.
.
SPORTS MEDICINE :
MEDICAL: CONDITIONS: POLYCYSTIC OVARIAN SYNDROME :
WOMEN: HEALTH:
A Primer on Polycystic Ovarian Syndrome (PCOS)
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A Primer on Polycystic Ovarian Syndrome (PCOS)
By Bryan Rone
January 18, 2015
Kentucky.com
Kentucky Herald Leader
http://www.kentucky.com/2015/01/18/3647905/
a-primer-on-polycystic-ovarian.html
.
A shorter URL for the above link:
.
http://tinyurl.com/npgklaj
.
.
Despite its name, polycystic ovarian syndrome (PCOS) isn't actually a
disease of the ovary.
.
Yes, it's a little confusing.
.
PCOS got its name after researchers and clinicians in the 1930s associated
abnormalities in ovarian function and appearance with endocrine
abnormalities in women.
.
Since then, we have realized that the ovarian dysfunction is a secondary
issue that is caused by the underlying metabolic and endocrine changes
seen with PCOS.
.
snip
.
How is PCOS diagnosed? There isn't one specific diagnostic test that is
used to diagnose PCOS.
.
The National Institute of Health recommends the use of specific clinical
and diagnostic criteria to make a diagnosis of PCOS. That criteria
includes:
.
1. Abnormal menstruation/ovulation
.
2. Clinical and or biochemical evidence of increased androgen hormones
(increased hair growth on the face and body, acne, balding)
.
3. Exclusion of other known diseases that could cause the excess
androgen hormones.
.
snip
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What causes PCOS? The ovaries are not the primary cause of PCOS.
Therefore, removing the ovaries will not cure this problem.
.
We don't fully understand all the factors involved in PCOS.
.
snip
.
PCOS cannot be cured, but the disease can be managed.
.
.
The complete article may be read at the URL above.
.
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Polycystic Ovary Syndrome (PCOS) - Topic Overview
Polycystic Ovary Syndrome (PCOS) Guide
WEB MD
http://www.webmd.com/women/tc/polycystic-
ovary-syndrome-pcos-topic-overview
OR
http://tinyurl.com/pr4hldr
Topic Overview
Health Tools
Cause
Symptoms
What Happens
What Increases Your Risk
When To Call a Doctor
Exams and Tests
Treatment Overview
Prevention
Home Treatment
Medications
Surgery
Other Places To Get Help
Related Information
References
Credits
.
.
Diseases and Conditions
Polycystic ovary syndrome (PCOS)
Mayo Clinic
http://www.mayoclinic.org/diseases-conditions/
pcos/basics/definition/con-20028841
OR
http://tinyurl.com/ngpvh2w
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.
Polycystic ovary syndrome
From Wikipedia
http://en.wikipedia.org/wiki/Polycystic_ovary_syndrome
.
Polycystic ovary syndrome (PCOS), also called hyperandrogenic anovulation
(HA),[1] or SteinLeventhal syndrome,[2] is one of the most common
endocrine disorders among women. PCOS has a diverse range of causes that
are not entirely understood, but there is evidence that it is largely a
genetic disease.[3][4][5] Others[who?] say it is generally a metabolic
dysfunction, since it is reversible.[citation needed] Even though
considered as a gynecological problem, PCOS consists of 28 clinical
symptoms.
.
Even though the name suggests that the ovaries are the cornerstone of
disease pathology, cysts are the 'result' , not the cause of the
disease.[citation needed] Symptoms of PCOS will persist even if both
ovaries are removed; the disease can appear even if cysts are absent.
Since its first description by Stein and Leventhal in 1935, the criteria
of diagnosis, symptoms, and causative factors are subject to debate.
Gynecologists often see it as a gynecological problem, with the ovaries
being the primary organ affected. However, recent insights show a
multisystem disorder, with the primary problem lying in hormonal
regulation in the hypothalamus, with the involvement of many organs. The
name PCOD is used when there is ultrasonographic evidence. The term PCOS
is used since there is a wide spectrum of symptoms possible, and cysts in
the ovaries are seen only in 15% of people.[6] Treatments like wedge
resection or laparoscopic drilling of ovaries are still performed around
the world, based on this false 'ovary-focused' belief.[citation needed]
.
