{"id":209,"date":"2017-01-12T14:30:37","date_gmt":"2017-01-12T13:30:37","guid":{"rendered":"http:\/\/www.mojidoktori.rs\/blog\/?p=209"},"modified":"2017-01-15T17:38:53","modified_gmt":"2017-01-15T16:38:53","slug":"sindrom-policisticnih-jajnika","status":"publish","type":"post","link":"https:\/\/www.mojidoktori.rs\/blog\/sindrom-policisticnih-jajnika\/","title":{"rendered":"Sindrom policisti\u010dnih jajnika"},"content":{"rendered":"

SINDROM POLICISTI\u010cNIH JAJNIKA<\/span><\/a><\/h4>\n

Grupe: Hormonski poreme\u0107aji i poreme\u0107aji metabolizma, \u017denske bolesti i stanja<\/a><\/span>
\nOstali nazivi: Policisti\u010dni jajnici, PCOS<\/span>
\nSindrom policisti\u010dnih jajnika (PCOS = engl. Policistic ovari sindrome) je skup simptoma koji karakteri\u0161u jajnici (pove\u0107ani ili normalne veli\u010dine) sa brojnim folikularnim (vodenim) cistama, poreme\u0107aji menstrualnog ciklusa (produ\u017eeni ciklusi ili potpuno izostali ciklusi), poja\u010dana maljavost, gojaznost, akne , poreme\u0107ena tolerancija glukoze, smanjena otpornost ciljnih organa na insulin (insulinska rezistencija). Svi ovi simptomi ne moraju bit prisutni da bi se postavila dijagnoza.<\/span>
\n\u0160ta uzrokuje PCOS?<\/span><\/a>
\nKoje testove je potrebno u\u010diniti kod sumnje na PCOS?<\/span>
\nLe\u010denje PCOS-a<\/span>
\nLe\u010denje primarno zavisi da li pacijentkinja \u017eeli trudno\u0107u ili ne.<\/span>
\nhirur\u0161ko le\u010denje<\/span>
\n\u0160ta uzrokuje PCOS?<\/span><\/p>\n


\nProblem policisti\u010dnih jajnika nije jedinstven<\/a>, \u0161to zna\u010di da postoje razli\u010diti uzroci koji mogu dovesti do nastanka policisti\u010dnih jajnika. Poslednjih godina uo\u010dena je povezanost PCOS<\/a> i povi\u0161enog nivoa insulina (hiperinzulinemije) koja po nekim autorima predstavlja centralni doga\u0111aj u nastanku i razvoju PCOS. Insulin je hormon kojeg izlu\u010duje pankreas a zaslu\u017ean je za regulaciju vrednosti glukoze u krvi. Insulinska rezistencija (otpornost ciljnih tkiva na insulin) dovodi do pove\u0107anih koncentracija glukoze u krvi koja opet poti\u010de pankreas na proizvodnju hormona. Tako se zatvara „za\u010darani krug“. Insulinska rezistencija osnovni je mehanizam koji dovodi i do nastanka \u0161e\u0107erne bolesti tipa 2. Pove\u0107ane vrednosti insulina stimuli\u0161u jajnike, koji po\u010dinju da proizvode mu\u0161ki hormon testosteron. On je zaslu\u017ean za pojavu akni, poja\u010danu maljavost i eventualno gubitak (prorje\u0111ivanje) kose. Tako\u0111e stvara se pretpostavka za nastajanje \u0161e\u0107erne bolesti tipa 2 sa svim problemima koje ona donosi.<\/span>
\nKoje testove je potrebno u\u010diniti kod sumnje na PCOS?<\/span>
\nDijagnostika i le\u010denje sindroma provodi se u saradnji endokrinologa (specijaliste za hormonalne poreme\u0107aje)<\/a>, ginekologa (specijaliste za bolesti \u017eenskih reproduktivnih organa) i dermatologa (specijaliste za ko\u017ene bolesti). Obi\u010dno se devojka javi na pregled ginekologu zbog poreme\u0107aja menstrualnog ciklusa, ili dermatologu zbog akni. Nakon osnovnog pregleda lekar \u0107e ih uputiti na pregled hormonskog statusa i pregled kod interniste – endokrinologa. Kod svih pacijentkinja potrebno je odrediti nivo polnih hormona ili tzv. bazalni hormonski status. Naziva se „bazalni“ jer je vreme u koje se pretraga radi (3.-5. Dan ciklusa) po\u010detak ciklusa, u kojoj jo\u0161 uvek na neki na\u010din „miruje“ funkcija jajnika (bazalna funkcija jajnika). U ovo vreme odre\u0111uju se: folikulostimuliraju\u0107i hormon (FSH), luteiniziraju\u0107i hormon (LH), testosteron, prolaktin, androstendion,<\/a> DHEAS, estradiol, TSH (hormon koji stimuli\u0161e \u0161titnja\u010du<\/a> (evtl. jo\u0161 T3, T4), Potom potrebno je obaviti test optere\u0107enja glukozom (OGTT), nivo insulina pre i nakon OGTT, te vaginalni collor Doppler (pregled ultrazvu\u010dnom sondom koja se uvodi u vaginu) u prvoj fazi ciklusa. nakon svih prikupljenih nalaza lekar \u0107e odrediti terapiju. Hormonske vrednosti pokazuju zna\u010dajne razlike kod bolesnica s PCOS i nepravilnim ciklusima. U odnosu na nivo insulina razlikuje se grupa pacijentkinja sa urednom nivoom insulina i grupa pacijentkinja sa povi\u0161enim nivoom insulina.<\/span>
