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Ovary Syndrome (ovary + syndrome)
Kinds of Ovary Syndrome Selected AbstractsOn the Association Between Valproate and Polycystic Ovary SyndromeEPILEPSIA, Issue 3 2001Pierre Genton Summary: Recent studies by Isojärvi et al. have raised the issue of an increased incidence of polycystic ovary syndrome (PCOS) in women with epilepsy treated with valproate (VPA) and have proposed replacement with lamotrigine (LTG). Polycystic ovaries (PCO) are a common finding, with a prevalence >20% in the general population, and are easily detected by pelvic or vaginal ultrasonography, whereas PCOS is comparatively rare: few women with PCO have fully developed PCOS, which includes hirsutism, acne, obesity, hypofertility, hyperandrogenemia, and menstrual disorders. From an extensive review of the current literature, it appears that there are no reliable data on the actual prevalence of PCOS in normal women and in women with epilepsy. The pathogenesis of PCO is multifactorial, including genetic predisposition and the intervention of environmental factors, among which weight gain and hyperinsulinism with insulin resistance may play a part. The roles of central (hypothalamic/pituitary), peripheral, and local ovarian factors are still debated. PCO and PCOS appear to be more frequent in women with epilepsy, but there are no reliable data showing a greater prevalence after VPA. The recent studies by Isojärvi et al. may have been biased by the retrospective selection of patients. To date, there is no reason to contraindicate the use of VPA in women with epilepsy. However, patients should be informed about the risk of weight gain and its consequences. [source] On the Association Between Valproate and Polycystic Ovary Syndrome: A Response and an Alternative ViewEPILEPSIA, Issue 3 2001Jouko I. T. Isojärvi First page of article [source] Report of the international symposium: polycystic ovary syndrome: first Latin-American consensusINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2010A. B. Motta Summary During the last years, numerous consensuses have been held in different countries in order to review the data concerning diagnosis and treatment and their relationship with the ethnic origin, social status and lifestyle of women with Polycystic Ovary Syndrome (PCOS). This study describes the conclusions concerning diagnostic criteria and the appropriate treatment of women with PCOS reached during the International Symposium Polycystic Ovary Syndrome, First Latin-American Consensus held in Buenos Aires, Argentina on 4th and 5th May 2009 to be applied in South American. [source] Acupuncture in Polycystic Ovary Syndrome: Current Experimental and Clinical EvidenceJOURNAL OF NEUROENDOCRINOLOGY, Issue 3 2008E. Stener-Victorin This review describes the aetiology and pathogenesis of polycystic ovary syndrome (PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms related with PCOS. PCOS is the most common female endocrine disorder and it is strongly associated with hyperandrogenism, ovulatory dysfunction and obesity. PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and insulin resistance, which can lead to type 2 diabetes, hypertension and an increased likelihood of developing cardiovascular risk factors and impaired mental health later in life. Despite extensive research, little is known about the aetiology of PCOS. The syndrome is associated with peripheral and central factors that influence sympathetic nerve activity. Thus, the sympathetic nervous system may be an important factor in the development and maintenance of PCOS. Many women with PCOS require prolonged treatment. Current pharmacological approaches are effective but have adverse effects. Therefore, nonpharmacological treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine and the neuroendocrine system. Experimental observations in rat models of steroid-induced polycystic ovaries and clinical data from studies in women with PCOS suggest that acupuncture exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation. [source] Health-Related Quality of Life Issues in Women With Polycystic Ovary SyndromeJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2005Judy Griffin McCook Objective: To evaluate the influence of obesity, fertility status, and androgenism scores on health-related quality of life in women with polycystic ovary syndrome (PCOS). Design: Cross-sectional, correlational. Setting: Private reproductive endocrinology practice in two southeast U.S. cities. Participants: Convenience sample of 128 women with PCOS, half of whom were attempting to conceive in addition to being treated for PCOS. Most were White (97%), married (78%), with a mean age of 30.4 years (SD ± 5.5). Main Outcome Measures: The Health-Related Quality of Life Questionnaire (PCOSQ) for women with polycystic ovary syndrome. A laboratory panel and clinical measures, including body mass index, waist-to-hip ratio, and degree of hirsutism. Results: The most common health-related quality of life concern reported by women with PCOS was weight, followed in descending order by menstrual problems, infertility, emotions, and body hair. Conclusions: The psychological implications of PCOS are easily underestimated and have been largely ignored. Nursing has a pivotal role in recognizing these concerns and implementing therapy to improve quality of life in women with PCOS. [source] Type 2 diabetes, cardiovascular disease, and the evolutionary paradox of the polycystic ovary syndrome: A