However, science is also managing to show that PCOS can also be caused, be
related to and / or be exacerbated by impacts during the prenatal period,
epigenetic factors, inter-related environmental impacts (especially due to
the contamination caused by so-called industrial endocrine disruptors,[7]
such as Bisphenol A - BPA - which is very present in plastic products -
and certain drugs) and the increasing rates of
obesity[7].[8][9][10][11][12][13][14]
.
PCOS produces symptoms in approximately 5% to 10% of women of reproductive
age (approximately 12 to 45 years old). It is thought to be one of the
leading causes of female subfertility[15][16][17] and the most frequent
endocrine problem in women of reproductive age.[18] Finding that the
ovaries appear polycystic on ultrasound is common, but it is not an
absolute requirement in all definitions of the disorder.
.
The most common immediate symptoms are anovulation, excess androgenic
hormones, and insulin resistance. Anovulation results in irregular
menstruation, amenorrhea, and ovulation-related infertility. Hormone
imbalance generally causes acne and hirsutism. Insulin resistance is
associated with obesity, type 2 diabetes, and high cholesterol levels.[19]
The symptoms and severity of the syndrome vary greatly among those
affected.
.
Contents
1 Signs and symptoms
2 Cause
3 Diagnosis
3.1 Definition
3.2 Standard diagnostic assessments
3.3 Associated conditions
3.4 Differential diagnosis
4 Pathogenesis
5 Management
5.1 Diet
5.2 Medications
5.3 Infertility
5.4 Hirsutism and acne
5.5 Menstrual irregularity and endometrial hyperplasia
5.6 Alternative medicine
6 Prognosis
7 Epidemiology
8 History
8.1 Names
9 See also
10 References
11 External links
.
.
Polycystic ovary syndrome (PCOS) fact sheet
Womens Health.gov
ePublications
http://womenshealth.gov/publications/our-publications/
fact-sheet/polycystic-ovary-syndrome.html
.
A shorter URL for the above link:
.
http://tinyurl.com/p63kq6g
.
.
Polycystic ovary syndrome (PCOS) fact sheet
What is polycystic ovary syndrome (PCOS)?
How many women have PCOS?
What causes PCOS?
What are the symptoms of PCOS?
Why do women with PCOS have trouble with their menstrual cycle and
fertility?
Does PCOS change at menopause?
How do I know if I have PCOS?
How is PCOS treated?
How does PCOS affect a woman while pregnant?
Does PCOS put women at risk for other health problems?
I have PCOS. What can I do to prevent complications?
How can I cope with the emotional effects of PCOS?
More information on polycystic ovary syndrome (PCOS)
What is polycystic ovary syndrome (PCOS)?
Polycystic (pah-lee-SIS-tik) ovary syndrome (PCOS) is a health problem
that can affect a woman's:
Menstrual cycle
Ability to have children
Hormones
Heart
Blood vessels
Appearance
With PCOS, women typically have:
High levels of androgens (AN-druh-junz). These are sometimes called
male hormones, though females also make them.
Missed or irregular periods (monthly bleeding)
Many small cysts (sists) (fluid-filled sacs) in their ovaries
How many women have PCOS?
Between 1 in 10 and 1 in 20 women of childbearing age has PCOS. As many as
5 million women in the United States may be affected. It can occur in
girls as young as 11 years old.
What causes PCOS?
The cause of PCOS is unknown. But most experts think that several factors,
including genetics, could play a role. Women with PCOS are more likely to
have a mother or sister with PCOS.
A main underlying problem with PCOS is a hormonal imbalance. In women with
PCOS, the ovaries make more androgens than normal. Androgens are male
hormones that females also make. High levels of these hormones affect the
development and release of eggs during ovulation.
