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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.htm8/14/2019 Polycystic Ovary Disease
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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
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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
http://www.nlm.nih.gov/medlineplus/ency/article/002339.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002339.htmhttp://www.nlm.nih.gov/medlineplus/ency/article/002339.htm8/14/2019 Polycystic Ovary Disease
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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.htm8/14/2019 Polycystic Ovary Disease
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Exams and TestsExams and Tests
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.htm8/14/2019 Polycystic Ovary Disease
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Exams and TestsExams and Tests
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.htm8/14/2019 Polycystic Ovary Disease
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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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