Polycystic Ovary Disease

8/14/2019 Polycystic Ovary Disease

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Polycystic ovaryPolycystic ovary

diseasedisease

Manjula. R

4thsemister


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contentscontents

IllustrationsIllustrations Alternative NamesAlternative Names DefinitionDefinition CausesCauses SymptomsSymptoms Exams and TestsExams and Tests

TreatmentTreatment Possible ComplicationsPossible Complications


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DefinitionDefinition

Polycystic ovary disease is characterized by enlargedPolycystic ovary disease is characterized by enlarged

ovaries with multiple small cysts, an abnormally highovaries with multiple small cysts, an abnormally high

number of follicles at various states of maturation, andnumber of follicles at various states of maturation, and

a thick, scarred capsule surrounding each ovary.a thick, scarred capsule surrounding each ovary.

The syndrome was originally reported by Stein andThe syndrome was originally reported by Stein and

Leventhal in 1935 when they described a group ofLeventhal in 1935 when they described a group of

women withwomen with amenorrheaamenorrhea (absence of menstrual period),(absence of menstrual period),

infertilityinfertility,, hirsutismhirsutism (unwanted hair growth in women),(unwanted hair growth in women),

and enlarged polycystic ovariesand enlarged polycystic ovaries
http://www.nlm.nih.gov/medlineplus/ency/article/001218.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001218.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001191.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001191.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003148.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003148.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003148.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001191.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001218.htm


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CausesCauses

1.1. Polycystic ovary disease is an endocrine disorder, whichPolycystic ovary disease is an endocrine disorder, which

means normal hormone cycles are interruptedmeans normal hormone cycles are interrupted

In polycystic ovary disease, under-developed folliclesIn polycystic ovary disease, under-developed follicles

accumulate in the ovaries. Follicles are sacs within theaccumulate in the ovaries. Follicles are sacs within the

ovaries that contain eggs.ovaries that contain eggs.

The eggs in these follicles do not mature and, therefore,The eggs in these follicles do not mature and, therefore,

cannot be released from the ovaries. Instead, theycannot be released from the ovaries. Instead, they

accumulate as cysts in the ovary.accumulate as cysts in the ovary.


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CausesCauses

This can contribute to infertility.This can contribute to infertility.

2.2. The lack of follicle maturation and theThe lack of follicle maturation and the

inability to ovulate are likely caused byinability to ovulate are likely caused by

low levels of follicle stimulatinglow levels of follicle stimulatinghormone (FSH) ,and higher-than-normalhormone (FSH) ,and higher-than-normal

levels of androgens (male hormones),levels of androgens (male hormones),

produced in the ovary.produced in the ovary.

3.3. Insulin resistance also seems to be aInsulin resistance also seems to be akey feature in polycystic ovariankey feature in polycystic ovarian

syndromesyndrome


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CausesCauses

High levels of insulin canHigh levels of insulin can

contribute to lack of ovulation,contribute to lack of ovulation,

high androgen levels, infertility,high androgen levels, infertility,

and early pregnancy loss.and early pregnancy loss. Many women with polycysticMany women with polycystic

ovary disease have irregularovary disease have irregular

periods and may have very littleperiods and may have very littlemenstruation (oligomenorrhea) ormenstruation (oligomenorrhea) or

no period at all (amenorrhea).no period at all (amenorrhea).


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S tt


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Symptomsymptoms

Abnormal, irregular, or scanty (veryAbnormal, irregular, or scanty (verylight or infrequent) menstrual periodslight or infrequent) menstrual periods

Absent periods , usually (but notAbsent periods , usually (but notalways) after having one or morealways) after having one or morenormal menstrual periods duringnormal menstrual periods duringpuberty (puberty (secondary amenorrheasecondary amenorrhea))

Weight gain, even obesityWeight gain, even obesity

Insulin resistance and diabetesInsulin resistance and diabetes

InfertilityInfertility
http://www.nlm.nih.gov/medlineplus/ency/article/001219.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001219.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/001219.htm


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SymptomsSymptoms

Increased hair growth; distribution ofIncreased hair growth; distribution ofbody hair may be in a male patternbody hair may be in a male pattern

VirilizationVirilization -- development of male sex-- development of male sex

characteristics in a female. This maycharacteristics in a female. This mayinclude an increase in body hair, facialinclude an increase in body hair, facialhair, a deepening of the voice, male-hair, a deepening of the voice, male-pattern baldness, and clitoralpattern baldness, and clitoralenlargement.enlargement.