Researchers also think insulin may be linked to PCOS. Insulin is a hormone
that controls the change of sugar, starches, and other food into energy
for the body to use or store. Many women with PCOS have too much insulin
in their bodies because they have problems using it. Excess insulin
appears to increase production of androgen. High androgen levels can lead
to:
Acne
Excessive hair growth
Weight gain
Problems with ovulation
What are the symptoms of PCOS?
The symptoms of PCOS can vary from woman to woman. Some of the symptoms of
PCOS include:
Infertility (not able to get pregnant) because of not ovulating. In
fact, PCOS is the most common cause of female infertility.
Infrequent, absent, and/or irregular menstrual periods
Hirsutism (HER-suh-tiz-um) increased hair growth on the face, chest,
stomach, back, thumbs, or toes
Cysts on the ovaries
Acne, oily skin, or dandruff
Weight gain or obesity, usually with extra weight around the waist
Male-pattern baldness or thinning hair
Patches of skin on the neck, arms, breasts, or thighs that are thick
and dark brown or black
Skin tags excess flaps of skin in the armpits or neck area
Pelvic pain
Anxiety or depression
Sleep apnea when breathing stops for short periods of time while
asleep
Why do women with PCOS have trouble with their menstrual cycle and
fertility?
The ovaries, where a womans eggs are produced, have tiny fluid-filled sacs
called follicles or cysts. As the egg grows, the follicle builds up fluid.
When the egg matures, the follicle breaks open, the egg is released, and
the egg travels through the fallopian tube to the uterus (womb) for
fertilization. This is called ovulation.
In women with PCOS, the ovary doesn't make all of the hormones it needs
for an egg to fully mature. The follicles may start to grow and build up
fluid but ovulation does not occur. Instead, some follicles may remain as
cysts. For these reasons, ovulation does not occur and the hormone
progesterone is not made. Without progesterone, a woman's menstrual cycle
is irregular or absent. Plus, the ovaries make male hormones, which also
prevent ovulation.
Does PCOS change at menopause?
Yes and no. PCOS affects many systems in the body. So, many symptoms may
persist even though ovarian function and hormone levels change as a woman
nears menopause. For instance, excessive hair growth continues, and
male-pattern baldness or thinning hair gets worse after menopause. Also,
the risks of complications (health problems) from PCOS, such as heart
attack, stroke, and diabetes, increase as a woman gets older.
How do I know if I have PCOS?
There is no single test to diagnose PCOS. Your doctor will take the
following steps to find out if you have PCOS or if something else is
causing your symptoms.
Medical history. Your doctor will ask about your menstrual periods, weight
changes, and other symptoms.
Physical exam. Your doctor will want to measure your blood pressure, body
mass index (BMI), and waist size. He or she also will check the areas of
increased hair growth. You should try to allow the natural hair to grow
for a few days before the visit.
Pelvic exam. Your doctor might want to check to see if your ovaries are
enlarged or swollen by the increased number of small cysts.
Blood tests. Your doctor may check the androgen hormone and glucose
(sugar) levels in your blood.
Vaginal ultrasound (sonogram). Your doctor may perform a test that uses
sound waves to take pictures of the pelvic area. It might be used to
examine your ovaries for cysts and check the endometrium
(en-do-MEE-tree-uhm) (lining of the womb). This lining may become thicker
if your periods are not regular.
How is PCOS treated?
Because there is no cure for PCOS, it needs to be managed to prevent
problems. Treatment goals are based on your symptoms, whether or not you
want to become pregnant, and lowering your chances of getting heart
disease and diabetes. Many women will need a combination of treatments to
meet these goals. Some treatments for PCOS include:
Lifestyle modification. Many women with PCOS are overweight or obese,
which can cause health problems. You can help manage your PCOS by eating
healthy and exercising to keep your weight at a healthy level. Healthy
eating tips include:
Limiting processed foods and foods with added sugars
Adding more whole-grain products, fruits, vegetables, and lean meats
to your diet
This helps to lower blood glucose (sugar) levels, improve the body's use
of insulin, and normalize hormone levels in your body. Even a 10 percent
loss in body weight can restore a normal period and make your cycle more
regular.