\nLe\u010denje PCOS-a<\/span><\/a>
\nLe\u010denje sindroma je vrlo individualno, \u0161to zavisi od uzrasta bolesnice, poreme\u0107aju ciklusa, nivou insulina, gojaznosti, \u017eelji za trudno\u0107om itd. Ako su bolesnice pove\u0107ane telesne te\u017eine svakako je dobro re\u0161iti se prekomernih kilograma jer se mnogi simptomi znatno poprave nakon regulisanja telesne te\u017eine. \u010cak i kod normalne telesne te\u017eine dobro je smanjiti unos ugljenih hidrata i umereno ve\u017ebati. Sindrom policisti\u010dnih jajnika ne mo\u017ee se u potpunosti izle\u010diti ve\u0107 samo „dr\u017eati pod kontrolom“.<\/span>
\nLe\u010denje primarno zavisi da li pacijentkinja \u017eeli trudno\u0107u ili ne.<\/span>
\nU slu\u010daju da bolesnica ne \u017eeli trudno\u0107u a ima problema sa poja\u010danom dlakavo\u0161\u0107u i aknama uspe\u0161na je terapija s kontracepcijskim tabletama koje sadr\u017ee tzv. antiandrogene kao \u0161to je npr. ciproteronacetat<\/a>. Vezanjem na testosteronski receptor spre\u010dava se delovanje mu\u0161kih hormona. S druge strane sve kontraceptivne tablete smanjuju delovanje jajnika inhibiraju\u0107i hipofizu pa ih je is te strane dobro uzimati u sindromu policisti\u010dnih jajnika. Svakako da treba po\u0161tovati sve mere opreza kao i kontraindikacije kod primene kontraceptivnih tableta. Terapiju treba sprovoditi barem 6 meseci da bi se video odre\u0111eni rezultat. Uspe\u0161na je kod umerene dlakavosti. Poja\u010dana dlakavost \u010desto se ne mo\u017ee re\u0161iti u potpunosti pa se uz terapiju savetuje i kozmeti\u010dko uklanjanje dla\u010dica (depilacija, epilacija) .Akne se moraju le\u010diti u saradnji sa dermatologom (vidi. Akne) U slu\u010daju da bolesnica \u017eeli trudno\u0107u, nema ovulacije ili ima retke ovulacije i produ\u017eene cikluse potrebno je podsta\u0107i ovulaciju. Najbolji rezultati posti\u017eu se klomifen-citratom. Pod kontrolom ginekologa, ultrazvukom se prati rast folikula i odre\u0111uje vreme ovulacije te savetuje ciljani odnos. Ako je prisutna povi\u0161en nivo insulina i poreme\u0107ena tolerancija glukoze dobri rezultati posti\u017eu se primenom metformina uz dobro regulisanu dijetu i ve\u017ebanje. Le\u010denje metforminom treba provoditi uz nadzor specijalista endokrinologa.<\/span>
\nhirur\u0161ko le\u010denje<\/span>
\nDrilling je tako\u0111e simptomatska, ali operativna metoda, prilikom koje se otvaraju sitni folikuli jajnika i smanjuje, odnosno prekida njihova funkcija (stvaranje mu\u0161kih polnih hormona)<\/a>. Delotvornost je na\u017ealost tako\u0111e privremena.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

SINDROM POLICISTI\u010cNIH JAJNIKA Grupe: Hormonski poreme\u0107aji i poreme\u0107aji metabolizma, \u017denske bolesti i stanja Ostali nazivi: Policisti\u010dni jajnici, PCOS Sindrom policisti\u010dnih jajnika (PCOS = engl. Policistic ovari sindrome) je skup simptoma koji karakteri\u0161u jajnici (pove\u0107ani ili normalne veli\u010dine) sa brojnim folikularnim (vodenim) cistama, poreme\u0107aji menstrualnog ciklusa (produ\u017eeni ciklusi ili potpuno