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Nutrients May 2023Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder that affects premenopausal women. The etiology of PCOS is multifaceted, involving... (Review)
Review
Polycystic ovary syndrome (PCOS) is a prevalent endocrine and metabolic disorder that affects premenopausal women. The etiology of PCOS is multifaceted, involving various genetic and epigenetic factors, hypothalamic-pituitary-ovarian dysfunction, androgen excess, insulin resistance, and adipose-related mechanisms. High-fat diets (HFDs) has been linked to the development of metabolic disorders and weight gain, exacerbating obesity and impairing the function of the hypothalamic-pituitary-ovarian axis. This results in increased insulin resistance, hyperinsulinemia, and the release of inflammatory adipokines, leading to heightened fat synthesis and reduced fat breakdown, thereby worsening the metabolic and reproductive consequences of PCOS. Effective management of PCOS requires lifestyle interventions such as dietary modifications, weight loss, physical activity, and psychological well-being, as well as medical or surgical interventions in some cases. This article systematically examines the pathological basis of PCOS and the influence of HFDs on its development, with the aim of raising awareness of the connection between diet and reproductive health, providing a robust approach to lifestyle interventions, and serving as a reference for the development of targeted drug treatments.
Topics: Humans; Animals; Female; Polycystic Ovary Syndrome; Diet, High-Fat; Life Style; Exercise; Reproduction; Mental Health
PubMed: 37432488
DOI: 10.3390/nu15092230 -
Current Pharmaceutical Design 2016Backgrouund: Polycystic ovary syndrome is a multifaceted disorder with a pathogenetic pathway that is not fully understood yet. Apart from hormonal derangements, insulin... (Review)
Review
UNLABELLED
Backgrouund: Polycystic ovary syndrome is a multifaceted disorder with a pathogenetic pathway that is not fully understood yet. Apart from hormonal derangements, insulin signaling defects and adipose tissue dysfunction, oxidative stress, defined as an imbalance derived from excessive formation of oxidants in the presence of limited antioxidants defenses, has been actively implicated in the etiology of the syndrome.
METHODS
This review focuses on understanding the putative role of oxidative stress in the pathophysiology of PCOS and analyzing its interconnection with the rest etiologic parameters and its contribution to the reproductive and metabolic manifestations of the syndrome.
RESULTS
Although underlying mechanisms have not been fully elucidated yet, it becomes evident that oxidative stress holds a respectable share in the pathogenesis of PCOS. In fact, PCOS can be considered as a purely oxidative state, where the body antioxidants cannot outweigh the excessive production of free radicals.
CONCLUSION
Oxidative stress, in conjunction with the rest etiologic mechanisms of PCOS and the cardinal contribution of environmental factors, leads to an adverse redox status that stigmatizes the natural process of the syndrome.
Topics: Female; Humans; Oxidative Stress; Polycystic Ovary Syndrome
PubMed: 26881435
DOI: 10.2174/1381612822666160216151852 -
Drug and Therapeutics Bulletin Jan 2001Up to one-third of women in the UK have polycystic ovaries (i.e. 10 or more follicles per ovary detected on ultrasound). An estimated one-third of these women have... (Review)
Review
Up to one-third of women in the UK have polycystic ovaries (i.e. 10 or more follicles per ovary detected on ultrasound). An estimated one-third of these women have polycystic ovary syndrome, usually defined in the UK as polycystic ovaries together with one or more characteristic features (hirsutism, male-pattern baldness, acne, oligomenorrhoea or amenorrhoea, obesity, or raised serum concentrations of testosterone and/or luteinising hormone [LH]). The metabolic abnormalities often associated with polycystic ovary syndrome (insulin resistance and abnormal serum lipid concentrations) also put some women with the syndrome at increased risk of developing diabetes mellitus. Here, we review the management of women with polycystic ovary syndrome.
Topics: Androgen Antagonists; Female; Fertility Agents, Female; Humans; Hypoglycemic Agents; Life Style; Mineralocorticoid Receptor Antagonists; Polycystic Ovary Syndrome
PubMed: 11221187
DOI: 10.1136/dtb.2001.3911-a -
American Family Physician Sep 2000Recent diagnostic and pharmacologic developments have focused renewed attention on polycystic ovary syndrome. Clinical features of the syndrome include anovulation,... (Review)
Review
Recent diagnostic and pharmacologic developments have focused renewed attention on polycystic ovary syndrome. Clinical features of the syndrome include anovulation, hyperandrogenism and menstrual dysfunction, but several other abnormalities, including hyperinsulinemia, luteinizing hormone hypersecretion, elevated testosterone levels and acyclic estrogen production, have been documented. Accompanying obesity and lipid abnormalities compound the risk of developing diabetes mellitus or cardiovascular disease, and chronic anovulation increases the risk for endometrial cancer. A careful history and physical examination should guide diagnostic testing. Slowly progressive hyperandrogenic symptoms with anovulation of peripubertal onset often represent polycystic ovary syndrome. Treatment goals include symptom management and the identification and prevention of potential cardiovascular risks. Treatment should take into account the patient's desire for fertility. Advances in transvaginal ultrasonography and infertility treatments, including newer medications, have facilitated assisted reproduction in patients with polycystic ovary syndrome. Ongoing pharmacologic research focusing on the treatment of insulin resistance appears promising in reversing the longterm complications of the syndrome.
