The gynecologist from Ginemed Sevilla, Elena Troncoso, emphasizes that early identification of polyendocrine metabolic ovarian syndrome (SOMP) is key to protecting female fertility and reducing long-term health risks.
This syndrome, previously referred to as polycystic ovary syndrome (PCOS), is estimated to affect approximately one in eight women. However, many of them only receive the diagnosis when they begin trying to get pregnant. Specialists insist that early detection allows for better management of its reproductive and metabolic repercussions throughout life.
According to Troncoso, the initial signs appear more frequently than believed. She points out that the combination of irregular menstrual cycles, acne that does not resolve, or excess hair accompanies many women for years without them associating it with a hormonal alteration that could have consequences for fertility and metabolism.
In recent months, the scientific community has proposed abandoning the term polycystic ovary syndrome to adopt that of polyendocrine metabolic ovarian syndrome. For the specialist, this terminological change better describes the complexity of a disorder that is not limited to the ovary but integrates endocrine and metabolic alterations, such as hyperandrogenism or insulin resistance, capable of modifying both ovarian function and the overall reproductive health of women.
In SOMP, what most conditions reproductive capacity is that the growth and maturation of the eggs do not follow a predictable rhythm: ovulation may occur sporadically or even be absent for months. This is often accompanied by elevated androgen levels and metabolic problems such as insulin resistance, which also affect ovarian function.
"The main warning sign is persistent menstrual irregularity: very long cycles, few menstruations per year, or prolonged periods of amenorrhea. Hyperandrogenism manifestations such as hirsutism, persistent acne, or androgenic alopecia are also common," says Troncoso.
For the gynecologist, it is essential not to assume as normal for years clearly irregular periods or signs of hyperandrogenism. "An early diagnosis allows for assessing reproductive and metabolic health, preventing the consequences of prolonged periods of anovulation, and conducting proper follow-up from a young age," she emphasized.
The PCOS does not necessarily imply infertility
The expert insists that, for the general population, it is essential to understand that PCOS does not automatically equate to infertility. "PCOS is not synonymous with infertility. It is a very heterogeneous syndrome: some women maintain regular ovulations and achieve spontaneous pregnancy, while others present oligoovulation or anovulation," the doctor clarifies.
She also reminds that fertility is equally conditioned by factors such as age, ovarian reserve, tubal permeability, or semen quality, so the study and treatment must be personalized from the first visit.
Alongside medical management, lifestyle plays a relevant role both in controlling the syndrome and in reproductive health. Troncoso emphasizes that a balanced diet, regular exercise, and avoiding a sedentary lifestyle are basic pillars. In women with excess weight, moderate weight loss can favor the regularity of cycles and increase the chances of ovulation, with benefits for both fertility and the course of future pregnancy.
Treatment options and pregnancy follow-up
When there is a desire for gestation and anovulation is identified as the main cause of infertility, the initial goal is usually to recover ovulation through ovarian induction treatments. "Many patients achieve pregnancy this way. When these treatments are not sufficient or there are other factors of infertility, we have other therapeutic steps available, including in vitro fertilization when indicated," explains Troncoso.
The specialist highlights an essential idea to avoid unnecessary worries: it is not always necessary to resort to complex assisted reproduction techniques, and a large number of women with PCOS achieve spontaneous pregnancy or with simple interventions.
Once pregnancy is achieved, the doctor points out that not all patients require a different obstetric control systematically. However, they may present a higher risk of metabolic and obstetric complications.
For this reason, she recommends optimizing the metabolic situation before conception and closely monitoring glucose and blood pressure control during pregnancy, adjusting the follow-up to the individual risk factors of each woman.