fertility first hypothesisAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2009Stephen J. Corbett Worldwide, the high prevalence of the Polycystic Ovary Syndrome (PCOS), a heritable cause of ovarian infertility, is an evolutionary paradox, which provides insight into the susceptibility of well-fed human populations to cardiovascular disease and diabetes. We propose that PCOS, Type 2 diabetes (T2D) and the Metabolic Syndrome are modern phenotypic expressions of a metabolic genotype attuned to the dietary and energetic conditions of the Pleistocene. This metabolic "Fertility First" rather than "Thrifty" genotype persisted at high prevalence throughout the entire agrarian period,from around 12,000 years ago until 1800 AD,primarily, we contend, because it conferred a fertility advantage in an environment defined by chronic and often severe seasonal food shortage. Conversely, we argue that genetic adaptations to a high carbohydrate, low protein agrarian diet, with increased sensitivity to insulin action, were constrained because these adaptations compromised fertility by raising the lower bound of body weight and energy intake optimal for ovulation and reproduction. After 1800, the progressive attainment of dietary energy sufficiency released human populations from this constraint. This release, through the powerful mechanism of fertility selection, increased, in decades rather than centuries, the prevalence of a genotype better suited to carbohydrate metabolism. This putative mechanism for rapid and recent human evolution can explain the lower susceptibility to T2D of today's Europid populations. This hypothesis predicts that the increasing rates of diabetes and cardiovascular disease, which typically accompany economic development, will be tempered by natural, but particularly fertility, selection against the conserved ancestral genotypes that currently underpin them. Am. J. Hum. Biol. 2009. © 2009 Wiley-Liss, Inc. [source] Obesity and polycystic ovary syndromeCLINICAL ENDOCRINOLOGY, Issue 2 2006T. M. Barber Summary The aetiology of Polycystic Ovary Syndrome (PCOS) is complex and multifactorial. There is much evidence, however, to suggest that adipose tissue plays an important role in the development and maintenance of PCOS pathology. There is a close correlation between adiposity and symptom severity in women with PCOS, and even modest reductions in weight generally translate into significant improvements in menstrual regularity, fertility and hyperandrogenic features. This review article considers the various mechanisms that might underlie this link between excess adiposity and PCOS , including the effects of differential insulin sensitivity, abnormal steroid hormone metabolism and adipocytokine secretion. Greater attention to the therapeutic options available to reduce the impact of excess adiposity on ovarian and metabolic function is essential to the management of PCOS. [source] Medical treatment of hirsutismDERMATOLOGIC THERAPY, Issue 5 2008Ulrike Blume-Peytavi ABSTRACT:, Hirsutism is usually the result of an underlying adrenal, ovarian, or central endocrine abnormality mainly due to polycystic ovary syndrome but may also be idiopathic or drug induced. The aim of medical treatment of hirsutism is to rectify any causal hormonal balance, slow down or stop excessive hair growth, and improve the aesthetic appearance of hirsutism, thereby positively affecting the patient's quality of life. Today, for the majority of women, a monotherapy with oral contraceptives that have antiandrogenic activity is recommended as a first-line treatment for hirsutism. Combining an oral contraceptive pill with an antiandrogen is recommended if clinical improvement of hirsutism is insufficient after 6,9 months' monotherapy. In women who present with hirsutism, hyperandrogenism, and insulin resistance, insulin sensitizers are effective for the hirsutism as well as the hyperinsulinemia, hyperandrogenism, and infertility but there is no convincing evidence that they are effective for hirsutism alone. Topical eflornithine is a medical therapy that can be a useful adjuvant for hirsutism when used in conjunction with systemic medications or with laser/photoepilation. [source] Acupuncture: is it effective for treatment of insulin resistance?DIABETES OBESITY & METABOLISM, Issue 7 2010F. Liang Insulin resistance (IR) is closely associated with obesity, type 2 diabetes mellitus (T2DM), hypertension, polycystic ovary syndrome (PCOS), non-alcohol fatty liver diseases (NAFLD) and metabolic syndrome and is also a risk factor for serious diseases such as cardiovascular diseases. Pharmacological treatments available for IR are limited by drug adverse effects. Because acupuncture has been practiced for thousands of years in China, it has been increasingly used worldwide for IR-related diseases. This review analyses 234 English publications listed on the PubMed database between 1979 and 2009 on the effectiveness of acupuncture as a treatment for IR. These publications provide clinical evidence, although limited, in support of the effectiveness of acupuncture in IR. At this stage, well-designed, evidence-based clinical randomized controlled trial studies are therefore needed to confirm the effects of acupuncture on IR. Numerous experimental studies have demonstrated that acupuncture can correct various metabolic disorders such as hyperglycemia, overweight, hyperphagia, hyperlipidemia, inflammation, altered activity of the sympathetic nervous system and insulin signal