Topics: Female; Humans; Infertility, Female; Patient Education as Topic; Polycystic Ovary Syndrome; Teaching Materials
PubMed: 10997532
DOI: No ID Found -
Problemy Endokrinologii Feb 2022Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder caused by both genetic and epigenetic factors. Depending on the period of a woman's life, the clinical...
Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder caused by both genetic and epigenetic factors. Depending on the period of a woman's life, the clinical picture, diagnosis, and treatment tactics of the disease are different. PCOS has a complex of reproductive, metabolic and psychological characteristics. The target audience of these clinical recommendations are obstetrician-gynecologists, endocrinologists, general practitioners, general practitioners. In these clinical guidelines, all information is ranked according to the level of persuasiveness of recommendations and the reliability of evidence, depending on the number and quality of studies on this issue.
Topics: Endocrinologists; Female; Humans; Polycystic Ovary Syndrome; Reproducibility of Results
PubMed: 35488762
DOI: 10.14341/probl12874 -
International Journal of Gynaecology... Mar 2024Polycystic ovary syndrome (PCOS) is a common chronic condition in women of child-bearing age. There is currently no effective treatment, so early and long-term... (Review)
Review
BACKGROUND
Polycystic ovary syndrome (PCOS) is a common chronic condition in women of child-bearing age. There is currently no effective treatment, so early and long-term management is essential. However, there are many problems in the practice of disease management in women with PCOS that make it difficult to achieve good outcomes.
OBJECTIVE
To explore women's experience of PCOS management and identify the relevant facilitators and barriers to management.
SEARCH STRATEGY
A structured search was undertaken in five bibliographic databases (MEDLINE, Web of Science, CINAHL, Embase, PubMed, and Cochrane) from the date of establishment of the database up to December 2022.
SELECTION CRITERIA
All qualitative and mixed-methods studies available in English describing the experience of PCOS management from the patients' perspective were included.
DATA COLLECTION AND ANALYSIS
The Joanna Briggs Institute Qualitative Assessment and Review Instrument was used to appraise study quality. The evidence was synthesized using a pragmatic meta-aggregative approach guided by the capability, opportunity, and motivation model of behavior (COM-B).
MAIN RESULTS
A total of 13 studies were included with 85 equivocal findings and 12 credible findings. The findings were meta-aggregated into three themes: (1) capability of women with PCOS, including patients' attitudes toward disease and management, knowledge, and skills of the disease; (2) opportunities in PCOS management, including information about PCOS, diagnostic delay, disease characteristics, disease management plan, and logistical and environmental problems; and (3) motivation in PCOS management, including impact of symptoms, perceived needs, support and feedback, and unpleasant medical experience.
CONCLUSIONS
This study identifies facilitators and barriers to PCOS management from the patient perspective, which can guide the design and implementation of PCOS management programs for patients. This study also provides information for future research into how the COM-B theory can be incorporated into specific management plans to promote patient action.
Topics: Humans; Female; Polycystic Ovary Syndrome; Delayed Diagnosis; Motivation
PubMed: 37605982
DOI: 10.1002/ijgo.15031 -
Ultrasound Quarterly Dec 2007Polycystic ovary syndrome is the most common endocrine disorder occurring in reproductive-age women. The syndrome is complex, multifactorial, and not always easily... (Review)
Review
Polycystic ovary syndrome is the most common endocrine disorder occurring in reproductive-age women. The syndrome is complex, multifactorial, and not always easily defined. Diagnosis is based upon a combination of clinical and biochemical criteria and ovarian morphology. The following review describes the clinical features, pathophysiology, diagnosis, and the role of imaging. Diagnostic imaging techniques are discussed, with emphasis on ultrasound as the main modality used worldwide. Contributions of 3-dimensional and Doppler ultrasound are addressed in addition to potential indications for magnetic resonance imaging in the evaluation of patients with suspected polycystic ovary syndrome.
