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Annales D'endocrinologie Feb 20101. The Rotterdam classification should be used to define PCOS in the event of: menstrual cycle anomalies; amenorrhoea, oligomenorrhoea or long cycles, clinical and/or... (Review)
Review
1. The Rotterdam classification should be used to define PCOS in the event of: menstrual cycle anomalies; amenorrhoea, oligomenorrhoea or long cycles, clinical and/or biochemical hyperandrogenism and ultrasound appearance of polycystic ovaries. 2. The presence of two of these three criteria is sufficient once all other diagnoses have been ruled out. 3. Diagnosis of hirsutism should not be based on the Ferriman-Gallway score. 4. The ultrasound definition of PCOS contains precise criteria that must be included in the report: presence of at least 12 follicles in each ovary measuring 2-9 mm in diameter, and/or increase in ovary size>10 ml. 5. Screening for elevated plasma LH no longer necessary. Testing for GnRH serves no purpose. 6. Routine screening for metabolic abnormalities should be carried out systematically based on weight, height and BMI, waist circumference, blood pressure and laboratory parameters: plasma glucose, triglycerides, HDL cholesterol. 7. In the case of obesity (BMI>30 kg/m(2)), oral glucose tolerance testing (OGTT) is recommended where fasting serum glucose is normal. 8. Clomiphene citrate (CC) remains the first-line therapy for ovulation induction. In patients with BMI>30, it should be preceded by improvement of metabolic status through appropriate lifestyle modifications.
Topics: Animals; Clomiphene; Diagnosis, Differential; Female; Fertility Agents, Female; Humans; Infertility, Female; Life Style; Polycystic Ovary Syndrome; Terminology as Topic
PubMed: 20096827
DOI: 10.1016/j.ando.2009.12.003 -
Journal of Psychosomatic Obstetrics and... Dec 2019
Topics: Female; Humans; Polycystic Ovary Syndrome
PubMed: 31595811
DOI: 10.1080/0167482X.2019.1672337 -
Endokrynologia Polska 2017Anti-Müllerian hormone (AMH) is a glycoprotein, a member of the transforming growth factor β family, reflecting the number of ovarian antral follicles. Polycystic... (Review)
Review
Anti-Müllerian hormone (AMH) is a glycoprotein, a member of the transforming growth factor β family, reflecting the number of ovarian antral follicles. Polycystic ovary syndrome (PCOS) is a common endocrinopathy predisposing to infertility, and metabolic and cardiovascular complications. In our review, we discuss the role of AMH in PCOS pathophysiology and its clinical applications according to the published studies. Improvement of AMH assay validity will allow the clinical utility of this valuable biomarker to be widened. (Endokrynol Pol 2017; 68 (1): 74-78).
Topics: Anti-Mullerian Hormone; Female; Humans; Polycystic Ovary Syndrome
PubMed: 27918066
DOI: 10.5603/EP.a2016.0065 -
Current Opinion in Obstetrics &... Oct 2012To highlight the new information in the field of polycystic ovary syndrome (PCOS) in adolescents and how it may pertain to current practice. (Review)
Review
PURPOSE OF REVIEW
To highlight the new information in the field of polycystic ovary syndrome (PCOS) in adolescents and how it may pertain to current practice.
RECENT FINDINGS
The diagnosis of adolescent PCOS remains controversial, and experts continue to debate the appropriate criteria to be used. There is growing support for using Rotterdam criteria, but requiring the presence of all three criteria (oligoovulation or anovulation, hyperandrogenism and polycystic ovaries on pelvic ultrasonography), as the standard 'two of three' criteria may overdiagnose PCOS in adolescents. As adolescent PCOS is better understood, a high rate of metabolic syndrome and sleep disorders is appreciated, which likely has implications on long-term health. The mainstay of PCOS treatment in adolescents should be lifestyle modification (diet, exercise and behavioral changes), and evidence exists that these interventions are beneficial. The use of insulin sensitizers to target PCOS-related insulin resistance and metabolic dysfunction is common, but further studies on its use and effectiveness are warranted.
SUMMARY
As a better understanding of adolescent PCOS evolves, including appropriate diagnostic criteria, factors associated with concomitant metabolic disorders and effective treatment options, improved care for these adolescents will be achieved.
