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Seminars in Reproductive Medicine Jul 2021
Topics: Female; Humans; Polycystic Ovary Syndrome
PubMed: 34530478
DOI: 10.1055/s-0041-1735506 -
International Journal of Gynaecology... Oct 2022Ovulatory disorders are common causes of amenorrhea, abnormal uterine bleeding, and infertility, and are frequent manifestations of polycystic ovary syndrome (PCOS)....
Ovulatory disorders are common causes of amenorrhea, abnormal uterine bleeding, and infertility, and are frequent manifestations of polycystic ovary syndrome (PCOS). There are many potential causes and contributors to ovulatory dysfunction that challenge clinicians, trainees, educators, and those who perform basic, translational, clinical, and epidemiological research. Similarly, therapeutic approaches to ovulatory dysfunction potentially involve a spectrum of lifestyle, psychological, medical, and procedural interventions. Collaborative research, effective education, and consistent clinical care remain challenged by the absence of a consensus comprehensive system for classification of these disorders. The existing and complex system, attributed to WHO, was developed more than three decades ago and did not consider more than 30 years of research into these disorders in addition to technical advances in imaging and endocrinology. This manuscript describes the development of a new classification of ovulatory disorders performed under the aegis of the International Federation of Gynecology and Obstetrics (FIGO) and conducted using a rigorously applied Delphi process. The stakeholder organizations and individuals who participated in this process comprised specialty journals, experts at large, national, specialty obstetrical and gynecological societies, and informed lay representatives. After two face-to-face meetings and five Delphi rounds, the result is a three-level multi-tiered system. The system is applied after a preliminary assessment identifies the presence of an ovulatory disorder. The primary level of the system is based on an anatomic model (Hypothalamus, Pituitary, Ovary) that is completed with a separate category for PCOS. This core component of the system is easily remembered using the acronym HyPO-P. Each anatomic category is stratified in the second layer of the system to provide granularity for investigators, clinicians, and trainees using the "GAIN-FIT-PIE" mnemonic (Genetic, Autoimmune, Iatrogenic, Neoplasm; Functional, Infectious and Inflammatory, Trauma and Vascular; Physiological, Idiopathic, Endocrine). The tertiary level allows for specific diagnostic entities. It is anticipated that, if widely adopted, this system will facilitate education, clinical care, and the design and interpretation of research in a fashion that better informs progress in this field. Integral to the deployment of this system is a periodic process of reevaluation and appropriate revision, reflecting an improved understanding of this collection of disorders.
Topics: Female; Gynecology; Humans; Polycystic Ovary Syndrome; Pregnancy; Uterine Diseases
PubMed: 35983674
DOI: 10.1002/ijgo.14331 -
Fertility and Sterility Oct 2022Ovulatory disorders are common causes of amenorrhea, abnormal uterine bleeding, and infertility, and are frequent manifestations of polycystic ovary syndrome (PCOS)....
Ovulatory disorders are common causes of amenorrhea, abnormal uterine bleeding, and infertility, and are frequent manifestations of polycystic ovary syndrome (PCOS). There are many potential causes and contributors to ovulatory dysfunction that challenge clinicians, trainees, educators, and those who perform basic, translational, clinical, and epidemiological research. Similarly, therapeutic approaches to ovulatory dysfunction potentially involve a spectrum of lifestyle, psychological, medical, and procedural interventions. Collaborative research, effective education, and consistent clinical care remain challenged by the absence of a consensus comprehensive system for classification of these disorders. The existing and complex system, attributed to WHO, was developed more than three decades ago and did not consider more than 30 years of research into these disorders in addition to technical advances in imaging and endocrinology. This manuscript describes the development of a new classification of ovulatory disorders performed under the aegis of the International Federation of Gynecology and Obstetrics (FIGO) and conducted using a rigorously applied Delphi process. The stakeholder organizations and individuals who participated in this process comprised specialty journals, experts at large, national, specialty obstetrical and gynecological societies, and informed lay representatives. After two face-to-face meetings and five Delphi rounds, the result is a three-level multi-tiered system. The system is applied after a preliminary assessment identifies the presence of an ovulatory disorder. The primary level of the system is based on an anatomic model (Hypothalamus, Pituitary, Ovary) that is completed with a separate category for PCOS. This core component of the system is easily remembered using the acronym HyPO-P. Each anatomic category is stratified in the second layer of the system to provide granularity for investigators, clinicians, and trainees using the "GAIN-FIT-PIE" mnemonic (Genetic, Autoimmune, Iatrogenic, Neoplasm; Functional, Infectious and Inflammatory, Trauma and vascular; Physiological, Idiopathic, Endocrine). The tertiary level allows for specific diagnostic entities. It is anticipated that, if widely adopted, this system will facilitate education, clinical care, and the design and interpretation of research in a fashion that better informs progress in this field. Integral to the deployment of this system is a periodic process of reevaluation and appropriate revision, reflecting an improved understanding of this collection of disorders.
