Polycystic Ovary Syndrome (PCOS) Treatment in Turkey: Managing Hormones and Health
What is PCOS? Learn about symptoms like irregular periods, hirsutism, and acne. Understand the link to insulin resistance and fertility. Expert PCOS management in Istanbul with Dr. Cengiz Andan.
When Hormonal Balance is Lost: Living with PCOS
Polycystic Ovary Syndrome (PCOS) is one of the most common reasons women visit a gynecology clinic. Affecting 1 in 10 women of reproductive age, it is not just a simple cyst problem affecting the ovaries; it is a complex metabolic and hormonal disorder that impacts the entire body.
Patients often come to us worried: “I have cysts on my ovaries, will I never have children?” At Dr. Cengiz Andan’s Clinic in Istanbul, our first message is reassuring: PCOS is not a disease, it is a syndrome. This means it is a manageable condition. The “cysts” seen on ultrasound are not actual tumors or harmful cysts, but rather many small, unruptured egg follicles that create a “string of pearls” appearance.
This guide explores the mechanisms of PCOS, from stubborn weight gain to acne, and the modern treatment approaches available in Turkey.
- Symptoms: What is Your Body Telling You?
PCOS presents differently in every woman. Some may only have irregular periods, while others experience severe symptoms.
Most Common Complaints:
- Irregular Periods: The most fundamental sign. Cycles often last longer than 35 days (oligomenorrhea) or periods may stop completely for months (amenorrhea).
- Hyperandrogenism (Excess Male Hormones):
- Hirsutism: Growth of thick, dark hair on the chin, upper lip, chest, belly, and back.
- Acne: Persistent pimples on the face and back, continuing well past adolescence.
- Hair Loss: Male-pattern thinning, especially at the crown of the head.
- Weight Issues: More than half of patients struggle with obesity or find it extremely difficult to lose weight, especially around the waist.
- Infertility: Irregular ovulation makes it difficult to conceive naturally.
- Why Does it Happen? The Culprits: Ovaries or Insulin?
While the exact cause is unknown, genetics and environment play a role. However, at the heart of the mechanism lies Insulin Resistance.
- The Insulin Cycle: When insulin (the hormone regulating blood sugar) levels are high, it stimulates the ovaries to produce excess Androgens (male hormones). High androgens disrupt ovulation and trigger weight gain. Weight gain increases insulin resistance, which worsens hormone imbalance—a vicious cycle.
- Genetics: If your mother or sister has PCOS, your risk is higher.
- Diagnosis: How is it Confirmed? (Rotterdam Criteria)
A single test is not enough. According to the internationally accepted Rotterdam Criteria, at least 2 of the following 3 must be present:
- Ovulation Dysfunction: Infrequent or absent periods.
- Androgen Excess: High testosterone in blood tests OR physical signs like hirsutism/acne.
- Polycystic Ovaries: Ultrasound showing enlarged ovaries with more than 12 small follicles arranged like a string of pearls.
Additionally, blood sugar, insulin, TSH, and Prolactin levels are checked to rule out other conditions.
- Treatment: Lifestyle Change is Key
PCOS is a chronic condition; it cannot be cured with a single box of pills. Treatment requires lifelong lifestyle management.
- Lifestyle Changes (The First & Most Important Step):Studies show that losing just 5-10% of body weightcan restore regular periods and restart ovulation without medication.
- Low glycemic index diet (avoid sugar and white flour).
- Regular exercise (the strongest “drug” to break insulin resistance).
- Medical Treatments:
- Birth Control Pills: The first choice for women not trying to conceive. They regulate periods, reduce male hormones, and improve acne/hirsutism.
- Metformin: Used to break insulin resistance and aid in weight control.
- Anti-Androgens: Prescribed for severe hair growth symptoms.
- For Women Trying to Conceive:
- Ovulation Induction: Pills like Letrozole or Clomiphene Citrate stimulate egg growth, followed by a “trigger shot” and timed intercourse or IUI.
- Laparoscopic Ovarian Drilling: For cases resistant to medication, a minimally invasive surgery where small holes are made in the ovaries to lower androgen levels.
- Long-Term Health Risks
PCOS is not just an aesthetic or fertility issue. If untreated and weight is not managed, it carries long-term risks:
- Type 2 Diabetes
- High Blood Pressure & Heart Disease
- Uterine (Endometrial) Cancer: Long gaps between periods can thicken the uterine lining, increasing cancer risk. Therefore, patients must have a period (induced if necessary) at least every 2-3 months.
Frequently Asked Questions (FAQ)
- Can I get pregnant with PCOS?Answer:Yes, absolutely. PCOS is not a cause of sterility, but of “difficulty conceiving.” Once ovulation is restored with treatment, pregnancy rates are very similar to women without PCOS. It just requires patience.
- Does PCOS go away completely?Answer:No, it is a genetic and metabolic condition that stays with you until menopause. However, with weight control and the right lifestyle, symptoms can be completely “put to sleep,” allowing you to feel perfectly healthy.
- Do herbal cures work?Answer:While some supplements have anti-inflammatory effects, PCOS is a metabolic syndrome. No herbal tea can replace medical treatment and diet. Using them without a doctor’s advice can worsen hormonal imbalance.
- Will medication make my excess hair fall out?Answer:Existing hair will not fall out with medication. Drugs prevent new hair growth and thin existing hair. Laser hair removal is required for existing hair, but it is much more effective when combined with medical treatment.
- Does Metformin make you lose weight?Answer:It is not a weight-loss pill. It helps the body use sugar correctly by breaking insulin resistance. This reduces sugar cravings, making it easier to lose weight if you follow a diet.
Dr. Cengiz Andan offers a holistic treatment plan for PCOS in Istanbul, protecting not just your fertility but your long-term metabolic health.
