Polycystic Ovarian

Syndrome

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Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam.

Definition

Definition

• Polycystic ovary syndrome (PCOS) is a common endocrine system disorder among women of reproductive age. Women with PCOS may have enlarged ovaries that contain small collections of fluid — called follicles — located in each ovary as seen during an ultrasound exam.

introduction

• Definition: polycystic ovary syndrome (PCOS) is a generic description for a broad spectrum of clinical and morphological findings in women with an endocrine dysfunction, specifically abnormal androgen production and metabolism.

• PCOS was first identified by Stein and Leventhal in 1935 so that it can also be known as Stein – Leventhal Syndrome.

What Are the Symptoms of PCOS?

• Irregular or Lack of Menses: Women will have “spotty” periods (1 every couple of months). Also, in some women with PCOS they simply cease having a menses at all.

• Hirsutism : Excessive body hair. In women with PCOS dark, coarse hair will appear on the face, neck, chest, arms, and in between the legs.

• Weight Problems : Depending on the woman, there could be a

decrease of weight or a rapid fluctuation of weight that settles around the stomach that will lead to morbid obesity.

• Acne : Because women with PCOS are producing more male hormone, that produces more sebum ( skin oils and old tissue) and causes blocked pores and more acne around the jawline, arms and chest.

• Alopecia or Female Pattern Baldness : This is caused by the increase of male

hormone in the women's body. Thinning or loss of hair is usually contained to top of the scalp, but in severe cases loss of hair in front or on the hairline has been documented.

PCOS

Other Symptoms

• “Dirty Skin” or Acanthosis Nigricans : This condition causes light brown to black rough patches around the neck and under arms.

• Migraines : Severe headaches that cause light sensitivity, nausea and dizziness.

Diagnosis

BBT (basal body temperature) B ultrasound: multiple small ovarian cysts enlarged ovaryEndometrium biopsy(Curettage ) before menses reveal to proliferative glands Determination of LH,FSH,E2,P,T,PRL， Ins，

(LH:FSH 3:1)≧Laparoscopy

TREATMENT:

• Lifestyle modification- weight loss- exercise- avoidance of tobacco- correction of lipids abnormalities

• Insulin sensitizers- metformin- Thiazolidinediones

They reduce hyper-insulinaemia and Improve steroidegenic dysfunction.

They help regulate the menstrual cycles, improve ovulation andachieve better fertility.

RECOMMENDATIONS:

• Early recognition of the syndrome

• Lifestyle modifications

• Measurement of glucose (and probably insulin). An oral OGTT in obese and those with family history should be considered.

• Detection and treatment of hyperlipidaemia

• Assessing BP and treating hypertension

• Measurement of atherogenic markers (CRP’

fibrinogen, and probably homocystine)

• Consideration of metformin as an initial preventive therapy particularly in overweight and obese PCOS patients.

• Thiazolidinediones improve hyperandrogenism and ovulation but they are still investigational tools.

• What Are the Potential Complications of PCOS?• Women with PCOS have a higher risk of developing:• hypertension (high blood pressure)• high cholesterol• anxiety and depression• sleep apnea (when a person stops breathing periodically during sleep)• endometrial cancer (cancer caused by thickening of the lining of the uterus)• heart attack• diabetes• breast cancer• If you become pregnant, your doctor may refer you to a physician who specializes in high-risk

pregnancies. Women with PCOS have a higher rate of miscarriage, gestational diabetes, and premature delivery, and may need extra monitoring during pregnancy.

• The earlier your PCOS is diagnosed and treated, the lower your risk of developing these complications. Avoiding tobacco products and participating in regular exercise can also reduce your risk of some of these co-morbidities. Talk with your doctor about what PCOS means for your overall health and how you can prevent serious complications.

• Find some pathways atlest one about the polysictic ovary.?