M109 INSULIN RESISTANCE IN ADOLESCENTS WITH MENSTRUAL IRREGULARITIES

Polycystic ovary syndrome (PCOS) is a common clinical condition that manifests during adolescence with menstrual irregularities, acne, and hirsutism. As these symptoms are frequently observed in healthy teenagers, it can be difficult to recognize PCOS. Establishment of hyperandrogenism, polycystic ovaries, and identifying a metabolic disorder are required for the management of PCOS in a teenager. The underlying defects in PCOS are still unclear; however, insulin resistance and the metabolic syndrome are common in both obese and non-obese PCOS patients, so that the evaluation of glucose tolerance is recommended. More than 50% of PCOS patients are overweight or obese, and will benefit from an increase in physical activity and weight loss. Metformin is a treatment option that requires further investigation before being recommended on a long-term basis.

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A prospective study of clinicoepidemiology, metabolic and hormonal profile of women with hirsutism in Konaseema region of Andhra Pradesh

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20213854 ◽

2021 ◽

Vol 10 (10) ◽

pp. 3875

Author(s):

M. Smitha

Keyword(s):

Insulin Resistance ◽

Cushing Syndrome ◽

Mean Value ◽

P Value ◽

Hormonal Profile ◽

Number Of Patients ◽

Menstrual Irregularities ◽

Before And After ◽

The Mean ◽

A Prospective Study

Background: Hirsutism is defined as presence of excess coarse hairs appear in male pattern in women.There is various aetiology of hirsutism like Idiopathic hirsutism, PCOS, androgen secreting ovarian tumours, menopause, CAH, Cushing’s syndrome, drugs which increases testosterone level, insulin resistance and tumour secreting androgen. We have designed present study with an aim to study the clinicoepidemiology, metabolic and hormonal profile of women with hirsutism in Konaseema region of Andhra Pradesh.Methods: All patients with hirsutism attending gynaecology outpatient department were selected for study based on inclusion and exclusion criteria. After that patient were examined clinically, BMI was calculated for each patient. Patients were clinically evaluated for signs of excess androgen secretion, Cushing syndrome, metabolic syndrome and hyperprolactinemia. Modified Ferriman-Gallwey scoring system was used for evaluating and quantifying hirsutism.Results: The mean Fasting plasma insulin12.42±2.41 (mIU/dl), the mean of HOMA-IR was 3.14±1.18. The mean value of dehydroepiandrosteronesulphate (DHEAS) 355.78±15.41 mcg/dl. There was statistically significant reduction in modified Ferriman-Gallwey scoring in before and after treatment (12.38± 1.55 vs. 9.62±1.6), the p value was 0.00001. The number of patients with menstrual irregularities were reduced from 63.3% to 20% after treatment and this difference is statistically significant (p=0.04).Conclusions: Hirsutism is associated with insulin resistance and DHEAS concentration was high. Modified Ferriman-Gallwey score was significantly reduced and there was significant weight loss and improvement in menstrual irregularities after treatment.

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An International Consortium Update: Pathophysiology, Diagnosis, and Treatment of Polycystic Ovarian Syndrome in Adolescence

Hormone Research in Paediatrics ◽

10.1159/000479371 ◽

2017 ◽

Vol 88 (6) ◽

pp. 371-395 ◽

Cited By ~ 75

Author(s):

Lourdes Ibáñez ◽

Sharon E. Oberfield ◽

Selma Witchel ◽

Richard J. Auchus ◽

R. Jeffrey Chang ◽

...

Keyword(s):

Insulin Resistance ◽

Polycystic Ovary ◽

Oral Contraceptive Pills ◽

International Consortium ◽

Severe Acne ◽

Contraceptive Pills ◽

Insulin Sensitizers ◽

Paediatric Endocrinology ◽

Ovarian Morphology ◽

Menstrual Irregularities

This paper represents an international collaboration of paediatric endocrine and other societies (listed in the Appendix) under the International Consortium of Paediatric Endocrinology (ICPE) aiming to improve worldwide care of adolescent girls with polycystic ovary syndrome (PCOS)1. The manuscript examines pathophysiology and guidelines for the diagnosis and management of PCOS during adolescence. The complex pathophysiology of PCOS involves the interaction of genetic and epigenetic changes, primary ovarian abnormalities, neuroendocrine alterations, and endocrine and metabolic modifiers such as anti-Müllerian hormone, hyperinsulinemia, insulin resistance, adiposity, and adiponectin levels. Appropriate diagnosis of adolescent PCOS should include adequate and careful evaluation of symptoms, such as hirsutism, severe acne, and menstrual irregularities 2 years beyond menarche, and elevated androgen levels. Polycystic ovarian morphology on ultrasound without hyperandrogenism or menstrual irregularities should not be used to diagnose adolescent PCOS. Hyperinsulinemia, insulin resistance, and obesity may be present in adolescents with PCOS, but are not considered to be diagnostic criteria. Treatment of adolescent PCOS should include lifestyle intervention, local therapies, and medications. Insulin sensitizers like metformin and oral contraceptive pills provide short-term benefits on PCOS symptoms. There are limited data on anti-androgens and combined therapies showing additive/synergistic actions for adolescents. Reproductive aspects and transition should be taken into account when managing adolescents.

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