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Annals of the New York Academy of... 2008Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among reproductive-aged women and is characterized by hyperandrogenemia, menstrual dysfunction, and... (Review)
Review
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy among reproductive-aged women and is characterized by hyperandrogenemia, menstrual dysfunction, and polycystic ovarian morphology. The hormonal abnormalities inherent in PCOS often begin in adolescence and include hyperinsulinemia and rapid luteinizing hormone (LH) pulse frequency, both of which mediate ovarian and adrenal overproduction of androgens. Although differences exist regarding the diagnostic criteria for PCOS, we believe that hyperandrogenemia is the final common pathway for the development of adolescent PCOS, and we propose a hypothesis to illustrate such. Recognizing and reducing androgen levels in adolescence is critical given their association with the metabolic syndrome (MBS), diabetes, and infertility in adulthood.
Topics: Adolescent; Androgens; Female; Humans; Hyperinsulinism; Luteinizing Hormone; Polycystic Ovary Syndrome
PubMed: 18574211
DOI: 10.1196/annals.1429.005 -
Paediatric Drugs 2006Polycystic ovary syndrome (PCOS) is a very common disorder affecting 5-10% of women of reproductive age. The pivotal endocrine abnormalities of this syndrome are insulin... (Review)
Review
Polycystic ovary syndrome (PCOS) is a very common disorder affecting 5-10% of women of reproductive age. The pivotal endocrine abnormalities of this syndrome are insulin resistance and ovarian and, to a lesser degree, adrenal hypersensitivity to hormonal stimulation. PCOS may manifest itself as early as the first decade of life by premature pubarche or menarche. Oligoamenorrhea in the first postpubarchal years, although very common, may be an early symptom of PCOS, especially in overweight girls with hirsutism or acne. Girls with low birth weight as well as a family history of diabetes mellitus or premature cardiovascular disease are at high risk for developing PCOS. Circulating bioavailable testosterone levels are usually elevated, while total testosterone may be normal due to low levels of sex hormone-binding globulin. The typical sonographic appearance of PCOS ovaries consists of high ovarian volume (>10 mL) and the presence of 12 or more follicles in each ovary measuring 2-9 mm in diameter. However, this finding is not specific, since it may occur in >20% of healthy girls. The therapeutic goals in adolescents with PCOS is first to restore bodyweight and menses and to reduce the signs of hyperandrogenism. The reduction of bodyweight in this young age group may require the collaboration of the pediatrician, dietitian, and psychotherapist. The adolescent should be urged to adopt a healthy lifestyle with the aim to maintain a normal body mass index throughout adolescence and adult life. The choice of medical therapy depends on the clinical presentation. Oral contraceptives are a good option when acne and hirsutism are the principal complaints. Adolescents with isolated cycle irregularity may be placed on a cyclical progestin regimen to induce withdrawal bleeding. Metformin, by decreasing insulin resistance, alleviates many of the hormonal disturbances and restores menses in a considerable proportion of patients. It may be used alone or in combination with oral contraceptives. Independently of medical treatment, restoration and maintenance of bodyweight within normal range is of paramount importance.
Topics: Adolescent; Anti-Obesity Agents; Female; Hormones; Humans; Hypoglycemic Agents; Metformin; Polycystic Ovary Syndrome
PubMed: 17037948
DOI: 10.2165/00148581-200608050-00004 -
Endocrinology and Metabolism Clinics of... Sep 2005Polycystic ovary syndrome (PCOS) is a syndrome of variable combinations of menstrual irregularity, hirsutism or acne, and obesity. It can be diagnosed in adolescence and... (Review)
Review
Polycystic ovary syndrome (PCOS) is a syndrome of variable combinations of menstrual irregularity, hirsutism or acne, and obesity. It can be diagnosed in adolescence and has early childhood antecedents. PCOS is the single most common endocrine cause of an ovulatory infertility and a major risk factor for the metabolic syndrome and, in turn, development of type 2 diabetes mellitus in women. Thus, it appears that PCOS increases a woman's risk of developing cardiovascular disease. Therefore, identifying girls at risk for PCOS and implementing treatment early in the development of PCOS may be an effective means of preventing some of the long-term complications associated with this syndrome. This article reviews the definition, clinical features, diagnosis, and treatment of PCOS.
