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Annals of Internal Medicine Feb 2011
Review
Topics: Diagnosis, Differential; Diet, Reducing; Female; Humans; Infertility, Female; Medical History Taking; Physical Examination; Polycystic Ovary Syndrome; Practice Guidelines as Topic; Pregnancy; Pregnancy Complications; Risk Factors
PubMed: 21282692
DOI: 10.7326/0003-4819-154-3-201102010-01002 -
Fertility and Sterility Jul 2016The field of the genetics of polycystic ovary syndrome (PCOS) has relatively recently moved into the era of genome-wide association studies. This has led to the... (Review)
Review
The field of the genetics of polycystic ovary syndrome (PCOS) has relatively recently moved into the era of genome-wide association studies. This has led to the discovery of 16 robust loci for PCOS. Some loci contain genes with clear roles in reproductive (LHCGR, FSHR, and FSHB) and metabolic (INSR and HMGA2) dysfunction in the syndrome. The next challenge facing the field is the identification of causal variants and genes and the role they play in PCOS pathophysiology. The potential for gene discovery to improve diagnosis and treatment of PCOS is promising, though there is much to be done in the field before the current findings can be translated to the clinic.
Topics: Female; Genetic Markers; Genetic Predisposition to Disease; Genetic Variation; Genome-Wide Association Study; Heredity; Humans; Phenotype; Polycystic Ovary Syndrome; Reproduction; Reproductive Health; Risk Factors
PubMed: 27179787
DOI: 10.1016/j.fertnstert.2016.04.040 -
Journal de Gynecologie, Obstetrique Et... Sep 2007Polycystic ovaries syndrome (PCOS) is one of the most common female hormonal disorders. Its multiple components--reproductive, metabolic, neoplasic and... (Review)
Review
Polycystic ovaries syndrome (PCOS) is one of the most common female hormonal disorders. Its multiple components--reproductive, metabolic, neoplasic and cardiovascular--have a major impact on the public health. Androgen excess and resistance to insulin, probably from genetic origin, are responsible for most of the clinical symptomatology. Resistance to insulin seems to be accompanied by a greater risk of glucose intolerance, type 2 diabetes, lipidic anomalies and can involve the development of cardiovascular diseases. In addition, sleep apnea syndrome is more progressively described in PCOS. Infertility, menses disorders and hirsutism often push these patients to consult their physician. A better understanding of the physiopathological mechanisms led to the emergence of new therapeutic options increasing the sensitivity to insulin. Besides the pregnancy wishes, cares aim to attenuate the marks of the hyper-androgenism (hormonal treatment and cosmetic) and to correct cardiovascular, respiratory and gynaecological risk factors. In case of infertility by anovulation, cares must be performed by trained experts to minimize the risk of ovarian hyper-stimulation syndrome and multiple pregnancies. A gradation from loose weight to clomiphene citrate ovulation induction, ovarian drilling, low dose gonadotropin, in vitro fertilisation, or in vitro maturation of oocytes should bring back good reproduction potential.
Topics: Female; Humans; Insulin Resistance; Polycystic Ovary Syndrome; Reproduction; Risk Factors
PubMed: 17540511
DOI: 10.1016/j.jgyn.2007.04.002 -
Clinical Obstetrics and Gynecology Sep 2020The diagnosis of polycystic ovary syndrome (PCOS) in adolescents is complicated by the overlap of normal puberty with features of PCOS. To address this difficulty,... (Review)
Review
The diagnosis of polycystic ovary syndrome (PCOS) in adolescents is complicated by the overlap of normal puberty with features of PCOS. To address this difficulty, recent diagnostic guidelines have worked to modify adult diagnostic criteria for use in adolescents. These guidelines stress that a definitive diagnosis of PCOS is not needed to initiate treatment. Deferring diagnosis, while providing symptom treatment and regular follow-up, is one recommended option. Treatment options for PCOS should be individualized to the presentation, needs, and preferences of each patient. The goals of treatment are to improve the quality of life and long-term health outcomes.
