PCOS care in Munich

Polycystic ovary syndrome, or PCOS for short, is a common hormonal disorder in women of childbearing age. Its hallmarks are irregular or absent ovulation, an excess of male hormones (androgens) and ovaries with many small follicles. The name is somewhat misleading: these are not true cysts but follicles that do not mature. The diagnosis is made when two of these three features are present and other causes have been ruled out. These include, for example, thyroid disease or raised prolactin. The exact causes are not fully understood. Hereditary factors, insulin resistance and being overweight play a role. PCOS looks different in every woman.

Many women with PCOS have insulin resistance: the body's cells respond less well to insulin, and the pancreas produces more of it. A high insulin level stimulates the ovaries to produce more male hormones. This creates a cycle that affects the menstrual cycle, skin and weight. In the long term, PCOS can increase the risk of type 2 diabetes and cardiovascular disease. That is no reason to worry, but it is a good reason to check blood sugar, blood fats and blood pressure regularly. Exercise and a balanced diet can improve the effect of insulin – even without major weight loss. In his publications, Prof. Dr. Schulte-Uebbing addresses the interplay of hormones, thyroid and insulin resistance.

Treatment depends on your main concern. If you do not wish to have a child, hormonal treatment can make the cycle regular and dampen the effect of male hormones on skin and hair. For insulin resistance, medications that improve the effect of insulin are an option. If you wish to have a child, the aim is to promote ovulation – first through lifestyle, then with medication that triggers ovulation. If that is not enough, treatment at a fertility centre may make sense. For increased hair growth, permanent hair removal is also an option, which we likewise offer at our practice. Herbal remedies, micronutrients and acupuncture can accompany treatment as a complement. Their effectiveness is not proven for every application.

In PCOS, lifestyle is not a side issue but a building block of treatment. Regular exercise, both endurance and strength, improves the effect of insulin. A balanced diet with plenty of vegetables, fibre and protein and little sugar and white flour helps to keep blood sugar stable. If you are overweight, even moderate weight loss can have a positive effect on the cycle. Sleep and stress management also play a role. Strict diets, by contrast, rarely help. What matters is what you can keep up in the long term. We discuss realistic steps with you. PCOS can also weigh on your self-image. Please feel free to raise this with us.

If you wish to have a child, it is worth looking beyond the ovaries. The thyroid also influences ovulation and fertility, and Hashimoto's thyroiditis is not uncommon in women. Prof. Dr. Schulte-Uebbing has worked on these connections for many years. His publications include “Unfulfilled wish for a child and Hashimoto's disease. The thyroid disease is an often underestimated (partial) cause” (CO’MED, 2013; published in German). That is why, with PCOS and a wish for a child, we also check the thyroid and other hormones. We discuss openly with you whether treatment at our practice is enough or whether a fertility centre should be added. You can read more on our fertility page.