defect, all of which contribute to the development of IR. In addition, acupuncture has the potential to improve insulin sensitivity. The evidence has revealed the mechanisms responsible for the beneficial effects of acupuncture, though further investigations are warranted. [source] Type 2 diabetes and cardiovascular disease in polycystic ovary syndrome: what are the risks and can they be reduced?DIABETIC MEDICINE, Issue 5 2010J. Tomlinson Diabet. Med. 27, 498,515 (2010) Abstract Polycystic ovary syndrome (PCOS) is a risk factor for Type 2 diabetes mellitus (T2DM) and cardiovascular disease (CVD), but these risks are poorly defined. This study aimed to evaluate the evidence for these risks and whether screening and risk reduction are feasible. Medline reviews and data quality analysis were used using standard tools. Results showed that (i) polycystic ovary syndrome is a risk factor forT2DM but the magnitude of risk is uncertain, (ii) fasting plasma glucose is an inadequate screening test forT2DM in this population and the oral glucose tolerance test is superior, (iii) the identification of women with PCOS for diabetes screening is constrained by current diagnostic criteria for PCOS; however, women with oligomenorrhoea and those with diagnosed PCOS and obesity or a family history of T2DM are at highest risk, (iv) risk factors for T2DM are improved by weight loss interventions and by metformin. However, no studies have determined whether T2DM incidence is reduced, (v) polycystic ovary syndrome is associated with cardiovascular disease (CVD) risk factors but data on CVD incidence are weak, (vi) risk factors for CVD are improved by the same interventions and statins and (vi) no studies have evaluated whether CVD incidence is reduced. While PCOS has important metabolic associations, and short-term interventions reduce risk factors for T2DM and CVD, data on prevalence and incidence of T2DM and particularly CVD are poor. There is a need for a clear definition of PCOS, for diabetes screening protocols and for long-term studies to determine whether risks can be reduced. [source] Metformin use and diabetic pregnancy,has its time come?DIABETIC MEDICINE, Issue 3 2006G. Hawthorne Abstract The prevalence of Type 2 diabetes in women of childbearing age continues to grow as the incidence of Type 2 diabetes increases. Recent evidence shows that treatment of gestational diabetes ensures the best possible outcome for pregnancy complicated by gestational diabetes. Metformin is a logical treatment in these circumstances but there has always been concern about its safety for the fetus, particularly as it crosses the placenta and it may increase the risk of teratogenesis. Although evidence is accumulating that metformin is useful and has a role in polycystic ovary syndrome, a condition of insulin resistance, it is not yet accepted as treatment for Type 2 diabetes in pregnancy and gestational diabetes. Observational data supports the use of metformin in Type 2 diabetes in pregnancy and its role in gestational diabetes is currently under investigation. Metformin may become an important treatment for women with either gestational or Type 2 diabetes in pregnancy and indeed may have additional important benefits for women, including reducing insulin resistance, body weight and long-term risk of diabetes. There is a need for a randomized controlled trial in women with Type 2 diabetes in pregnancy with long-term follow-up of both mothers and children. Until then the best advice remains that optimized glycaemic control prior to conception and during pregnancy is the most important intervention for best possible pregnancy outcome. [source] Epidemiology of gestational diabetes mellitus and its association with Type 2 diabetesDIABETIC MEDICINE, Issue 2 2004A. Ben-Haroush Abstract Gestational diabetes (GDM) is defined as carbohydrate intolerance that begins or is first recognized during pregnancy. Although it is a well-known cause of pregnancy complications, its epidemiology has not been studied systematically. Our aim was to review the recent data on the epidemiology of GDM, and to describe the close relationship of GDM to prediabetic states, in addition to the risk of future deterioration in insulin resistance and development of overt Type 2 diabetes. We found that differences in screening programmes and diagnostic criteria make it difficult to compare frequencies of GDM among various populations. Nevertheless, ethnicity has been proven to be an independent risk factor for GDM, which varies in prevalence in direct proportion to the prevalence of Type 2 diabetes in a given population or ethnic group. There are several identifiable predisposing factors for GDM, and in the absence of risk factors, the incidence of GDM is low. Therefore, some authors suggest that selective screening may be cost-effective. Importantly, women with an early diagnosis of GDM, in the first half of pregnancy, represent a high-risk subgroup, with an increased incidence of obstetric complications, recurrent GDM in subsequent pregnancies, and future development of Type 2 diabetes. Other factors that place women with GDM at increased risk of Type 2 diabetes are obesity and need for insulin for glycaemic control. Furthermore, hypertensive disorders in pregnancy and afterwards may be more prevalent in women with GDM. We conclude that the epidemiological data suggest an association between several high-risk prediabetic states, GDM, and Type 2 diabetes. Insulin resistance is suggested as a pathogenic