Birth control pills. For women who don't want to get pregnant, birth
control pills can:
Control menstrual cycles
Reduce male hormone levels
Help to clear acne
Keep in mind that the menstrual cycle will become abnormal again if the
pill is stopped. Women may also think about taking a pill that only has
progesterone (proh-JES-tuh-rohn), like Provera, to control the menstrual
cycle and reduce the risk of endometrial cancer (See Does PCOS put women
at risk for other health problems?). But, progesterone alone does not help
reduce acne and hair growth.
Diabetes medications. The medicine metformin (Glucophage) is used to treat
type 2 diabetes. It has also been found to help with PCOS symptoms, though
it isnt approved by the U.S Food and Drug Administration (FDA) for this
use. Metformin affects the way insulin controls blood glucose (sugar) and
lowers testosterone production. It slows the growth of abnormal hair and,
after a few months of use, may help ovulation to return. Recent research
has shown metformin to have other positive effects, such as decreased body
mass and improved cholesterol levels. Metformin will not cause a person to
become diabetic.
Fertility medications. Lack of ovulation is usually the reason for
fertility problems in women with PCOS. Several medications that stimulate
ovulation can help women with PCOS become pregnant. Even so, other reasons
for infertility in both the woman and man should be ruled out before
fertility medications are used. Also, some fertility medications increase
the risk for multiple births (twins, triplets). Treatment options include:
Clomiphene (KLOHM-uh-feen) (Clomid, Serophene) the first choice
therapy to stimulate ovulation for most patients.
Metformin taken with clomiphene may be tried if clomiphene alone
fails. The combination may help women with PCOS ovulate on lower doses
of medication.
Gonadotropins (goe-NAD-oh-troe-pins) given as shots, but are more
expensive and raise the risk of multiple births compared to
clomiphene.
Another option is in vitro fertilization (IVF). IVF offers the best chance
of becoming pregnant in any given cycle. It also gives doctors better
control over the chance of multiple births. But, IVF is very costly.
Surgery. "Ovarian drilling" is a surgery that may increase the chance of
ovulation. Its sometimes used when a woman does not respond to fertility
medicines. The doctor makes a very small cut above or below the navel
(belly button) and inserts a small tool that acts like a telescope into
the abdomen (stomach). This is called laparoscopy (lap-uh-RAHS-kuh-pee).
The doctor then punctures the ovary with a small needle carrying an
electric current to destroy a small portion of the ovary. This procedure
carries a risk of developing scar tissue on the ovary. This surgery can
lower male hormone levels and help with ovulation. But, these effects may
only last a few months. This treatment doesn't help with loss of scalp
hair or increased hair growth on other parts of the body.
Medicine for increased hair growth or extra male hormones. Medicines
called anti-androgens may reduce hair growth and clear acne.
Spironolactone (speer-on-oh-LAK-tone) (Aldactone), first used to treat
high blood pressure, has been shown to reduce the impact of male hormones
on hair growth in women. Finasteride (fin-AST-uhr-yd) (Propecia), a
medicine taken by men for hair loss, has the same effect. Anti-androgens
are often combined with birth control pills. These medications should not
be taken if you are trying to become pregnant.
Before taking Aldactone, tell your doctor if you are pregnant or plan to
become pregnant. Do not breastfeed while taking this medicine. Women who
may become pregnant should not handle Propecia.
Other options include:
Vaniqa (van-ik-uh) cream to reduce facial hair
Laser hair removal or electrolysis to remove hair
Hormonal treatment to keep new hair from growing
Other treatments. Some research has shown that bariatric (weight loss)
surgery may be effective in resolving PCOS in morbidly obese women. Morbid
obesity means having a BMI of more than 40, or a BMI of 35 to 40 with an
obesity-related disease. The drug troglitazone (troh-GLIT-uh-zohn) was
shown to help women with PCOS. But, it was taken off the market because it
caused liver problems. Similar drugs without the same side effect are
being tested in small trials.