Decreased breast sizeDecreased breast size Aggravation of acneAggravation of acne


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Exams and TestsExams and Tests

In a pelvic examination, the health careIn a pelvic examination, the health care

provider may note an enlarged clitorisprovider may note an enlarged clitoris

(very rare finding) and enlarged ovaries.(very rare finding) and enlarged ovaries.

Tests include:Tests include: FSH levelsFSH levels -- low or normal-- low or normal

LH levelsLH levels -- generally high-- generally high

Androgen (Androgen (testosteronetestosterone) levels -- high) levels -- high
http://www.nlm.nih.gov/medlineplus/ency/article/003710.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003710.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003708.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003708.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003707.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003707.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003707.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003708.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003710.htm


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Estrogen (primarily estrone and estradiol)Estrogen (primarily estrone and estradiol)

levels -- relatively highlevels -- relatively high

UrineUrine 17-ketosteroids17-ketosteroids -- possibly high-- possibly high

Vaginal ultrasoundVaginal ultrasound and, possibly,and, possibly,abdominal ultrasoundabdominal ultrasound

Abdominal MRIAbdominal MRI

LaparoscopyLaparoscopy

OvarianOvarian biopsybiopsy
http://www.nlm.nih.gov/medlineplus/ency/article/003460.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003460.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003779.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003779.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003777.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003777.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003796.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003796.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003918.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003918.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003416.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003416.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003416.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003918.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003796.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003777.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003779.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003460.htm


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Other blood tests that may beOther blood tests that may be

done include:done include:

Serum HCG (Serum HCG (

pregnancy testpregnancy test

))

negativenegative

Thyroid function testsThyroid function tests

ProlactinProlactinlevelslevels
http://www.nlm.nih.gov/medlineplus/ency/article/003432.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003432.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003444.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003444.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003718.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003718.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003718.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003718.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003718.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003718.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003444.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/003432.htm


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TreatmentTreatment

Medications used to treat the symptoms ofMedications used to treat the symptoms of

polycystic ovary disease include birth controlpolycystic ovary disease include birth control

pills, spironolactone, flutamide, and clomiphenepills, spironolactone, flutamide, and clomiphene

citrate. Treatment with clomiphene induces thecitrate. Treatment with clomiphene induces the

pituitary gland to produce more FSH, which inpituitary gland to produce more FSH, which inturn stimulates maturity and release of theturn stimulates maturity and release of the

eggs. Occasionally, more potent ovulation-eggs. Occasionally, more potent ovulation-

induction medications (fertility drugs, humaninduction medications (fertility drugs, human

menopausal gonadotropins) are needed tomenopausal gonadotropins) are needed to

achieve pregnancy.achieve pregnancy.


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Possible ComplicationsPossible Complications

SterilitySterility

Obesity-related conditions, like high bloodObesity-related conditions, like high bloodpressure and diabetespressure and diabetes

Increased the risk ofIncreased the risk ofendometrial cancerendometrial cancer -- this-- this

is because the endometrium (lining of theis because the endometrium (lining of theuterine wall that sheds when you menstruate)uterine wall that sheds when you menstruate)can get thicker and thicker (hyperplasia) duecan get thicker and thicker (hyperplasia) dueto the lack of ovulationto the lack of ovulation

Possible increased risk of breast cancerPossible increased risk of breast cancer


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Polycystic Ovary Disease