Das polyzystische Ovarsyndrom: Aktuelle Evidenz und praktische Empfehlungen

2020 ◽  
Vol 15 (01) ◽  
pp. 37-47
Author(s):  
Susanne Reger-Tan ◽  
Christian Böing ◽  
Dagmar Führer-Sakel
Keyword(s):  
Polycystic Ovary ◽  
Treatment Strategies ◽  
Lifestyle Changes ◽  
Success Rates ◽  
Childbearing Age ◽  
Oral Contraceptive Pills ◽  
Vein Thrombosis ◽  
Recommended Treatment ◽  
Estrogen Dose ◽  
Therapeutic Lifestyle Changes

AbstractPolycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing age. Due to hyperandrogenism and chronic anovulation affected women may suffer from hirsutism, androgenetic alopecia, acne, menstrual disturbance and sub-/infertility. Furthermore underlying insulin resistance promotes hyperandrogenemia, overweight and risk for diabetes. Therefore, routine evaluation of glycemic status is recommended. Treatment strategies are based on therapeutic lifestyle changes and focus on patient-important complaints. First line pharmacologic treatment for infertility in women with PCOS is letrozole. Clomiphene and metformin can be used alternatively with lower success rates. Women seeking medical advice for hyperandrogenism can be offered oral contraceptive pills with the lowest effective estrogen dose without any preference of a certain gestagen. Risk for deep vein thrombosis should be taken into account when choosing estrogen dose and type of gestagen. Antiandrogen substances such as spironolactone should only be prescribed in combination with safe contraception due to their risk of fetal undervirilisation. Additionally, substance specific risks should be considered. Baseline treatment of overweight or metabolic issues includes behaviour modification, weight reduction and physical activity. Additional benefit can be reached by combination of lifestyle changes with metformin. Studies indicate a positive effect of inositol and antidiabetic substances like liraglutide and empagliflozin but should be regarded as experimental therapies.

Polycystic Ovary Syndrome in the Adolescent

2019 ◽  
Author(s):  
Tara A. Singh ◽  
Kathleen F. Harney
Keyword(s):  
Young Women ◽  
Early Recognition ◽  
Polycystic Ovary ◽  
Poor Quality ◽  
Lifestyle Changes ◽  
Hormonal Contraceptives ◽  
Menstrual Irregularity ◽  
Oral Contraceptive Pills ◽  
Adolescent Women ◽  
First Line Therapy

The typical PCOS phenotype of anovulation, androgen excess, and polycystic ovarian morphology can overlap with normal adolescence, thus making the diagnosis more difficult. Early recognition of adolescents at a risk for PCOS allows for earlier intervention with the potential for improved cardiovascular and metabolic health. Mental health issues and poor quality of life are frequently associated with PCOS in adolescent women and, therefore, should be identified and addressed. As with many issues confronting the adolescent, peer and family support should be encouraged. Lifestyle changes and weight loss should be thought of as first-line therapy for young women with PCOS. Combined hormonal contraceptives remain the medical therapy of choice for the treatment of menstrual irregularity, hirsutism, acne, and contraception. Metformin and spironolactone may be considered, with metformin particularly beneficial in young women with metabolic abnormalities. This review contains 2 tables and  50 references. Key Words: antiandrogens, antimüllerian hormone, hirsutism, hyperandrogenism, hyperinsulinemia, insulin resistance, menstrual irregularity, obesity, oral contraceptive pills, polycystic ovary

027. In vitro growth and maturation: how does this technology fit for clinical application?

2005 ◽  
Vol 17 (9) ◽  
pp. 69
Author(s):  
M. Lane ◽  
C. Yeo ◽  
K. S. Cashman ◽  
H. M. Hamilton
Keyword(s):  
In Vitro Maturation ◽  
Polycystic Ovary ◽  
Oocyte Quality ◽  
Attractive Alternative ◽  
Success Rates ◽  
Human Oocytes ◽  
Vein Thrombosis

