characteristics do not recognize the syndrome or because they more or less trivialize it by reducing it to the infertility and let other factors into account. So Anastasia was indeed quite reasonable prescribed the pill because it stimulates the cycle and can regulate skin and other problems (which the syndrome obscured in many women turn long). However, although that did not work with her, and also insulin was an issue, it said, "I should not have worried, take the pill on and come back when I want to have children."

Long-term risks: Even without fertility treatment is an important

Afterwards, however, a woman should be based not it: "It is often forgotten that the syndrome caused long-term risks," warns Prof. Keck. "The probability of diabetes by insulin resistance, but also of heart attacks, osteoporosis or tumors of the uterine lining is significantly increased if the women are hormonally and metabolically sided not set correctly." Who is not listened to his gynecologist turns most directly to a woman doctor who specializes in hormone disorders ( "Gynecological Endocrinology"). To diagnose at least ultrasound and hormone diagnostics, possibly made a test for insulin resistance.

to meet most: to have children with polycystic ovary syndrome

The treatment is individually tailored to the symptoms and the goals of the women. In case of infertility that can be a very comprehensive program and last between a few months to five years. "But when women reach their full potential, the success rate, in the long term only marginally lower than in an unaffected woman" makes Prof. Keck hope and explains the procedure: "The central problem is the lack of ovulation. We try medication to the central clomiphene trigger. This works in two thirds of cases. If not, we move on to hormone injections. If a woman also obese and insulin resistant, include a change in diet, exercise therapy and possibly the diabetes drug metformin for treatment. So we always look if the metabolism needs to be adjusted or the thyroid. We also recommend that all patients in need of a psychological counseling. And always examine the partner, because not always the restrictions are only in women. "

Even the woman: information, stay tuned, go to specialists

At Christina which placed even before the course for the diagnosis: Various female doctors had attributed their cycles lengths of over 100 days of the long-term pill - a typical misconception in polycystic ovary syndrome and its symptoms. Only when the couple for a sub-optimal semen of the man went to a fertility clinic, the syndrome came to light and could be considered in the treatment. It took more than a year and took several attempts at artificial insemination until Christina was holding a positive pregnancy test in hand, but "I was happy that finally something has been found and would advise all women as soon as possible to a fertility clinic to go where you familiar with it. I am also sure that I am ultimately only come to the goal, because I myself very much informed me, do not let up, and my doctors have annoyed with suggestions to try different treatments, "the mother of a nearly three-year-old daughter today concludes. Since pregnancy Christina even relatively regular cycles of about 35 days. "Who knows if child number two because not just come like that?" As a rule, are Prof. Keck but warns the same preparations and therapies are needed again in subsequent pregnancies.

What can afford alternative treatments when PCOS?

Whose PCOS is expressed in long cycles with rare Eisprüngen, follicles and dense hair for Maja *, a hormone treatment did not feel for the ideal way to a planned child, "I did not want to clomiphene and believed in a natural alternative. It was not until I made myself with the basal body temperature better with my cycles familiar, also then discussed with the principle of Zyklustees and me well read on medicinal plants, and with a naturopath, what opportunities it looks to me. "The recommended Alchemilla mother tincture, acupuncture and fertility massage , Four weeks later, after only two dates, Maja was pregnant. And is looking forward to her baby.

But Prof. Keck points out that "there are no firm strategy by complementary treatment options that sustainable success in would have to prevent the long-term damage caused by the syndrome." As complementary therapies for symptom alleviation - like depression or for losing weight - whether However useful. 

Risks and barriers possible pregnancy and lactation with PCOS

During pregnancy, it is possible in principle that the PCO syndrome does not lead to complications, "but can be guaranteed not," said Prof. Keck. "When insulin resistance women tend increasingly to a gestational diabetes to excessive weight gain and toxemia. Also, premature birth and a lack of development of the child occur. The syndrome is not treated, the infant mortality rate has increased. "Regular checks are therefore necessary. "Measures must be discussed individually, but the main factors are usually careful adjustment of the sugar household and weight regulation. That is why the polycystic ovary syndrome diet plays an important role. The androgens we can influence only after pregnancy. They often lead to late-onset lactation and breastfeeding problems, even in a shortened duration of breastfeeding. It is important that women be well advised and supported, "the doctor says.  

PCOS Treatment: Do not lose hope

Anastasia was now in dozens of different gynecologists, even abroad. After four years of pill nothing had recorded at her, even after 25 kilos of weight loss she got over 20 no spontaneous menstruation. "I had to fight so much and completely retired for a while. could or no one wanted to help me by the doctors. Now with 22 I met my dream man and we both want necessarily a child. "In the last four months she has therefore tried again to stimulate the pill a cycle changed the diet, further reducing weight is very fresh with clomiphene started. "Unfortunately, coming back to doubt, even though my husband is a good confidence and build tempted me again and again. I keep my fingers crossed that it will work. "Otherwise, it will soon in fertility clinic.

* Name changed by the editors.


In the web

  • For more information, detailed answers to frequently asked questions and support sufferers find the "self-help PCOS Germany e.V." under
  • Tips from concerned women and exchange with each other via the PCOS is also available at Urbia forum Fertility

Further reading

Literature for polycystic ovary syndrome, there are (as of May 2013) only as textbooks or in English, e.g .:

  • Christoph Keck, Wilhelm Krone: The Polycystic Ovarian Syndrome. Multidisciplinary approaches to diagnosis and treatment of PCOS. Thieme. 2011. ISBN-13: 978-3131456113. 39.99 euros.
  • Gaynor Bussell et. al: PCOS for Dummies. Hungry Minds. 2011. ISBN-13: 978-1118098653. Approximately 13 euros.
  • Colette Harris et. al .: The Ultimate PCOS Handbook. Lose Weight, Boost Fertility, Clear Skin and Restore Self-Esteem. Conari. 2008. ISBN-13: 978-1573243711. Approximately 16 euros.