linkage. It is possible that improving insulin sensitivity with diet, exercise and drugs such as metformin may reduce the risk of diabetes in individuals at high risk, such as women with polycystic ovary syndrome, impaired glucose tolerance, and a history of GDM. Large controlled studies are needed to clarify this issue and to develop appropriate diabetic prevention strategies that address the potentially modifiable risk factors. Diabet. Med. 20, ***,*** (2003) [source] On the Association Between Valproate and Polycystic Ovary SyndromeEPILEPSIA, Issue 3 2001Pierre Genton Summary: Recent studies by Isojärvi et al. have raised the issue of an increased incidence of polycystic ovary syndrome (PCOS) in women with epilepsy treated with valproate (VPA) and have proposed replacement with lamotrigine (LTG). Polycystic ovaries (PCO) are a common finding, with a prevalence >20% in the general population, and are easily detected by pelvic or vaginal ultrasonography, whereas PCOS is comparatively rare: few women with PCO have fully developed PCOS, which includes hirsutism, acne, obesity, hypofertility, hyperandrogenemia, and menstrual disorders. From an extensive review of the current literature, it appears that there are no reliable data on the actual prevalence of PCOS in normal women and in women with epilepsy. The pathogenesis of PCO is multifactorial, including genetic predisposition and the intervention of environmental factors, among which weight gain and hyperinsulinism with insulin resistance may play a part. The roles of central (hypothalamic/pituitary), peripheral, and local ovarian factors are still debated. PCO and PCOS appear to be more frequent in women with epilepsy, but there are no reliable data showing a greater prevalence after VPA. The recent studies by Isojärvi et al. may have been biased by the retrospective selection of patients. To date, there is no reason to contraindicate the use of VPA in women with epilepsy. However, patients should be informed about the risk of weight gain and its consequences. [source] No effect of Chinese green tea on body-weight of patients with polycystic ovary syndromeFOCUS ON ALTERNATIVE AND COMPLEMENTARY THERAPIES AN EVIDENCE-BASED APPROACH, Issue 2 2006Article first published online: 14 JUN 2010 [source] Prediagnostic levels of C-peptide, IGF-I, IGFBP -1, -2 and -3 and risk of endometrial cancer,INTERNATIONAL JOURNAL OF CANCER, Issue 2 2004Annekatrin Lukanova Abstract Conditions related to chronic hyperinsulinemia, such as obesity, noninsulin dependent diabetes mellitus and polycystic ovary syndrome, are associated with an increased risk of endometrial cancer. Elevated plasma IGF-I and decreased levels of IGF-binding proteins have been shown to be associated with increased risk of several cancer types that are frequent in affluent societies. We investigated for the first time in a prospective study the association of pre-diagnostic blood concentrations of C-peptide (a marker of pancreatic insulin production), IGF-I, IGFBP-1, -2 and -3 with endometrial cancer risk. A case-control study was nested within 3 cohorts in New York (USA), Umeå (Sweden) and Milan (Italy). It included 166 women with primary invasive endometrial cancer and 315 matched controls, of which 44 case and 78 control subjects were premenopausal at recruitment. Endometrial cancer risk increased with increasing levels of C-peptide (ptrend = 0.0002), up to an odds ratio (OR) of 4.76 [95% confidence interval (CI) = 1.91,11.8] for the highest quintile. This association remained after adjustment for BMI and other confounders [OR for the top quintile = 4.40 (1.65,11.7)]. IGFBP-1 levels were inversely related to endometrial cancer [ptrend = 0.002; OR in the upper quintile = 0.30 (0.15,0.62)], but the association was weakened and lost statistical significance after adjustment for confounders [ptrend = 0.06; OR in the upper quintile = 0.49 (0.22,1.07)]. Risk was unrelated to levels of IGF-I, IGFBP-2 and IGFBP-3. Chronic hyperinsulinemia, as reflected by increased circulating C-peptide, is associated with increased endometrial cancer risk. Decrease in the prevalence of chronic hyperinsulinemia, through changes in lifestyle or medication, is expected to prevent endometrial cancer. © 2003 Wiley-Liss, Inc. [source] Report of the international symposium: polycystic ovary syndrome: first Latin-American consensusINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 5 2010A. B. Motta Summary During the last years, numerous consensuses have been held in different countries in order to review the data concerning diagnosis and treatment and their relationship with the ethnic origin, social status and lifestyle of women with Polycystic Ovary Syndrome (PCOS). This study describes the conclusions concerning diagnostic criteria and the appropriate treatment of women with PCOS reached during the International Symposium Polycystic Ovary Syndrome, First Latin-American Consensus held in Buenos Aires, Argentina on 4th and 5th May 2009 to be applied in South American. [source] Ovarian morphology and prevalence of polycystic ovary syndrome in reproductive aged women with or without mild acneINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 7 2010ymet Handan Kelekci MD Background, Acne and hirsutism are common manifestations of hyperandrogenemia. They may also be a sign of underlying severe diseases. Aim, To compare ovarian morphology and prevalence of polycystic ovary syndrome (PCOS) in reproductive aged women with or without mild acne and hirsutism. Methods, 