Superovulation protocols used in IVF result in multiple eggs that can be fertilized and grown in the laboratory to allow for selection of the best embryo for return to the mother, thereby increasing the chances for a successful pregnancy. However, there are many side effects of these superovulation drug protocols, such as deep vein thrombosis and hyperstimulation. The latter is of particular concern for women with polycystic ovary syndrome. Furthermore, the use of gonadotrophins has been reported to compromise both oocyte quality and the uterine environment and may contribute to the low success rates of IVF. Therefore the ability to collect large numbers of oocytes from women and mature them in vitro is an attractive alternative. However, although there are reports in the literature on extended maturation/culture periods of human oocytes the pregnancy rates are significantly lower than that observed after in vivo maturation. The ability to offer such technology is currently limited by the lack of understanding of how the conditions for in vitro maturation affect the quality of the oocyte and the resulting embryo. Our research is concentrated on establishing the role of metabolic balance in the oocyte for the maintenance of subsequent viability. We have determined that disruptions to the balance between mitochondrial and cytoplasmic metabolism in animal oocytes have significant adverse consequences for the resultant embryo. Changing conditions for in vitro maturation were also found to alter the establishment of the metabolic settings of the oocyte. The ability to determine the role of such parameters in maturing human oocytes will be important for the prospect of adoption of this technology for routine clinical practice.

scholarly journals A Comparison of a Pulse-Based Diet and the Therapeutic Lifestyle Changes Diet in Combination with Exercise and Health Counselling on the Cardio-Metabolic Risk Profile in Women with Polycystic Ovary Syndrome: A Randomized Controlled Trial

Nutrients ◽  
2018 ◽  
Vol 10 (10) ◽  
pp. 1387 ◽  
Author(s):  
Maryam Kazemi ◽  
Laura McBreairty ◽  
Donna Chizen ◽  
Roger Pierson ◽  
Philip Chilibeck ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Disease Risk ◽  
Polycystic Ovary ◽  
Density Lipoprotein ◽  
Lifestyle Changes ◽  
Lipoprotein Cholesterol ◽  
Oral Glucose ◽  
Post Intervention ◽  
Ovary Syndrome ◽  
Therapeutic Lifestyle Changes

We compared the effects of a low-glycemic index pulse-based diet, containing lentils, beans, split peas, and chickpeas, to the Therapeutic Lifestyle Changes (TLC) diet on cardio-metabolic measures in women with polycystic ovary syndrome (PCOS). Ninety-five women (18–35 years) enrolled in a 16-week intervention; 30 women in the pulse-based and 31 in the TLC groups completed the study. Women participated in aerobic exercise training (minimum 5 days/week for 45 min/day) and were counselled (monthly) about PCOS and lifestyle modification. Women underwent longitudinal follow-up post-intervention. The pulse-based group had a greater reduction in total area under the curve for insulin response to a 75-g oral glucose tolerance test (mean change ± SD: −121.0 ± 229.9 vs. −27.4 ± 110.2 µIU/mL × min; p = 0.05); diastolic blood pressure (−3.6 ± 6.7 vs. −0.2 ± 6.7 mmHg, p = 0.05); triglyceride (−0.2 ± 0.6 vs. 0.0 ± 0.5 mmol/L, p = 0.04); low-density lipoprotein cholesterol (−0.2 ± 0.4 vs. −0.1 ± 0.4 mmol/L, p = 0.05); total cholesterol/high-density lipoprotein cholesterol (TC/HDL-C; −0.4 ± 0.4 vs. 0.1 ± 0.4, p < 0.001); and a greater increase in HDL-C (0.1 ± 0.2 vs. −0.1 ± 0.2 mmol/L, p < 0.01) than the TLC group. Decreased TC/HDL-C (p = 0.02) at six-month and increased HDL-C and decreased TC/HDL-C (p ≤ 0.02) at 12-month post-intervention were maintained in the pulse-based group. A pulse-based diet may be more effective than the TLC diet at improving cardio-metabolic disease risk factors in women with PCOS. Trial registration: CinicalTrials.gov identifier, NCT01288638.

Effect of short-term use of oral contraceptive pills on intraocular pressure

2020 ◽  
Vol 35 (3) ◽  
Author(s):  
Tayyaba Gul Malik ◽  
Hina Nadeem ◽  
Eiman Ayesha ◽  
Rabail Alam
Keyword(s):  
Oral Contraceptive ◽  
Childbearing Age ◽  
Short Term ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Time Period ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Short Time

Objective: To study the effect of short-term use of oral contraceptive pills on intra-ocular pressures of women of childbearing age.   Methods: It was a comparative observational study, conducted at Arif memorial teaching hospital and Allied hospital Faisalabad for a period of six months. Hundred female subjects were divided into two groups of 50 each. Group A, included females, who had been taking oral contraceptive pills (OCP) for more than 6 months and less than 36 months. Group B, included 50 age-matched controls, who had never used OCP. Ophthalmic and systemic history was taken. Careful Slit lamp examination was performed and intraocular pressures (IOP) were measured using Goldman Applanation tonometer. Fundus examination was done to rule out any posterior segment disease. After collection of data, we analyzed and compared the intra ocular pressures between the two groups by using ANOVA in SPSS version 21.   Results: Average duration of using OCP was 14.9 months. There was no significant difference of Cup to Disc ratios between the two groups (p= 0.109). However, significant difference was noted between the IOP of OCP group and controls. (p=0.000). Conclusion: OCP significantly increase IOP even when used for short time period.