Researchers continue to search for new ways to treat PCOS. To learn more
about current PCOS treatment studies, visit ClinicalTrials.gov. Talk to
your doctor about whether taking part in a clinical trial might be right
for you.
How does PCOS affect a woman while pregnant?
Women with PCOS appear to have higher rates of:
Miscarriage
Gestational diabetes
Pregnancy-induced high blood pressure (preeclampsia)
Premature delivery
Babies born to women with PCOS have a higher risk of spending time in a
neonatal intensive care unit or of dying before, during, or shortly after
birth. Most of the time, these problems occur in multiple-birth babies
(twins, triplets).
Researchers are studying whether the diabetes medicine metformin can
prevent or reduce the chances of having problems while pregnant. Metformin
also lowers male hormone levels and limits weight gain in women who are
obese when they get pregnant.
Metformin is an FDA pregnancy category B drug. It does not appear to cause
major birth defects or other problems in pregnant women. But, there have
only been a few studies of metformin use in pregnant women to confirm its
safety. Talk to your doctor about taking metformin if you are pregnant or
are trying to become pregnant. Also, metformin is passed through
breastmilk. Talk with your doctor about metformin use if you are a nursing
mother.
Does PCOS put women at risk for other health problems?
Women with PCOS have greater chances of developing several serious health
conditions, including life-threatening diseases. Recent studies found
that:
More than 50 percent of women with PCOS will have diabetes or
pre-diabetes (impaired glucose tolerance) before the age of 40.
The risk of heart attack is 4 to 7 times higher in women with PCOS
than women of the same age without PCOS.
Women with PCOS are at greater risk of having high blood pressure.
Women with PCOS have high levels of LDL (bad) cholesterol and low
levels of HDL (good) cholesterol.
Women with PCOS can develop sleep apnea. This is when breathing stops
for short periods of time during sleep.
Women with PCOS may also develop anxiety and depression. It is important
to talk to your doctor about treatment for these mental health conditions.
Women with PCOS are also at risk for endometrial cancer. Irregular
menstrual periods and the lack of ovulation cause women to produce the
hormone estrogen, but not the hormone progesterone. Progesterone causes
the endometrium (lining of the womb) to shed each month as a menstrual
period. Without progesterone, the endometrium becomes thick, which can
cause heavy or irregular bleeding. Over time, this can lead to endometrial
hyperplasia, when the lining grows too much, and cancer.
I have PCOS. What can I do to prevent complications?
If you have PCOS, get your symptoms under control at an earlier age to
help reduce your chances of having complications like diabetes and heart
disease. Talk to your doctor about treating all your symptoms, rather than
focusing on just one aspect of your PCOS, such as problems getting
pregnant. Also, talk to your doctor about getting tested for diabetes
regularly. Other steps you can take to lower your chances of health
problems include:
Eating right
Exercising
Not smoking
How can I cope with the emotional effects of PCOS?
Having PCOS can be difficult. You may feel:
Embarrassed by your appearance
Worried about being able to get pregnant
Depressed
Getting treatment for PCOS can help with these concerns and help boost
your self-esteem. You may also want to look for support groups in your
area or online to help you deal with the emotional effects of PCOS. You
are not alone and there are resources available for women with PCOS.
More information on polycystic ovary syndrome (PCOS)
For more information about polycystic ovary syndrome (PCOS), call
womenshealth.gov at 800-994-9662 (TDD: 888-220-5446) or contact the
following organizations:
American Association of Clinical Endocrinologists (AACE)
Phone: 904-353-7878
American College of Obstetricians and Gynecologists
Phone: 202-638-5577
American Society for Reproductive Medicine (ASRM)
Phone: 205-978-5000
InterNational Council on Infertility Information Dissemination, Inc.
(INCIID)
Phone: 703-379-9178
Women's Health Research, National Institute of Child Health and Human
Development, NIH, HHS
Phone: 800-370-2943
.
.