52 women with mild acne and 59 age-matched controls were included in this study. Main outcome measures were the prevalence of PCOS, ovarian morphology, and ovarian stromal thickness in both groups, and acne and hirsutism subgroups. Patients in both groups were taking no hormonal therapy at that time. Androgen profiles were compared between the two groups. Results, The prevalence of PCOS was 17.1% (19/111) in all women included in this study. In the acne group, the prevalence of PCOS was 26.9% (14/52), and significantly more prevalent than in control group [8.4% (5/59), P = 0.001]. Total ovarian volume was significantly larger and stromal thickness of the ovary was thicker in women with acne than women without acne. There were no statistically significant difference between the two groups in terms of dehydroepiandrosterone sulfate, and 17-hydroxyprogesterone, respectively, while serum total testosterone levels were significantly higher (P < 0.05) in women with acne than those women in the control group. Conclusions, Acne and hirsutism may not only cause cosmetic concern but may also be a sign of underlying PCOS. Therefore, women presenting with acne and/or hirsutism should be evaluated in terms of PCOS. [source] Angiogenesis in the female reproductive organs: pathological implicationsINTERNATIONAL JOURNAL OF EXPERIMENTAL PATHOLOGY, Issue 4 2002Lawrence P. Reynolds Summary. The female reproductive organs (ovary, uterus, and placenta) are some of the few adult tissues that exhibit regular intervals of rapid growth. They also are highly vascular and have high rates of blood flow. Angiogenesis, or vascular growth, is therefore an important component of the growth and function of these tissues. As with many other tissues, vascular endothelial growth factors (VEGFs) and fibroblast growth factors (FGFs) appear to be major angiogenic factors in the female reproductive organs. A variety of pathologies of the female reproductive organs are associated with disturbances of the angiogenic process, including dysfunctional uterine bleeding, endometrial hyperplasia and carcinoma, endometriosis, failed implantation and subnormal foetal growth, myometrial fibroids (uterine leiomyomas) and adenomyosis, ovarian hyperstimulation syndrome, ovarian carcinoma, and polycystic ovary syndrome. These pathologies are also associated with altered expression of VEGFs and/or FGFs. In the near future, angiogenic or antiangiogenic compounds may prove to be effective therapeutic agents for treating these pathologies. In addition, monitoring of angiogenesis or angiogenic factor expression may provide a means of assessing the efficacy of these therapies. [source] Color doppler sonographic analysis of uterine and ovarian artery blood flow in women with polycystic ovary syndromeJOURNAL OF CLINICAL ULTRASOUND, Issue 6 2007Sebiha Özkan MD Abstract Purpose. To study the blood flow patterns of utero-ovarian circulation in polycystic ovary syndrome (PCOS) and to assess their relationship with clinical, metabolic, and hormonal data. Methods. Forty-three women with PCOS and 43 age-matched healthy controls underwent Doppler examination of the utero-ovarian circulation in the follicular phase. Demographic, hormonal, and metabolic parameters were determined. Student's t -test, ,2 -test, and Spearman correlation test were used for statistical analysis. Results. The ovarian artery pulsatility index (PI), resistance index (RI), and SD ratios were significantly lower in PCOS than in controls on the right side (p < 0.001, p = 0.02, p = 0.001, respectively) as well as on the left side (p < 0.001, p < 0.001, p < 0.001, respectively). The uterine artery systolic/diastolic (S/D) ratio was higher on both sides (p = 0.01) and the PI was higher on the left side (p = 0.02) in PCOS than in controls. The right uterine artery PI was positively correlated with luteinizing hormone and hemoglobin (r = 0.417, p = 0.043; r = 0.427, p = 0.033, respectively), the right uterine artery S/D was positively correlated with body mass index (r = 0.479, p = 0.015), and the left uterine artery PI was positively correlated with insulin (r = 0.458, p = 0.021). Conclusion. Doppler sonography of the utero-ovarian circulation may contribute to the evaluation of PCOS patients and a better understanding of the pathophysiology of this syndrome. © 2007 Wiley Periodicals, Inc. J Clin Ultrasound, 2007 [source] The frequency of polycystic ovary syndrome in females with resistant acne vulgarisJOURNAL OF COSMETIC DERMATOLOGY, Issue 2 2010Azar Hadi Maluki MD, CABMS (DV), FICMS (DV), MBCHB Summary Background, Acne vulgaris in females may be resistant to treatment in spite of topical and systemic therapy for a sufficient period. In this condition, acne may be a manifestation of underlying endocrine conditions such as polycystic ovary syndrome (PCOS). Objective, To evaluate the frequency of PCOS in females with resistant acne vulgaris. Patients and methods, This case-controlled study was conducted in the Department of Dermatology and Venereology in The Teaching Hospital in Al-Najaf during the period from October 2007 to November 2008. One hundred and twenty-three female patients with resistant acne vulgaris were included in this study. One hundred and twenty-three women, age-matched, without acne were enrolled as a control group. Detailed history, clinical examination, abdominal ultrasound study, and hormonal assays were obtained for the patients and the control group. Results, One hundred and twenty-three females with