Topics: Endocrinology; Female; Gynecology; Humans; Polycystic Ovary Syndrome; Pregnancy; Uterine Diseases
PubMed: 35995633
DOI: 10.1016/j.fertnstert.2022.07.009 -
American Family Physician Mar 2023
Topics: Female; Humans; Polycystic Ovary Syndrome
PubMed: 36920820
DOI: No ID Found -
Hormone Research in Paediatrics 2017This paper represents an international collaboration of paediatric endocrine and other societies (listed in the Appendix) under the International Consortium of...
This paper represents an international collaboration of paediatric endocrine and other societies (listed in the Appendix) under the International Consortium of Paediatric Endocrinology (ICPE) aiming to improve worldwide care of adolescent girls with polycystic ovary syndrome (PCOS)1. The manuscript examines pathophysiology and guidelines for the diagnosis and management of PCOS during adolescence. The complex pathophysiology of PCOS involves the interaction of genetic and epigenetic changes, primary ovarian abnormalities, neuroendocrine alterations, and endocrine and metabolic modifiers such as anti-Müllerian hormone, hyperinsulinemia, insulin resistance, adiposity, and adiponectin levels. Appropriate diagnosis of adolescent PCOS should include adequate and careful evaluation of symptoms, such as hirsutism, severe acne, and menstrual irregularities 2 years beyond menarche, and elevated androgen levels. Polycystic ovarian morphology on ultrasound without hyperandrogenism or menstrual irregularities should not be used to diagnose adolescent PCOS. Hyperinsulinemia, insulin resistance, and obesity may be present in adolescents with PCOS, but are not considered to be diagnostic criteria. Treatment of adolescent PCOS should include lifestyle intervention, local therapies, and medications. Insulin sensitizers like metformin and oral contraceptive pills provide short-term benefits on PCOS symptoms. There are limited data on anti-androgens and combined therapies showing additive/synergistic actions for adolescents. Reproductive aspects and transition should be taken into account when managing adolescents.
Topics: Adolescent; Congresses as Topic; Female; Humans; Polycystic Ovary Syndrome
PubMed: 29156452
DOI: 10.1159/000479371 -
Pediatrics in Review Jun 2024
Review
Topics: Humans; Polycystic Ovary Syndrome; Female; Child; Adolescent
PubMed: 38821890
DOI: 10.1542/pir.2023-006036 -
Roczniki Panstwowego Zakladu Higieny 2016PCOS (polycystic ovary syndrome) is called a pathology of the XX century and affects at least 10-15% women of childbearing age. The therapy involves pharmacotherapy of...
BACKGROUND
PCOS (polycystic ovary syndrome) is called a pathology of the XX century and affects at least 10-15% women of childbearing age. The therapy involves pharmacotherapy of hormonal imbalance, as well as the change of lifestyle, including the diet.
OBJECTIVE
Performing the quantitative assessment of components of diets of women with PCOS, comparing the results with current dietary standards for Polish people and defining dietary requirements for the patients.
MATERIAL AND METHODS
The study was performed on 54 women of childbearing age (average age 26.03± 5.52) with PCOS syndrome diagnosed according to on the Rotterdam criteria. Anthropometric measurements of the patients were made and BMI and WHR calculated. Quantitative assessment of women’s diets was performed based on the analysis of 3-day food diaries and food records taken from the previous 24h with the interview method. The data were introduced to a dietary software DIETA 5.0, calculating the average intake of the energy, nutrients, vitamins, minerals, cholesterol and dietary fibre. The obtained results were compared to Polish dietary guidelines.
RESULTS
Examined group was characterized by increased waist circumference (98.71± 13.6 cm) and an average WHR was 0.92± 0.08. An increased average value of BMI was also shown (28.91± 5.54 kg/m2). The patients consumed, on average, 1952.5±472.7 kcal daily, and the risk of insufficient intake of protein was determined in 36.7% of examined women. The highest risk of deficiency in minerals in women with PCOS was related to calcium (634 mg), potassium (3493 mg) and magnesium (250.1 mg), whereas with reference to vitamins deficiency as much as 70% of tested women were at risk of insufficient intake of folic acid, 36.7% of them - vitamin C, and 26.7% - vitamin B12. The average consumption of vitamin D was at the level of 3.4 μg. Test group was characterized by excessive average consumption of total fat (50%), SFA (70.4%) and saccharose (50%). The percentage of people with excessive average intake of cholesterol was at the level of 40.74%. As much as 83.3% patients consumed too low amounts of dietary fibre in their diets (<25g).