Polycystic Ovarian Syndrome
Medscape
http://emedicine.medscape.com/article/256806-overview
Practice Essentials
Essential update: Endocrine Society publishes guidelines for diagnosis and
management of polycystic ovarian syndrome
Signs and symptoms
Diagnosis
Management
.
.
Polycystic ovary syndrome
Medline Plus
National Library of Medicine
http://www.nlm.nih.gov/medlineplus/ency/article/000369.htm
.
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Polycystic Ovary Syndrome (PCOS)
Hormone Health Network
http://www.hormone.org/diseases-and-conditions/
womens-health/polycystic-ovary-syndrome
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A shorter URL for the above link:
.
http://tinyurl.com/nbzzc6a
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About Polycystic Ovarian Syndrome - PCOS Foundation
http://www.pcosfoundation.org/about-pcos
PCOS Awareness 5K
Bayou City Step Challenge
Race Day Information
PCOS Symposium
Post Race
Resources
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What is PCOS?
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Types of Testing
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Shop Randalls, Support PCOSF
Signs and Symptoms of Polycystic Ovarian Syndrome ( 3 Articles )
Risks and Related Conditions ( 3 Articles )
Getting Help ( 3 Articles )
.
" About Polycystic Ovarian Syndrome
PCOS is Polycystic Ovary Syndrome, also known as Stein-Leventhal
Syndrome, and is one of the most common hormonal endocrine disorders in
women. PCOS has been recognized and diagnosed for seventy-five years.
There are many signs and symptoms that a woman may experience. Since PCOS
cannot be diagnosed with one test alone and symptoms vary from woman to
woman, PCOS has been known as the Silent Killer. Early diagnosis of PCOS
is important as it has been linked to an increased risk for developing
several medical risks including insulin resistance, type 2 diabetes, high
cholesterol, high blood pressure, and heart disease."
.
.
PCOS: An Infertility Issue That Is Little Understood
By Jane E. Brody
November 24, 2014 12:59 pm
New York Times
Well
http://well.blogs.nytimes.com/2014/11/24/
pcos-an-infertility-issue-that-is-little-understood/
.
A shorter URL for the above link:
.
http://tinyurl.com/qjuhoyh
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In most women with PCOS, the pituitary gland produces excessive amounts of
luteinizing hormone, which, like insulin, can stimulate the ovaries to
secrete androgens, according to a practice guideline written by Dr. Robert
L. Barbieri, head of obstetrics and gynecology at Brigham and Womens
Hospital in Boston.
.
When ovarian follicles are enlarging, women with PCOS also produce high
levels of estradiol but low levels of progesterone, resulting in a thick
uterine lining and over time an increased risk of endometrial cancer.
.
There is no cure for PCOS, and the best approach to treatment is
individualized, depending on the goals of each patient, Dr. Lucidi said.
.
For women with prolonged intervals between menses or excessive hairiness,
or both, contraceptives containing estrogen and progestin are used to
regulate the menstrual cycle and suppress the production of androgens.
.
Often, the blood pressure drug spironolactone is also given to counteract
androgen-caused acne or hirsutism in adult women.
.
For a woman trying to become pregnant, a different regimen is needed. Two
drugs, clomiphene and letrozole, are commonly prescribed to stimulate
ovulation. Both these drugs prompt the pituitary to secrete
follicle-stimulating hormone (FSH), which enhances the growth of small
follicles and thus can trigger ovulation.
.
.
Polycystic Ovarian Syndrome FROM PogoFrog
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.
Polycystic Ovarian Syndrome FROM Google Scholar
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Polycystic Ovarian Syndrome FROM Google Books
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Polycystic Ovarian Syndrome FROM Google Blog Search WHILE IT LASTS
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Polycystic Ovarian Syndrome FROM Google Videos
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Polycystic Ovarian Syndrome FROM Google Images
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.
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Various Bibliographies and Webliographies Related to Social Work
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WEBBIB1415
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The complete articles may be read at the URLs provided for each.
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Sincerely,
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Temple University
(215) 204 - 4584
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