resistant acne were included; their ages ranged from 17 to 40 years with a mean of 25.016 ± 6.041 (SD). One hundred and twenty-three control women without acne were enrolled; their ages ranged from 17,40 years with a mean of 26.014 ± 6.251 (SD). The patients and the control group are age-matched (P = 0.192). It was found that 63 patients (51.2%) with resistant acne have PCOS in comparison to only eight control women (6.2%). The difference is highly significant. Conclusion, Polycystic ovary syndrome is an important contributing factor in females with resistant acne vulgaris. [source] Acupuncture in Polycystic Ovary Syndrome: Current Experimental and Clinical EvidenceJOURNAL OF NEUROENDOCRINOLOGY, Issue 3 2008E. Stener-Victorin This review describes the aetiology and pathogenesis of polycystic ovary syndrome (PCOS) and evaluates the use of acupuncture to prevent and reduce symptoms related with PCOS. PCOS is the most common female endocrine disorder and it is strongly associated with hyperandrogenism, ovulatory dysfunction and obesity. PCOS increases the risk for metabolic disturbances such as hyperinsulinaemia and insulin resistance, which can lead to type 2 diabetes, hypertension and an increased likelihood of developing cardiovascular risk factors and impaired mental health later in life. Despite extensive research, little is known about the aetiology of PCOS. The syndrome is associated with peripheral and central factors that influence sympathetic nerve activity. Thus, the sympathetic nervous system may be an important factor in the development and maintenance of PCOS. Many women with PCOS require prolonged treatment. Current pharmacological approaches are effective but have adverse effects. Therefore, nonpharmacological treatment strategies need to be evaluated. Clearly, acupuncture can affect PCOS via modulation of endogenous regulatory systems, including the sympathetic nervous system, the endocrine and the neuroendocrine system. Experimental observations in rat models of steroid-induced polycystic ovaries and clinical data from studies in women with PCOS suggest that acupuncture exert long-lasting beneficial effects on metabolic and endocrine systems and ovulation. [source] Health-Related Quality of Life Issues in Women With Polycystic Ovary SyndromeJOURNAL OF OBSTETRIC, GYNECOLOGIC & NEONATAL NURSING, Issue 1 2005Judy Griffin McCook Objective: To evaluate the influence of obesity, fertility status, and androgenism scores on health-related quality of life in women with polycystic ovary syndrome (PCOS). Design: Cross-sectional, correlational. Setting: Private reproductive endocrinology practice in two southeast U.S. cities. Participants: Convenience sample of 128 women with PCOS, half of whom were attempting to conceive in addition to being treated for PCOS. Most were White (97%), married (78%), with a mean age of 30.4 years (SD ± 5.5). Main Outcome Measures: The Health-Related Quality of Life Questionnaire (PCOSQ) for women with polycystic ovary syndrome. A laboratory panel and clinical measures, including body mass index, waist-to-hip ratio, and degree of hirsutism. Results: The most common health-related quality of life concern reported by women with PCOS was weight, followed in descending order by menstrual problems, infertility, emotions, and body hair. Conclusions: The psychological implications of PCOS are easily underestimated and have been largely ignored. Nursing has a pivotal role in recognizing these concerns and implementing therapy to improve quality of life in women with PCOS. [source] Difference in non-weight-bearing effects on bone mineral density between trunk and peripheral fat mass in women with polycystic ovary syndromeJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2 2010Yumi Yanazume Abstract Aim:, To investigate the difference in non-weight-bearing effects on bone mineral density (BMD) between trunk and peripheral fat mass in women with polycystic ovary syndrome (PCOS). Methods:, Subjects were 123 amenorrheic PCOS women with right side dominance. Age, height, body weight, and body mass index were recorded. Trunk, peripheral (extremities), trunk,leg fat ratio as an index of body fat distribution, left arm (non-weight-bearing site) lean mass and BMD were measured by dual-energy X-ray absorptiometry. Serum testosterone and estradiol levels were measured. Relationships of BMD with trunk, peripheral fat mass, and sex hormones levels were investigated. Results:, Trunk fat mass amount was 9.8 ± 6.7 kg and was lower than the peripheral fat mass amount (12.2 ± 4.4 kg, P < 0.01). On Pearson's correlation test, trunk fat mass and left arm lean mass were positively correlated with arm BMD (r = 0.359, P < 0.001 and r = 0.501, P < 0.0001, respectively), while peripheral fat mass and serum testosterone levels were not correlated with BMD (r = 0.083 and 0.114, respectively, NS). On multiple regression analysis, trunk fat mass was positively correlated with BMD (t -value = 3.465; P < 0.001), independent of age and height. However, this relationship disappeared after additionally adjusting for left arm lean mass. Conclusion:, Trunk fat mass, despite the smaller amount, is more associated with arm BMD than peripheral fat mass is through its non-weight-bearing effects. [source] Serum ghrelin, leptin and resistin levels in adolescent girls with polycystic ovary syndromeJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2008Aysun Bideci Abstract Aim:, The aim of the present study was to investigate the levels of leptin, resistin