Topics: Adolescent; Female; Humans; Polycystic Ovary Syndrome
PubMed: 16085166
DOI: 10.1016/j.ecl.2005.04.005 -
Human Reproduction (Oxford, England) Sep 2002Polycystic ovary syndrome (PCOS) is a true syndrome, being a heterogeneous collection of signs and symptoms that gathered together form a spectrum of a disorder with a... (Review)
Review
Polycystic ovary syndrome (PCOS) is a true syndrome, being a heterogeneous collection of signs and symptoms that gathered together form a spectrum of a disorder with a mild presentation in some, whilst in others there is a severe disturbance of reproductive, endocrine and metabolic function. There has been much debate about phenotype and, more recently, genotype. There has also been scepticism in some quarters, with a feeling that we may be looking at one end of a spectrum that is in reality 'normal', or perhaps a consequence of the modern disease of obesity. Whilst the polycystic ovary is at the centre of the syndrome, it is external effects such as hyperinsulinism, that influence its expression. There is no consensus on the definition of PCOS and so studies that compare epidemiology and treatments often have very different starting points, and so cannot be compared. In this debate we wish to re-explore our current thinking on PCOS, with a particular emphasis on the British and European perspective and invite others to contribute to the discussion which could form the basis for an international consensus.
Topics: Ethnicity; Female; Humans; Polycystic Ovary Syndrome; Racial Groups
PubMed: 12202405
DOI: 10.1093/humrep/17.9.2219 -
Journal de Medecine Vasculaire 2022
Topics: Female; Humans; Polycystic Ovary Syndrome; Endometriosis; Vascular Diseases
PubMed: 36464415
DOI: 10.1016/j.jdmv.2022.11.001 -
Current Opinion in Pediatrics Aug 2007To provide an overview of our current understanding of polycystic ovary syndrome, its epidemiology and natural history, and potential therapeutic options. (Review)
Review
PURPOSE OF REVIEW
To provide an overview of our current understanding of polycystic ovary syndrome, its epidemiology and natural history, and potential therapeutic options.
RECENT FINDINGS
Polycystic ovary syndrome is estimated to affect 5-10% of premenopausal women. While once thought to affect primarily adult women, polycystic ovary syndrome is frequently diagnosed during adolescence and may be increasing in prevalence secondary to the recent trend of increasing obesity among teenagers. Adolescents and young women often present with hirsutism, irregular menses, and obesity. There is increasing evidence that these women are also at increased risk later in life for cardiovascular and metabolic disease. Early treatment may prevent disease progression. Treatment options have focused on improving clinical symptoms of androgen excess and anovulation. Newer therapies, such as insulin-sensitizing agents, are beneficial in correcting the underlying metabolic disorder and, therefore, theoretically may have a more significant impact on reducing associated long-term morbidity.
SUMMARY
An increasing number of adolescents are presenting with signs of polycystic ovary syndrome. While once thought to primarily affect appearance and fertility, it has become clear that women with this syndrome may also potentially face long-term health sequelae. Efforts should be made to diagnose and treat these women in adolescence to minimize the development of symptoms, and prevent the onset of cardiovascular and metabolic problems.
Topics: Adolescent; Algorithms; Androgen Antagonists; Disease Progression; Female; Humans; Hypoglycemic Agents; Life Style; Metformin; Obesity; Polycystic Ovary Syndrome
PubMed: 17630601
DOI: 10.1097/MOP.0b013e328236743f -
Endocrine Development 2005Polycystic ovary syndrome (PCOS) is a prevalent cause of menstrual disorders, acne and hirsutism presenting during adolescence. In the majority of cases, a familial... (Review)
Review
Polycystic ovary syndrome (PCOS) is a prevalent cause of menstrual disorders, acne and hirsutism presenting during adolescence. In the majority of cases, a familial trait is obvious but the offending genes have yet to be identified. However, much of the pathophysiology of the syndrome causing the overproduction of ovarian androgens is now becoming clearer. The early diagnostic signs are often mistakenly dismissed as normal changes of adolescence but it is important to make an early diagnosis in order to save the adolescent from the early and late stigmata of the syndrome. The avoidance of overweight, frank obesity and the consequential exaggeration of symptoms by the associated insulin resistance is of prime importance as hyperinsulinemia plays a key role in the pathogenesis. Anti-androgens are the most widely used medication and, in combination with estrogen, are capable of restoring menstrual regularity and reducing the symptoms of acne and hirsutism, so important for the improvement of the disturbing psychosocial effect that they may play at this age. The use of metformin, an insulin sensitizer, for affected adolescents is the topic of a presently heated debate.