Topics: Adolescent; Female; Humans; Metabolic Syndrome; Polycystic Ovary Syndrome; Sleep Wake Disorders
PubMed: 22781076
DOI: 10.1097/GCO.0b013e32835669ff -
Life Sciences Nov 2020Polycystic ovary syndrome (PCOS) is an endocrinopathy, and it accounts for 75% of non-ovulatory infertile in women of childbearing age. It is clear that obesity, insulin... (Review)
Review
Polycystic ovary syndrome (PCOS) is an endocrinopathy, and it accounts for 75% of non-ovulatory infertile in women of childbearing age. It is clear that obesity, insulin resistance, dyslipidaemia coexist in PCOS. Apelin, as an endogenous ligand of the previously orphan receptor, is an adipokine that secreted by adipose tissue. Apelin and apelin receptors are expressed in many tissues and organ to regulate their physiological functions. Studies have shown that Apelin/apelin-receptor also expressed in ovary such as follicles, granulosa cells. Furthermore, Apelin/apelin-receptor play roles in vascular establishment and hormone metabolism in ovary. These indicate that the Apelin/apelin-receptor play an important role in the development of follicle. Apelin/apelin-receptor are increased in ovary of PCOS, which are associated with abnormal ovarian hormones and function. These are important causes of menstrual cycle disorders and anovulation. Moreover, apelin now appears clearly as a new player in energy metabolism. Apelin can regulate glucose and lipid metabolism but also modulate insulin secretion. And plasma apelin concentrations are elevated in obesity and type 2 diabetes patients. Interestedly, obesity and type 2 diabetes are also companied with polycystic ovary syndrome patients. We speculate apelin/apelin-receptor may play a vital role in pathogenesis of polycystic ovary syndrome, but the underlying mechanisms remain under exploration. Here, we review apelin/apelin-receptor, as a new therapeutic target, have effects on ovarian function and energy metabolism in polycystic ovary syndrome.
Topics: Animals; Apelin; Apelin Receptors; Female; Gene Expression Regulation; Humans; Molecular Targeted Therapy; Polycystic Ovary Syndrome; Signal Transduction
PubMed: 32835696
DOI: 10.1016/j.lfs.2020.118310 -
The Journal of Steroid Biochemistry and... Jan 2023Polycystic ovary syndrome (PCOS) is one of the main endocrine and reproductive disorders affecting women in their reproductive age. The syndrome is considered a... (Review)
Review
Polycystic ovary syndrome (PCOS) is one of the main endocrine and reproductive disorders affecting women in their reproductive age. The syndrome is considered a multifactorial pathology. Therefore, genetic susceptibility and environmental factors contribute to PCOS development and phenotypic manifestation. Ethnicity and socioeconomic factors influence the development of PCOS and could affect the possibility of its diagnosis. Latin America is a unique case of study because of the heterogeneity within the region, complex socioeconomic status, and the mixed ancestry found in these populations. Up-to-date, most studies have focused on developed countries' populations, and there is a lack of evidence regarding Latin-American countries. We propose to review the state of the art of PCOS knowledge regarding Latin American populations, including the metabolic and reproductive aspects of the syndrome and the different influencing factors, and suggest future directions to deepen the study of PCOS.
Topics: Female; Humans; Polycystic Ovary Syndrome; Latin America; Racial Groups
PubMed: 36183993
DOI: 10.1016/j.jsbmb.2022.106195 -
Molecular Diagnosis & Therapy Jun 2020Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. PCOS is characterized by ovarian dysfunction and metabolic abnormalities... (Review)
Review
Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. PCOS is characterized by ovarian dysfunction and metabolic abnormalities with widely varying clinical manifestations brought about by intricate mechanisms of interplay between the genome and the environment. The popularity of epigenome-wide association studies (EWASs) is helping to facilitate the discovery of environment-mediated molecular modification in PCOS from disease etiology to epigenetic marker discovery. Current epigenetic studies have provided convincing observational evidence linking epigenetic regulation with PCOS origin, manifestation, clinical heterogeneity and comorbidity, which could lead to improved management of the disease through efficient intervention and prevention strategies. Several biological pathways have been consistently reported by independent studies, revealing functional regulation due to endocrine abnormalities and metabolic dysfunction in PCOS, while also suggesting an autoimmune component in the condition. The use of high-throughput sequencing technologies for analysing the epigenome integrated with causal inferences is expected to facilitate effective and efficient PCOS management to promote reproductive health.