Recent Advances in Treatment of Childhood Obesity

2020 ◽  
Vol 21 (14) ◽  
pp. 1072-1078
Author(s):  
Walter Milano ◽  
Paola Ambrosio ◽  
Francesca Carizzone ◽  
Walter Di Munzio ◽  
Valeria De Biasio ◽  
...  
Keyword(s):  
Public Health ◽  
Physical Activity ◽  
Bariatric Surgery ◽  
Childhood Obesity ◽  
Treatment Strategies ◽  
Lifestyle Changes ◽  
Family Context ◽  
Review Of The Literature ◽  
Biological Factors ◽  
The Family

: Childhood obesity has assumed epidemic proportions and is currently one of the most widespread public health problems. Many are the factors involved in the pathogenesis of excess weight with interactions between genetic, environmental and biological factors and therefore, also the therapeutic approach must be multidisciplinary and multidimensional. In this review of the literature, we report the contiguity of childhood obesity with eating disorders and the importance of involving the family context in order to induce stable lifestyle changes, both in relation to dietary and nutritional habits, but also in increasing physical activity. Finally, among the therapeutic options, although for selected cases, pharmacotherapy and bariatric surgery can be used as treatment strategies.

Eating Green: Shining Light on the Use of Dietary Phytochemicals as a Modern Approach in the Prevention and Treatment of Head and Neck Cancers

2018 ◽  
Vol 18 (3) ◽  
pp. 182-191 ◽  
Author(s):  
Linda L. Eastham ◽  
Candace M. Howard ◽  
Premalatha Balachandran ◽  
David S. Pasco ◽  
Pier Paolo Claudio
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Cancer Cell ◽  
Squamous Cell ◽  
Treatment Strategies ◽  
Lifestyle Changes ◽  
Neck Squamous Cell Carcinoma ◽  
Laboratory Research ◽  
Modern Approach

Enthusiasm for the use of dietary bioactive compounds as chemopreventive agents and adjuvants for current therapies has increased laboratory research conducted on several types of cancers including Head and Neck Squamous Cell Carcinoma (HNSCC). The green chemoprevention movement is a modern approach to highlight healthy lifestyle changes that aim to decrease the incidence of HNSCC. A healthy diet can be an effective way to prevent the development of oral cancers. Discovery of the naturally occurring plant based compounds called phytochemicals has facilitated the development of new treatment strategies for patients that are at risk for, or have developed HNSCC. Many of these compounds have been shown to elicit very potent anti-carcinogenic properties. While there are many compounds that have been studied, the compounds from two specific categories of phytochemicals, phenolics (resveratrol, EGCG, curcumin, quercetin, and honokiol) and glucosinolates (sulforaphane, PEITC and BITC), are emerging as potent and effective inhibitors of oral carcinogenesis. These compounds have been shown to inhibit HNSCC growth through a variety of mechanisms. Research has demonstrated that these compounds can regulate cancer cell proliferation through the regulation of multiple cell signaling pathways. They can impede cell cycle progression, induce differentiation and apoptosis, prevent angiogenesis, and inhibit cancer cell invasive and metastatic properties. They can protect normal cells during treatment and reduce the damage caused by chemotherapy and radiotherapy. This review aims to provide an overview of some of the most effective phytochemicals that have the potential to successfully prevent and treat head and neck squamous cell carcinoma.

CLINICAL EFFECTIVENESS OF THERAPEUTIC LIFESTYLE CHANGES IN PATIENTS WITH PREHYPERTENSION

2006 ◽  
Vol 26 (4) ◽  
pp. 267 ◽  
Author(s):  
Venkata V. Bavikati ◽  
Laurence S. Sperling ◽  
Richard D. Salmon ◽  
George C. Faircloth ◽  
Richard F. Leighton ◽  
...  
Keyword(s):  
Clinical Effectiveness ◽  
Lifestyle Changes ◽  
Therapeutic Lifestyle Changes
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