and ghrelin in polycystic ovary syndrome (PCOS), and to assess their possible correlations with the hormonal and metabolic features of PCOS. Methods:, Sixteen obese (ObPCOS) and 12 lean (LeanPCOS) subjects with PCOS and 19 obese control subjects were enrolled in the study. Results:, Ghrelin, leptin and resistin concentrations were similar between groups when body mass index (BMI) was used as a covariate (P > 0.05). Mean androgen, SHBG, luteinizing hormone (LH) levels and luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio tended to be similar between polycystic ovary syndrome (PCOS) groups. However, when compared with the control group, SHBG was lower and androgen, LH levels and LH/FSH ratio were higher in the PCOS groups. Free testosterone levels significantly correlated with resistin (r = ,0.38), SHBG correlated significantly with body mass index (BMI) (r = ,0.45) and resistin (r = ,0.67), LH/FSH ratio was significantly correlated with ghrelin (r = ,0.52) and estradiol (E2) levels (r = 0.51). Conclusion:, ObPCOS and LeanPCOS groups having higher LH/FSH ratios and lower SHBG levels suggest that there could be factors other than adiposity responsible for the clinical features of PCOS patients. In the light of our results, those factors can be suggested as ghrelin and E2 for the elevated LH/FSH ratio and resistin for the lowered SHBG. [source] Metabolic syndrome in females with polycystic ovary syndrome and International Diabetes Federation criteriaJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2008Sudhindra M. Bhattacharya Abstract Aim:, To find out the incidence of metabolic syndrome (MS) in females with polycystic ovary syndrome (PCOS) and to assess the metabolic risk factors as per the definition of International Diabetes Federation. Methods:, One hundred and seventeen females (39 adolescents and 78 adults) diagnosed with PCOS underwent assessments clinically and by appropriate laboratory tests for the evidence of MS, as per the criteria laid down by International Diabetes Federation. Results:, MS was diagnosed in 54 cases (46.2%), of which 43.6% were adolescents and 47.4% were adults (difference not statistically significant). MS in females with PCOS had significantly higher body mass index compared to those who did not have MS, irrespective of age. Abnormalities in both the lipids were more common than fasting glucose abnormalities. Conclusion:, MS was found in 46.2% of females with PCOS, with both adolescents and adults being similarly affected. Dyslipidaemia is more common than impaired fasting glucose and finding one risk factor should prompt the clinician to search for other risk factors. All females with PCOS should undergo periodic screening for MS. [source] New tide for women with polycystic ovary syndromeJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 2007Prof Hong-Nerng Ho [source] Lipoprotein(a) levels in girls with premature adrenarcheJOURNAL OF PAEDIATRICS AND CHILD HEALTH, Issue 3 2008Nesibe Andiran Aim: Elevated lipoprotein(a) (Lp(a)) level is a risk factor for cardiovasculary disease (CVD). Women with polycystic ovary syndrome (PCOS) have higher Lp(a) and risk for CVD than controls. The girls with premature adrenarche (PA) were shown to share similar hormonal/metabolic properties with PCOS. We compared Lp(a) levels in PA, with healthy and PCOS girls. Methods: In total, 25 PA, 20 controls and 10 girls with PCOS were evaluated. Lp(a), lipid profiles and insulin, glucose, free testosterone, dehydroepiandrosterone sulfate (DHEAS) and androstenedione levels were measured. A family history about CVD was obtained. Results: The mean age of girls with PA, at time of the study, was 10.04 ± 1.53, control 9.83 ± 1.58 and PCOS was 16.58 ± 1.46 years. The median (range) of Lp(a) levels were 22.5 (3.50,99.90), 9.6 (3.33,32.40) and 21.2 (5.89,85.65) mg/dL in PA, control and PCOS groups, respectively (P > 0.05). The median Lp(a)'s were 14.5 (3.50,87.00) and 24.30 (6.20,99.90) mg/dL, in prepubertal (Tanner 1) and pubertal PA girls (Tanner 2,5), respectively (P > 0.05). The median Lp(a) of prepubertal peers was 8.7 (3.33,21.17), while that of pubertal ones was 15.4 (4.72,32.40) mg/dL (P > 0.05). There was no difference between Lp(a) levels of pre-pubertal PA girls and their peers; however, significant difference was found in Lp(a) levels in pubertal stages of PA and healthy peers (P < 0.05). The positive family history of CVD was 60% in PA; 55% and 80% in the control and PCOS groups, respectively, with no statistical difference. Lp(a) level was correlated with DHEAS (r = 0.386, P = 0.008) and free testosterone (r = 0.337, P = 0.022) levels positively. There was no significant correlation between Lp(a) and body mass index, fasting insulin and fasting glucose/insulin ratio. Conclusions: Lipoprotein(a) levels in pubertal girls with PA differ significantly from healthy peers. However, to clarify whether the girls with PA have an additional risk for CVD with respect to Lp(a), further follow-up studies with larger number of patients are necessary. [source] Venous thromboembolism associated with cyproterone acetate in combination with ethinyloestradiol (Dianette®): observational studies using the UK General Practice Research Database,PHARMACOEPIDEMIOLOGY AND DRUG SAFETY, Issue 7 2004H. E. Seaman Abstract Purpose To derive risk estimates for venous thromboembolism (VTE) in women prescribed cyproterone acetate combined with ethinyloestradiol (CPA/EE), a drug licensed in the UK for the treatment of women with acne