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

2017 ◽  
Vol 88 (6) ◽  
pp. 371-395 ◽  
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.

scholarly journals Clinical Profiles, Occurrence, and Management of Adolescent Patients with HAIR-AN Syndrome

2004 ◽  
Vol 4 ◽  
pp. 507-511 ◽  
Author(s):  
Hatim A. Omar ◽  
Stephanie Logsdon ◽  
Jessica Richards
Keyword(s):  
Insulin Resistance ◽  
Young Women ◽  
Polycystic Ovary ◽  
Common Disease ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Common Causes ◽  
Adolescent Clinic ◽  
Better Than

The syndrome of hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN) is a subphenotype of the polycystic ovary syndrome. It is one of the most common causes of menstrual problems, hyperandrogenic symptoms, and insulin resistance among young women. Review of clinical data in an outpatient adolescent clinic showed that of the 1,002 young women (ages 10—21 years) attending the clinic over a 2-year period, 50 (5%) were diagnosed with HAIR-AN syndrome. Mean age of the patients was 15.5, initial mean weight at diagnosis was 94.5 kg, and the mean BMI was 33.33 kg/m2. Patients were treated with a weight-stabilization and -reduction program, oral contraceptive pills, and in most cases metformin. Of the patients, 80% were compliant with the follow-up and treatment regimen, 60% maintained or reduced their weight, 95% had regular menstrual cycles, and in most patients, the acne and/or hirsutism were the same or better than at the start of treatment. We conclude that HAIR-AN syndrome is a common disease in young women and multifaceted, aggressive treatment appears to be effective in reducing the severity of symptoms and preventing further consequences.

A Modern Medical Quandary: Polycystic Ovary Syndrome, Insulin Resistance, and Oral Contraceptive Pills

2003 ◽  
Vol 88 (5) ◽  
pp. 1927-1932 ◽  
Author(s):  
Evanthia Diamanti-Kandarakis ◽  
Jean-Patrice Baillargeon ◽  
Maria J. Iuorno ◽  
Daniela J. Jakubowicz ◽  
John E. Nestler
Keyword(s):  
Insulin Resistance ◽  
Oral Contraceptive ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills

scholarly journals Cardiovascular profile of pharmacological agents used for the management of polycystic ovary syndrome

2018 ◽  
Vol 10 ◽  
pp. 204201881880567
Author(s):  
Huda Alalami ◽  
Thozhukat Sathyapalan ◽  
Stephen L. Atkin
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovary Syndrome ◽  
Pharmacological Agents ◽  
Oral Contraceptive Pills ◽  
Contraceptive Pills ◽  
Increased Risk ◽  
Dipeptidyl Peptidase Iv Inhibitors ◽  
Onset Of Diabetes ◽  
Glucagon Like Peptide 1

Women with polycystic ovary syndrome (PCOS) have an adverse metabolic profile with an increased risk of prediabetes and type 2 diabetes (T2DM); however, it is unclear if PCOS is associated with increased cardiovascular events in later years independent of the presence of T2DM. Many therapies have been used to treat the differing facets of PCOS, including those for menstrual irregularity, hirsutism, acne and anovulatory infertility. The aim of this review was to evaluate the cardiovascular profiles associated with the medications used in the management of PCOS and evaluate whether they have cardiovascular benefit, detriment or are neutral. The medications reviewed include oral contraceptive pills, antiandrogens, clomiphene and drugs specifically used in diabetes therapy; metformin, glitazones, dipeptidyl peptidase IV inhibitors and glucagon-like peptide-1 receptor agonists. This review concludes that therapies that are used to treat these patients appear not to add to the cardiovascular risk and that there is no evidence that any interventional medical therapy may prevent the onset of diabetes in patients with PCOS, though in the case of metformin, this agent may be beneficial in preventing development of gestational diabetes.

scholarly journals Metabolism and Ovarian Function in PCOS Women: A Therapeutic Approach with Inositols

2016 ◽  
Vol 2016 ◽  
pp. 1-9 ◽  
Author(s):  
Antonio Simone Laganà ◽  
Paola Rossetti ◽  
Massimo Buscema ◽  
Sandro La Vignera ◽  
Rosita Angela Condorelli ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Ovarian Function ◽  
Polycystic Ovary ◽  
Second Messengers ◽  
Biological Functions ◽  
Androgen Excess ◽  
Glucose And Lipid Metabolism ◽  
Insulin Sensitizers ◽  
Degree Of Severity ◽  
Correlate Data

Polycystic ovary syndrome (PCOS) is characterized by chronical anovulation and hyperandrogenism which may be present in a different degree of severity. Insulin-resistance and hyperinsulinemia are the main physiopathological basis of this syndrome and the failure of inositol-mediated signaling may concur to them. Myo (MI) and D-chiro-inositol (DCI), the most studied inositol isoforms, are classified as insulin sensitizers. In form of glycans, DCI-phosphoglycan and MI-phosphoglycan control key enzymes were involved in glucose and lipid metabolism. In form of phosphoinositides, they play an important role as second messengers in several cellular biological functions. Considering the key role played by insulin-resistance and androgen excess in PCOS patients, the insulin-sensitizing effects of both MI and DCI were tested in order to ameliorate symptoms and signs of this syndrome, including the possibility to restore patients’ fertility. Accumulating evidence suggests that both isoforms of inositol are effective in improving ovarian function and metabolism in patients with PCOS, although MI showed the most marked effect on the metabolic profile, whereas DCI reduced hyperandrogenism better. The purpose of this review is to provide an update on inositol signaling and correlate data on biological functions of these multifaceted molecules, in view of a rational use for the therapy in women with PCOS.

scholarly journals Contemporary approaches to the management of polycystic ovary syndrome

2018 ◽  
Vol 9 (4) ◽  
pp. 123-134 ◽  
Author(s):  
Renato Pasquali
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Ovarian Function ◽  
Polycystic Ovary ◽  
Review Article ◽  
Metabolic Abnormalities ◽  
Androgen Excess ◽  
Ovary Syndrome ◽  
Ovulatory Dysfunction ◽  
Ovarian Morphology

Polycystic ovary syndrome (PCOS) is a common disorder in women in their reproductive years and is characterized by androgen excess, ovulatory dysfunction, and polycystic ovarian morphology. It is also associated with several metabolic abnormalities, particularly insulin resistance and obesity, which play an important role in the pathophysiology of PCOS and, in particular, negatively influence ovarian function and fertility. This review article summarizes the available treatment for women with PCOS. Specifically, current and potentially new therapies are discussed.

scholarly journals An adolescent with polycystic ovary syndrome

2006 ◽  
Vol 155 (suppl_1) ◽  
pp. S149-S152 ◽  
Author(s):  
Marja Ojaniemi ◽  
Michel Pugeat
Keyword(s):  
Physical Activity ◽  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
The Metabolic Syndrome ◽  
Menstrual Irregularities ◽  
Term Basis

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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