izostali…<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[1],"tags":[149,143,142,148,146,150,145,147,144],"class_list":["post-209","post","type-post","status-publish","format-standard","hentry","category-blog","tag-ciste","tag-hirursko-lecenje","tag-hormonski-poremecaji","tag-jajajnici","tag-lecenje-pcos-a","tag-pojacana-maljavost","tag-sindrom-policisticnih-jajnika","tag-sta-uzrokuje-pcos","tag-zenske-bolesti"],"yoast_head":"\nSindrom policisti\u010dnih jajnika - Popusti i kuponi<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.mojidoktori.rs\/blog\/sindrom-policisticnih-jajnika\/\" \/>\n<meta property=\"og:locale\" content=\"sr_RS\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Sindrom policisti\u010dnih jajnika - Popusti i kuponi\" \/>\n<meta property=\"og:description\" content=\"SINDROM POLICISTI\u010cNIH JAJNIKA Grupe: Hormonski poreme\u0107aji i poreme\u0107aji metabolizma, \u017denske bolesti i stanja Ostali nazivi: Policisti\u010dni jajnici, PCOS Sindrom policisti\u010dnih jajnika (PCOS = engl. Policistic ovari sindrome) je skup simptoma koji karakteri\u0161u jajnici (pove\u0107ani ili normalne veli\u010dine) sa brojnim folikularnim (vodenim) cistama, poreme\u0107aji menstrualnog ciklusa (produ\u017eeni ciklusi ili potpuno izostali…\" \/>\n<meta property=\"og:url\" content=\"https:\/\/www.mojidoktori.rs\/blog\/sindrom-policisticnih-jajnika\/\" \/>\n<meta property=\"og:site_name\" content=\"Popusti i kuponi\" \/>\n<meta property=\"article:publisher\" content=\"https:\/\/www.facebook.com\/mojidoktori.rs\/\" \/>\n<meta property=\"article:published_time\" content=\"2017-01-12T13:30:37+00:00\" \/>\n<meta property=\"article:modified_time\" content=\"2017-01-15T16:38:53+00:00\" \/>\n<meta name=\"author\" content=\"Ordinacije@\" \/>\n<meta name=\"twitter:card\" content=\"summary_large_image\" \/>\n<meta name=\"twitter:creator\" content=\"@MojiDoktori\" \/>\n<meta name=\"twitter:site\" content=\"@MojiDoktori\" \/>\n<meta name=\"twitter:label1\" content=\"\u041d\u0430\u043f\u0438\u0441\u0430\u043d\u043e \u043e\u0434\" \/>\n\t<meta name=\"twitter:data1\" content=\"Ordinacije@\" \/>\n\t<meta name=\"twitter:label2\" content=\"\u041f\u0440\u043e\u0446\u0435\u045a\u0435\u043d\u043e \u0432\u0440\u0435\u043c\u0435 \u0447\u0438\u0442\u0430\u045a\u0430\" \/>\n\t<meta name=\"twitter:data2\" content=\"4 \u043c\u0438\u043d\u0443\u0442\u0430\" \/>\n<script type=\"application\/ld+json\" class=\"yoast-schema-graph\">{\"@context\":\"https:\\\/\\\/schema.org\",\"@graph\":[{\"@type\":\"Article\",\"@id\":\"https:\\\/\\\/www.mojidoktori.rs\\\/blog\\\/sindrom-policisticnih-jajnika\\\/#article\",\"isPartOf\":{\"@id\":\"https:\\\/\\\/www.mojidoktori.rs\\\/blog\\\/sindrom-policisticnih-jajnika\\\/\"},\"author\":{\"name\":\"Ordinacije@\",\"@id\":\"https:\\\/\\\/www.mojidoktori.rs\\\/blog\\\/#\\\/schema\\\/person\\\/299c5a1124d6a5f07b551b49e3187e6e\"},\"headline\":\"Sindrom policisti\u010dnih jajnika\",\"datePublished\":\"2017-01-12T13:30:37+00:00\",\"dateModified\":\"2017-01-15T16:38:53+00:00\",\"mainEntityOfPage\":{\"@id\":\"https:\\\/\\\/www.mojidoktori.rs\\\/blog\\\/sindrom-policisticnih-jajnika\\\/\"},\"wordCount\":865,\"publisher\":{\"@id\":\"https:\\\/\\\/www.mojidoktori.rs\\\/blog\\\/#organization\"},\"keywords\":[\"ciste\",\"hirur\u0161ko le\u010denje\",\"Hormonski poreme\u0107aji\",\"jajajnici\",\"Le\u010denje PCOS-a\",\"poja\u010dana maljavost\",\"Sindrom policisti\u010dnih jajnika\",\"\u0160ta uzrokuje PCOS\",\"\u017denske bolesti\"],\"articleSection\":[\"blog\"],\"inLanguage\":\"sr-RS\"},{\"@type\":\"WebPage\",\"@id\":\"https:\\\/\\\/www.mojidoktori.rs\\\/blog\\\/sindrom-policisticnih-jajnika\\\/\",\"url\":\"https:\\\/\\\/www.mojidoktori.rs\\\/blog\\\/sindrom-policisticnih-jajnika\\\/\",\"name\":\"Sindrom policisti\u010dnih jajnika - 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