Losing weight will reduce acne


Endocrinologists demand consistent therapy for PCOS

Regenstauf - Polycystic Ovary Syndrome (PCOS) is the most common hormonal disorder in women of childbearing age. Those affected are mostly sterile due to an excess of male hormones. The German Society for Endocrinology (DGE) therefore advocates comprehensive treatment at an early stage. Experts from the medical society point out that for most patients, losing weight is a first and very effective step.

In every 10th to 20th woman between 20 and 50 years of age, the ovaries are riddled with cysts. Ovulations occur irregularly or not at all. Women with PCOS also often suffer from acne and are very hairy on their bodies while their scalp hair falls out - all signs of too much male hormones. "Women with polycystic ovaries produce too many androgens, but above all too much insulin," says Professor Dr. med. Harald Klein, media spokesman for the DGE and diabetes expert from the Bergmannsheil University Clinic in Bochum.

In healthy people, insulin effectively lowers blood sugar levels. In contrast, it is less effective in women with PCOS. Because of this "insulin resistance" the body produces more and more of it. The high insulin level, in turn, promotes obesity and disrupts the hormonal balance. According to Professor Dr. med. Hendrik Lehnert, Director of the Medical Clinic I at the University Medical Center Schleswig-Holstein in L├╝beck, has to start the therapy here: "A weight loss of five percent alone reduces the symptoms of polycystic ovary syndrome considerably," says the endocrinologist. Because this improves the effectiveness of the insulin. "The women not only feel better, the chances of normal ovulation and pregnancy also increase," says Professor Lehnert. The risk of gestational diabetes and miscarriages is falling.

Doctors are now also using drugs to increase the effect of insulin in women with PCOS. The use of newer antidiabetic agents such as metformin or - in special cases - also a glitazon has proven itself. These active ingredients help even if there is no diabetes: "This medication can increase the number of ovulations in women affected by five to ten times," says Professor Lehnert. Often the disorders caused by the androgens would also improve. However: The drugs mentioned are not approved for the treatment of PCOS. Their use in its treatment is therefore "off label" and requires, among other things, detailed medical information about possible risks and a declaration of consent from the patient, according to DGE.

The hormonal confusion of PCOS also damages the heart and blood vessels in the long term: "Studies show that women with polycystic ovary syndrome are at great risk from atherosclerosis," emphasizes Professor Klein. Because blood pressure and cholesterol levels are increased in many patients, the walls of the blood vessels are thickened. "We have every reason to fear that this will lead to fatal cardiovascular diseases such as heart attacks or strokes, and we therefore urge us to intervene at an early stage," said Professor Klein. According to the DGE, treatment of PCOS also protects against consequential damage.

H. Lehnert: Endocrinology 2007; German Medical Weekly 2007; 132: 1420-1423


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