Topics: Diagnostic Imaging; Female; Humans; Imaging, Three-Dimensional; Magnetic Resonance Imaging; Ovary; Polycystic Ovary Syndrome; Ultrasonography, Doppler
PubMed: 18090834
DOI: 10.1097/ruq.0b013e318159927f -
Revista Da Associacao Medica Brasileira... Dec 2016Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder with variable prevalence, affecting about one in every 15 women worldwide. The diagnosis of... (Review)
Review
Polycystic ovary syndrome (PCOS) is a heterogeneous endocrine disorder with variable prevalence, affecting about one in every 15 women worldwide. The diagnosis of polycystic ovary syndrome requires at least two of the following criteria: oligoovulation and/or anovulation, clinical and/or biochemical evidence of hyperandrogenism and morphology of polycystic ovaries. Women with PCOS appear to have a higher risk of developing metabolic disorders, hypertension and cardiovascular disorders. The aim of this article was to present a review of the literature by searching the databases Pubmed and Scielo, focusing on publications related to polycystic ovaries, including its pathogenesis, clinical manifestations, diagnosis and therapeutic aspects, as well as its association with cardiovascular and arterial hypertensive disorders.
Topics: Cardiovascular Diseases; Female; Humans; Hypertension; Insulin Resistance; Polycystic Ovary Syndrome
PubMed: 28001262
DOI: 10.1590/1806-9282.62.09.867 -
Current Pharmaceutical Design 2016Insulin resistance and the associated compensatory hyperinsulinemia are common findings in women with PCOS, and may play a key role in this condition. (Review)
Review
BACKGROUND
Insulin resistance and the associated compensatory hyperinsulinemia are common findings in women with PCOS, and may play a key role in this condition.
METHODS
In this article, we focused on the significance of insulin resistance in PCOS, reviewing the available literature on epidemiology, pathogenesis, pathophysiology and treatment of this condition.
RESULTS
It has been estimated that approximately 70% of these women are insulin resistant, but this figure is affected by frequent referral bias. In addition, there is metabolic heterogeneity between clinical phenotypes of PCOS. A fundamental issue is the role that hyperinsulinemia plays in androgen overproduction, which is enhanced by bidirectional links between insulin resistance and hyperandrogenism. Available data suggest that women with PCOS may have insulin action alterations of heterogeneous origins, which induce specific abnormalities in these subjects due to the presence of intrinsic defects. Obesity is a common finding in these patients and contributes to the association between PCOS and insulin resistance, combining with the effect of PCOS per se. Insulin sensitization shows several beneficial effects in the treatment of this condition. However, clinical response is heterogeneous.
CONCLUSION
Insulin resistance is a common feature of women with PCOS, although it is not universal and differ between clinical phenotypes of PCOS. Insulin resistance and hyperandrogenism appear to be interrelated key factors in the pathogenesis of PCOS. We hypothesize that PCOS might represent a common end-stage clinical phenotype of different processes, in which there are impaired insulin action and hyperandrogenism, probably favoured by specific, intrinsic abnormalities of these women.
Topics: Animals; Female; Humans; Insulin Resistance; Polycystic Ovary Syndrome
PubMed: 27510482
DOI: 10.2174/1381612822666160720155855 -
Fertility and Sterility Jul 2016Polycystic ovary syndrome (PCOS) is a common and complex genetic disorder that develops under varying degrees of hyperandrogenemic and hyperinsulinemic conditions that... (Review)
Review
Polycystic ovary syndrome (PCOS) is a common and complex genetic disorder that develops under varying degrees of hyperandrogenemic and hyperinsulinemic conditions that cause phenotypic variability ranging from mild hirsutism to anovulation and infertility. In addition to increased risk of reproductive disability, PCOS is associated with metabolic diseases including type 2 diabetes, dyslipidemia, and cardiovascular disease. Similar prevalence rates and shared genetic susceptibility of PCOS among different populations suggest that genetic risk factors were already present in the ancestors of humans. Contemporary human genetic studies inform us that the origin of human ancestors is from Africa. Sharing common susceptibility loci between Chinese and European ancestry suggests that PCOS may have persisted for more than 50,000 years, before the migration of humans out of Africa. Although PCOS is the most common cause of anovulatory infertility, its high prevalence is still a paradox. From an evolutionary perspective, the pathogenic mechanisms underlying PCOS might be candidate factors for survival advantage of the human being. Former compensatory advantageous factors may become pathogenic mechanisms underlying complex metabolic disease with prolonged life expectancy and transition to sedentary lifestyle.
Topics: Evolution, Molecular; Female; Genetic Markers; Genetic Predisposition to Disease; Genetic Variation; Genome-Wide Association Study; Humans; Life Style; Phenotype; Polycystic Ovary Syndrome; Racial Groups; Reproduction; Reproductive Health; Risk Factors
PubMed: 27238626
DOI: 10.1016/j.fertnstert.2016.05.010