Polycystic Ovarian Syndrome (PCOS) Overview:
- PCOS is a complex endocrine disorder affecting women of childbearing age characterized by increased androgen production and ovulatory dysfunction
- PCOS is the leading cause of anovulatory infertility and hirsutism
- Women with PCOS have an increased risk of miscarriage, insulin resistance, hyperlipidemia, type 2 diabetes, cardiovascular disease, and endometrial cancer
PCOS: National Institutes of Health Diagnostic Criteria
- Presence of ovulatory dysfunction, polymenorrhea, oligomenorrhea, or amenorrhea
Clinical evidence of hyperandrogenism and/or hyperandrogenemia
- Exclusion of other endocrinopathies (eg, Cushing syndrome, hypothyroidism, late-onset congenital adrenal hyperplasia
- May appear at puberty with a delayed menarche followed by the onset of irregular periods or as the breakdown of a previously regular cycle
- Anovulation is usually chronic and presents as oligomenorrhea or amenorrhea
Clinical Features of PCOS - Hyperandrogenism
- Symptoms may include hirsutism, acne, male pattern balding, and/or male distribution of body hair
- Common Endocrine Abnormalities in PCOS
- Elevated luteinizing hormone (LH)
- Increased LH/follicle-stimulating hormone (FSH) ratio
- Elevated androgen levels
- Decreased sex hormone binding globulin levels
Metabolic Abnormalities in PCOS
- Hyperinsulinemia and insulin resistance
- Insulin resistance may be independent of the effect of obesity
- Decreased peripheral insulin sensitivity and consequent hyperinsulinemia may play an important role in the pathogenesis of PCOS
Lipid and Lipoprotein Abnormalities in PCOS
- Elevated LDL cholesterol
- Elevated triglycerides
- Decreased HDL cholesterol
- Decreased apolipoprotein A-I
- Impaired fibrinolytic activity
Etiology of PCOS
PCOS may be caused by interactions between
- Genetic factors (eg, autosomal dominant transmission)
- Endocrine factors (eg, increased LH/FSH ratio, increased insulin and androgen concentrations)
- Metabolic factors (eg, increased insulin resistance, decreased SHBG)
- Neurologic factors (eg, epileptic discharges)
- Environmental factors (eg, anabolic steroids)
Developmental Origin of PCOS
During gestation, human chorionic gonadotrophin, LH, and genes regulating folliculogenesis and steroidogenesis may cause excess prenatal androgen
Postpubertally, hyperinsulinemia and LH hypersecretion augment ovarian steroidogenesis, leading to anovulation.
by
Akshaya Srikanth,
Pharm.D Internee,
Hyderabad, India
during treatment of pcos...........various antiobesity drugs are also used...........
ReplyDeleteDear Shouvik,
ReplyDeleteThanks for your comment.
With reference to your comment weight loss and weight maintenance are central to the care of women with PCOS. This usually involves a combination of lifestyle advice on diet and exercise provided by a healthcare professional (Doctors &Dietician), the use of anti-obesity drugs and in extreme cases anti-obesity surgery. However, although some women with PCOS will successfully lose weight, weight maintenance is a real challenge in women with obesity with most women putting back the weight within a few years of losing the weight. As the Anti-obesity drugs works as appetite suppression and use of these drugs has side effects like ncreased blood pressure, faster heart rate, insomnia, headache and dizziness. Using these medications with lipase inhibitors causes abdominal cramping, oily stools and loose stools. Usually anti-obesity drugs are not required and patient can reduce their weight by physical exercises,dietary control.
thanking you
Akshaya Srikanth
Now you can get the best PCOS treatment in India only from the our centre without paying to much money. Just visit our website now and get your appointment.
ReplyDeleteVery helpful information about Polycystic Ovary Syndrome (PCOS) . Thanks for sharing.
ReplyDelete