CONCLUSIONS
In diet therapy of women with PCOS there should be higher intake of folic acid, vitamins D and C, cobalamin, dietary fibre and calcium. The consumption of total fats, saturated fatty acids and cholesterol should be reduced, as through facilitating the development of diabetes and cardio-vascular diseases, they affect the dysfunction of ovaries. The diet of some of the patients should be also supplemented by potassium, magnesium and zinc. The introduction of a properly balanced diet should be the key in the treatment of women with PCOS diagnosed according to Rotterdam criteria.
Topics: Adult; Energy Intake; Female; Humans; Middle Aged; Nutrition Policy; Nutritional Requirements; Nutritional Status; Poland; Polycystic Ovary Syndrome; Young Adult
PubMed: 27925712
DOI: No ID Found -
Pediatric Research Jan 2020Polycystic ovary syndrome (PCOS), characterized by hormonal imbalance and ovarian dysfunction, often starts during adolescence. Inconsistent diagnostic criteria,... (Review)
Review
Polycystic ovary syndrome (PCOS), characterized by hormonal imbalance and ovarian dysfunction, often starts during adolescence. Inconsistent diagnostic criteria, variable provider knowledge, and lack of consensus pose specific challenges for the care of women with PCOS. These factors encourage inaccurate diagnosis with both under and overdiagnosis. This unfavorable diagnostic experience exasperates affected women and limits timely opportunities for intervention to minimize associated comorbidities, especially during the transition from pediatric to adult care. Recognition of these issues in the care of adolescents and women with PCOS inspired the development of the International Evidence-Based PCOS Guidelines, which emphasize the prevention, screening, and treatment of PCOS across the reproductive lifespan. The Guidelines and accompanying meta-analyses focus on three major categories of associated comorbidities: (1) reproductive; (2) metabolic; and (3) psychological. With the exception of infertility, this article considers common manifestations and comorbidities associated with PCOS throughout the lifecycle. Healthy lifestyle interventions with prevention of excess weight gain comprise the primary intervention for all comorbidities. Hence, early identification of girls "at risk" for PCOS and those with PCOS is a priority. Extensive guidelines for provider and patient education aim to decrease the medical, psychosocial, and economic burdens attributable to PCOS and its associated comorbidities.
Topics: Adolescent; Adult; Age Factors; Comorbidity; Early Diagnosis; Early Medical Intervention; Female; Fertility; Healthy Lifestyle; Humans; Ovary; Polycystic Ovary Syndrome; Predictive Value of Tests; Preventive Health Services; Prognosis; Reproductive Health; Risk Assessment; Risk Factors; Risk Reduction Behavior; Young Adult
PubMed: 31627209
DOI: 10.1038/s41390-019-0615-1 -
South Dakota Medicine : the Journal of... Nov 2014
Topics: Female; Humans; Polycystic Ovary Syndrome
PubMed: 25490793
DOI: No ID Found -
Annales D'endocrinologie Sep 2019PolyCystic Ovary Syndrome (PCOS) is the first endocrinopathy of women of child-bearing age and the leading cause of anovulatory infertility. The pathophysiology of this... (Review)
Review
PolyCystic Ovary Syndrome (PCOS) is the first endocrinopathy of women of child-bearing age and the leading cause of anovulatory infertility. The pathophysiology of this syndrome is complex and involves genetic traits highlighted by GWAS and epigenetic traits with DNA methylation modifications. Initially described as an ovarian disease, works carried out over recent years were turned towards neuroendocrine disorder involving GABAergic pathways, KNDy neurons and a possible role of prenatal androgen exposure determined by animal models. Clinically, PCOS leads to many complications including psychological and emotional disorders demonstrated in large populations of PCOS women. © 2019 Published by Elsevier Masson SAS. All rights reserved. Cet article fait partie du numéro supplément Les Must de l'Endocrinologie 2019 réalisé avec le soutien institutionnel de Ipsen-Pharma.
Topics: Androgens; Endocrinology; Epigenesis, Genetic; Female; Genome-Wide Association Study; Humans; Mental Disorders; Polycystic Ovary Syndrome; Pregnancy; Prenatal Exposure Delayed Effects
PubMed: 31606059
DOI: 10.1016/S0003-4266(19)30114-3