Topics: Adolescent; Female; Humans; Polycystic Ovary Syndrome
PubMed: 15722622
DOI: 10.1159/000084099 -
Seminars in Reproductive Medicine Jul 2021Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with negative metabolic, reproductive, endocrine, and psychological consequences among... (Review)
Review
The Need to Reassess the Diagnosis of Polycystic Ovary Syndrome (PCOS): A Review of Diagnostic Recommendations from the International Evidence-Based Guideline for the Assessment and Management of PCOS.
Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with negative metabolic, reproductive, endocrine, and psychological consequences among women of reproductive age. The diagnosis of PCOS remains challenging due to limited and conflicting evidence regarding definitions for each of the diagnostic features. This review of the recommended PCOS assessment criteria from the international evidence-based guideline highlights the crucial need to reassess, redefine, and optimize the diagnosis of PCOS. Notably, normal values and cut-offs need to be defined for each diagnostic feature across the lifespan and diverse ethnic groups. Understanding how these features cluster together and relate to short- and long-term health outcomes in PCOS is also vital. Ultimately, greater knowledge of the natural history of PCOS is needed through well-characterized, community-based longitudinal studies, which will inform future PCOS diagnosis guidelines and optimize women's health in reproductive life.
Topics: Female; Humans; Polycystic Ovary Syndrome; Reproduction; Women's Health
PubMed: 34404096
DOI: 10.1055/s-0041-1735259 -
Clinica Chimica Acta; International... Jun 2017Retinoids (retinol and its derivatives) are required for maintaining vision, immunity, barrier function, reproduction, embryogenesis, cell proliferation and... (Review)
Review
Retinoids (retinol and its derivatives) are required for maintaining vision, immunity, barrier function, reproduction, embryogenesis, cell proliferation and differentiation. Furthermore, retinoid signaling plays a key role in initiating meiosis of germ cells of the mammalian fetal ovary. Recently, studies indicated that precise retinoid level regulation in the ovary provides a molecular control of ovarian development, steroidogenesis and oocyte maturation. Besides, abnormal retinoid signaling may be involved in the pathogenesis of polycystic ovary syndrome (PCOS), one of the most common ovarian endocrinopathies in reproductive-aged women worldwide. This review primarily summarizes recent advancements made in investigating the action of retinoid signaling in ovarian physiology as well as the abnormal retinoid signaling in PCOS.
Topics: Female; Humans; Ovary; Polycystic Ovary Syndrome; Retinoids; Signal Transduction
PubMed: 28359780
DOI: 10.1016/j.cca.2017.03.025 -
The American Journal of Medicine Feb 2007Polycystic ovary syndrome affects 6%-7% of reproductive-aged women, making it the most common endocrine disorder in this population. It is characterized by chronic... (Review)
Review
Polycystic ovary syndrome affects 6%-7% of reproductive-aged women, making it the most common endocrine disorder in this population. It is characterized by chronic anovulation and hyperandrogenism. Affected women may present with reproductive manifestations such as irregular menses or infertility, or cutaneous manifestations, including hirsutism, acne, or male-pattern hair loss. Over the past decade, several serious metabolic complications also have been associated with polycystic ovary syndrome including type 2 diabetes mellitus, metabolic syndrome, sleep apnea, and possibly cardiovascular disease and nonalcoholic fatty liver disease. In addition to treating symptoms by regulating menstrual cycles and improving hyperandrogenism, it is imperative that clinicians recognize and treat metabolic complications. Lifestyle therapies are first-line treatment in women with polycystic ovary syndrome, particularly if they are overweight. Pharmacological therapies are also available and should be tailored on an individual basis. This article reviews the diagnosis, clinical manifestations, metabolic complications, and treatment of the syndrome. A table summarizing treatment recommendations is provided.
Topics: Female; Humans; Polycystic Ovary Syndrome
PubMed: 17275449
DOI: 10.1016/j.amjmed.2006.06.029