or hirsutism. CPA/EE provides a treatment option for women with polycystic ovary syndrome (PCOS). CPA/EE has been associated with an increased risk of VTE. Methods Using the General Practice Research Database, we conducted cohort and case-control analyses in all women aged 15,39 and then nested in a population of women of the same age with acne, hirsutism or PCOS. Results The incidence rate ratio (IRR) for VTE in women exposed to CPA/EE versus conventional combined oral contraceptives (COCs) was significantly raised (all women: 1.92; 95%,CI: 1.22,2.88; nested: 2.51; 95%,CI: 1.07,5.75). Using exposure to conventional COCs as the reference, the adjusted odds ratio (ORadj) for VTE associated with CPA/EE was 1.45 (95%,CI: 0.80,2.64) in all women and 1.71 (95%,CI: 0.31,9.49) in women with acne, hirsutism or PCOS. Conclusions The risk of VTE associated with CPA/EE use does not differ significantly from that associated with the use of conventional COCs. These data are reassuring and together with knowledge of the risks associated with other treatments for acne, in particular, should influence prescribing practice. Copyright © 2003 John Wiley & Sons, Ltd. [source] Type 2 diabetes, cardiovascular disease, and the evolutionary paradox of the polycystic ovary syndrome: A fertility first hypothesisAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 5 2009Stephen J. Corbett Worldwide, the high prevalence of the Polycystic Ovary Syndrome (PCOS), a heritable cause of ovarian infertility, is an evolutionary paradox, which provides insight into the susceptibility of well-fed human populations to cardiovascular disease and diabetes. We propose that PCOS, Type 2 diabetes (T2D) and the Metabolic Syndrome are modern phenotypic expressions of a metabolic genotype attuned to the dietary and energetic conditions of the Pleistocene. This metabolic "Fertility First" rather than "Thrifty" genotype persisted at high prevalence throughout the entire agrarian period,from around 12,000 years ago until 1800 AD,primarily, we contend, because it conferred a fertility advantage in an environment defined by chronic and often severe seasonal food shortage. Conversely, we argue that genetic adaptations to a high carbohydrate, low protein agrarian diet, with increased sensitivity to insulin action, were constrained because these adaptations compromised fertility by raising the lower bound of body weight and energy intake optimal for ovulation and reproduction. After 1800, the progressive attainment of dietary energy sufficiency released human populations from this constraint. This release, through the powerful mechanism of fertility selection, increased, in decades rather than centuries, the prevalence of a genotype better suited to carbohydrate metabolism. This putative mechanism for rapid and recent human evolution can explain the lower susceptibility to T2D of today's Europid populations. This hypothesis predicts that the increasing rates of diabetes and cardiovascular disease, which typically accompany economic development, will be tempered by natural, but particularly fertility, selection against the conserved ancestral genotypes that currently underpin them. Am. J. Hum. Biol. 2009. © 2009 Wiley-Liss, Inc. [source] Reproductive adaptations to a large-brained fetus open a vulnerability to anovulation similar to polycystic ovary syndromeAMERICAN JOURNAL OF HUMAN BIOLOGY, Issue 3 2003Deborah K. Barnett During the ovarian or menstrual cycle, prior to ovulation, many female primates exhibit a relatively prolonged follicular phase and terminate the postovulatory luteal phase with menstrual bleeding. The prolonged follicular phase is a trait that distinguishes primate from nonprimate species. It enables extended estrogen-induced proliferation and growth of the uterine endometrium prior to progesterone-induced maturation during the luteal phase to accommodate a potential pregnancy with a rapidly invading placenta. Progressive development of both an extended duration of estrogen-induced, preimplantation endometrial proliferation and a rapidly invading placenta across the Primate order may well have been necessary to accommodate differentiation and growth of an increasingly large fetal brain. Prolongation of the follicular phase in primates has also led to the isolation of the final stages of follicle selection (growth deviation of the dominant follicle from its contemporaries) solely within the follicular phase and thus outside the protection of luteal phase progesterone inhibition of pituitary luteinizing hormone (LH) secretion. Such primate reproductive characteristics put the latter stages of ovarian follicle selection at risk of exposure to excessive pituitary secretion of LH. Excessive secretion of LH during follicle selection could result not only in impaired follicle development, excessive ovarian androgen secretion, and ovulation failure, but also in excessive estrogenic stimulation of the uterine endometrium without intervening menstrual periods. Such reproductive abnormalities are all found in a single, prevalent infertility syndrome afflicting women in their reproductive years: polycystic ovary syndrome (PCOS). We propose that successful female reproductive adaptations to accommodate the growth demands of large-brained primate fetuses have facilitated a particular vulnerability of higher primates to hypergonadotropic disruption of ovulatory function, as found in PCOS. Am. J. Hum. Biol. 15:296,319, 2003. © 2003 Wiley-Liss. [source] | ||||||||||||||||||||||||||||