Topics: Adolescent; Diagnosis, Differential; Diagnostic Techniques, Obstetrical and Gynecological; Female; Humans; Patient Preference; Patient Selection; Polycystic Ovary Syndrome; Prognosis; Puberty; Quality of Life; Symptom Assessment
PubMed: 32384287
DOI: 10.1097/GRF.0000000000000538 -
The Australian & New Zealand Journal of... Nov 1989
Review
Topics: Anovulation; Female; Humans; Obesity; Polycystic Ovary Syndrome
PubMed: 2698617
DOI: 10.1111/j.1479-828x.1989.tb01778.x -
Endocrinologia Y Nutricion : Organo de... 2010Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women of reproductive age. PCOS typically develops during adolescence and is a... (Review)
Review
Polycystic ovary syndrome (PCOS) is one of the most common endocrine diseases in women of reproductive age. PCOS typically develops during adolescence and is a heterogeneous syndrome classically characterized by features of anovulation combined with signs of androgen excess (hirsutism, acne). Increasing obesity in adolescents probably exacerbates signs of PCOS, contributing to its earlier recognition. Recognizing the features of this syndrome can be very challenging in adolescence. Although adolescents' concerns are often cosmetic, if left untreated these girls are at risk for diabetes, metabolic syndrome, and infertility as they mature. Efforts should be made to diagnose and treat PCOS to minimize the development of symptoms and prevent the onset of cardiovascular and metabolic disturbances.
Topics: Adolescent; Algorithms; Female; Humans; Polycystic Ovary Syndrome
PubMed: 20708160
DOI: 10.1016/j.endonu.2010.04.007 -
Human Reproduction (Oxford, England) Jan 1996Recent progress in the diagnosis, pathophysiology, long-term ramifications and treatment of polycystic ovary syndrome has been rapid but the pathogenesis remains a... (Review)
Review
Recent progress in the diagnosis, pathophysiology, long-term ramifications and treatment of polycystic ovary syndrome has been rapid but the pathogenesis remains a challenging enigma and the treatment symptomatic. Objective ultrasound criteria for diagnosis are being formulated and have enabled an appreciation of the true prevalence and the associated clinical and biochemical manifestations. Although a heterogeneous syndrome, the final common pathway seems to involve a dysregulation of enzymes responsible for ovarian androgen biosynthesis, possibly influenced by insulin, growth factors and luteinizing hormone. A single gene defect, inherited in an autosomal dominant pattern, has been proposed. The treatment is necessarily symptomatic, depending on the needs of the patient. Long-term deleterious sequelae now emerging may demand suppression of the syndrome earlier in life. As the most prevalent cause of anovulatory infertility, a further elucidation of the basic pathogenesis is needed to allow the application of more specific and successful modalities of treatment.
Topics: Female; Humans; Luteinizing Hormone; Polycystic Ovary Syndrome; Pregnancy
PubMed: 8671153
DOI: 10.1093/oxfordjournals.humrep.a019031 -
Annals of the New York Academy of... Jun 1997
Review
Topics: Adolescent; Adult; Child; Female; Humans; Polycystic Ovary Syndrome; Psychology, Adolescent
PubMed: 9238269
DOI: 10.1111/j.1749-6632.1997.tb52143.x -
Best Practice & Research. Clinical... Jun 2002Polycystic ovary syndrome (PCOS) frequently presents during adolescence and is the commonest cause of menstrual irregularity and hirsutism. The characteristic endocrine... (Review)
Review
Polycystic ovary syndrome (PCOS) frequently presents during adolescence and is the commonest cause of menstrual irregularity and hirsutism. The characteristic endocrine abnormalities include hypersecretion of androgens and LH. Metabolic dysfunction is also a feature of many young women with PCOS. Hyperinsulinaemia and insulin resistance, which can be regarded as an exaggeration of the normal metabolic changes that occur during puberty, are further amplified by obesity. The aetiology of PCOS is uncertain but there is evidence for a primary abnormality of ovarian androgen production which is manifest at puberty but may have its origins in childhood or even during fetal development.
Topics: Adolescent; Aging; Diagnosis, Differential; Female; Humans; Hyperandrogenism; Ovary; Polycystic Ovary Syndrome
PubMed: 12064892
DOI: 10.1053/beem.2002.0203 -
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