Topics: Biomarkers; Comorbidity; DNA Methylation; Disease Management; Disease Susceptibility; Epigenesis, Genetic; Epigenome; Epigenomics; Female; Humans; Molecular Diagnostic Techniques; Polycystic Ovary Syndrome
PubMed: 32297305
DOI: 10.1007/s40291-020-00463-w -
Tidsskrift For Den Norske Laegeforening... Sep 2005In May 2003, leading American and European experts reached a consensus for the definition of polycystic ovary syndrome (PCOS). This consensus implies that the same... (Review)
Review
INTRODUCTION
In May 2003, leading American and European experts reached a consensus for the definition of polycystic ovary syndrome (PCOS). This consensus implies that the same criteria can be used when research on PCOS is performed, which is fundamental to further knowledge development.
MATERIAL AND METHODS
The present review is based on a search in PubMed/Medline and personal clinical experience.
RESULTS AND INTERPRETATION
Based on existing knowledge, women with PCOS have an increased risk of overweight, insulin resistance, type 2 diabetes mellitus, cardiovascular disease, and most likely certain types of gynaecologic cancer. Treatment of PCOS should therefore not only be symptomatic, focusing on existing symptoms. In addition, prophylactic measures should also be initiated. This change in treatment philosophy is a huge challenge to all doctors. In order to correctly diagnosing PCOS, general practitioners need to co-operate with gynaecologists. For optimal management of PCOS, general practitioners as well as gynaecologists have to be aware of the diagnostic criteria; the syndrome should be diagnosed as early as possible and the patient informed about the syndrome. The doctor and the patient should decide upon a long-term follow-up strategy together.
Topics: Consensus; Female; Follow-Up Studies; Humans; Metabolic Syndrome; Polycystic Ovary Syndrome; Practice Guidelines as Topic
PubMed: 16151492
DOI: No ID Found -
Southern Medical Journal Oct 2013Polycystic ovary syndrome is the single most common endocrine abnormality of women of reproductive age and is a leading cause of female infertility. Common clinical... (Review)
Review
Polycystic ovary syndrome is the single most common endocrine abnormality of women of reproductive age and is a leading cause of female infertility. Common clinical features include hirsutism, various ovarian abnormalities, obesity, and insulin resistance. Expert consensus recommendations on diagnostic criteria vary, but the most recent focus on the presence of clinical features of hyperandrogenism, hyperandrogenemia, polycystic ovaries, and ovulatory and menstrual dysfunction to the exclusion of alternative diagnoses. In adolescence, diagnosis is more difficult because of the frequent presence of individual clinical findings in otherwise "normal" individuals. Laboratory tests and pelvic ultrasound are necessary to confirm polycystic ovary syndrome and exclude other disorders that may mimic this syndrome. Treatment is centered on the clinical manifestations and should be initiated early to prevent/limit long-term complications, including the metabolic syndrome, diabetes, endometrial carcinoma, and infertility.
Topics: Adolescent; Diagnosis, Differential; Early Diagnosis; Female; Humans; Polycystic Ovary Syndrome
PubMed: 24096951
DOI: 10.1097/SMJ.0000000000000003 -
Journal of Medicine and Life 2015To elucidate the prepubertal risk factors associated with the development of Polycystic Ovary Syndrome (PCOS) and determine the special clinical manifestations of the... (Review)
Review
RATIONALE
To elucidate the prepubertal risk factors associated with the development of Polycystic Ovary Syndrome (PCOS) and determine the special clinical manifestations of the syndrome in this transitional time of a woman's life.
OBJECTIVE
To propose therapeutic targets and regimens, not only to prevent the long-term complications of the syndrome, but also to improve the self-esteem of a young girl who matures into womanhood.
METHODS AND RESULTS
A systematic review of literature was performed through electronic database searches (Pubmed, Medline and Embase). Studies published in English-language, peer-reviewed journals from 1996 to 2013 were included. The selected studies focused on the risk factors, the unique features and treatment options of the PCOS in puberty. The pathogenesis of the PCOS was hypothesized to be based on interactions between genetic and certain environmental factors. The diagnosis was usually difficult in young girls. The syndrome was related to a greater risk of future infertility, type II diabetes mellitus, the metabolic syndrome and cardiovascular disease. Early treatment was crucial to prevent the long-term complications of the syndrome, especially infertility and cardiovascular disease.
DISCUSSION
The recognition of the early signs of PCOS during or even before adolescence is of great importance. It is essential to establish the correct diagnosis for PCOS and rule out other causes of androgen excess in young women with hyperandrogenism. The type of treatment applied should be considered on an individual basis.
ABBREVIATIONS
PCOS = Polycystic Ovary Syndrome.
Topics: Adolescent; Diagnosis, Differential; Diagnostic Imaging; Female; Humans; Polycystic Ovary Syndrome; Puberty; Risk Factors
PubMed: 26351529
DOI: No ID Found