Health Care-Related Economic Burden of Polycystic Ovary Syndrome in the United States: Pregnancy-Related and Long-Term Health Consequences

2021 ◽  
Author(s):  
Carrie Riestenberg ◽  
Anika Jagasia ◽  
Daniela Markovic ◽  
Richard P Buyalos ◽  
Ricardo Azziz
Keyword(s):  
United States ◽  
Polycystic Ovary Syndrome ◽  
Economic Burden ◽  
Polycystic Ovary ◽  
The United States ◽  
Reproductive Age ◽  
Cochrane Library ◽  
Control Group ◽  
Ovary Syndrome

Abstract Context Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-aged women, affecting approximately 5-20% of women of reproductive age. A previous estimate noted that the economic burden of PCOS approximates $3.7 billion annually in 2020 USD when considering only the costs of the initial diagnosis and of reproductive endocrine morbidities, not considering the costs of pregnancy-related and long-term morbidities. Objective To estimate the excess prevalence and economic burden of pregnancy-related and long-term health morbidities attributable to PCOS. Data Sources PubMed, EmBase and Cochrane Library. Study Selection Studies in which the diagnosis of PCOS was consistent with the Rotterdam, National Institutes of Health (NIH), or Androgen Excess & PCOS (AE-PCOS) Society criteria, or that used electronic medical record diagnosis codes, or diagnosis based on histopathologic sampling were eligible for inclusion. Studies that included an outcome of interest and a control group of non-PCOS patients who were matched or controlled for body mass index (BMI) were included. Data Extraction Two investigators working independently extracted data on study characteristics and outcomes. Data Synthesis Data was pooled using random-effects meta-analysis. The I 2statistic was used to assess inter-study heterogeneity. The quality of selected studies was assessed using the Newcastle-Ottawa Scale. Results The additional total healthcare-related economic burden due to pregnancy-related and long-term morbidities associated with PCOS in the United States is estimated to be $4.3 billion annually in 2020 USD. Conclusions Together with our prior analysis, the economic burden of PCOS is estimated at $8 billion annually in 2020 USD.

Polycystic ovary syndrome

2020 ◽  
pp. 528-535
Author(s):  
Zhongwei Huang ◽  
Eu Leong Yong
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Endometrial Hyperplasia ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Endocrine Disorders ◽  
Age Group ◽  
Ovary Syndrome ◽  
Reproductive Ageing ◽  
Reproductive Age Group

Polycystic ovary syndrome (PCOS) is an enigmatic condition and its pathophysiology remains to be determined but it is likely to involve the androgen, insulin, and anti-Mullerian hormone pathways. PCOS is diagnosed in women in the reproductive age group based on the Rotterdam criteria. The spectrum of disease involves various phenotypes based on the current diagnostic criteria and this may have reproductive, metabolic, and endocrine consequences. Reproductive issues include that of irregular menstrual cycles and anovulation. Metabolic disorders such as insulin resistance, obesity, dyslipidaemia, and hypertension must be screened for in all women who are diagnosed with PCOS. Long-term risks of metabolic and endocrine disorders in women with PCOS still need further confirmation with more robust data. Reproductive ageing appears to be increased in women with PCOS and they seem to menopause at a later age. Thus far, PCOS appears to be associated with endometrial hyperplasia and cancer.

scholarly journals Impact of Short-Term Isoflavone Intervention in Polycystic Ovary Syndrome (PCOS) Patients on Microbiota Composition and Metagenomics

Nutrients ◽  
2020 ◽  
Vol 12 (6) ◽  
pp. 1622 ◽  
Author(s):  
Christoph Haudum ◽  
Lisa Lindheim ◽  
Angelo Ascani ◽  
Christian Trummer ◽  
Angela Horvath ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Biochemical Characterization ◽  
Polycystic Ovary ◽  
Alpha Diversity ◽  
Intestinal Bacteria ◽  
Reproductive Age ◽  
Control Group ◽  
Interventional Study ◽  
Ovary Syndrome ◽  
Receptor Modulator

Background: Polycystic ovary syndrome (PCOS) affects 5–20% of women of reproductive age worldwide and is associated with disorders of glucose metabolism. Hormone and metabolic signaling may be influenced by phytoestrogens, such as isoflavones. Their endocrine effects may modify symptom penetrance in PCOS. Equol is one of the most active isoflavone metabolites, produced by intestinal bacteria, and acts as a selective estrogen receptor modulator. Method: In this interventional study of clinical and biochemical characterization, urine isoflavone levels were measured in PCOS and control women before and three days after a defined isoflavone intervention via soy milk. In this interventional study, bacterial equol production was evaluated using the log(equol: daidzein ratio) and microbiome, metabolic, and predicted metagenome analyses were performed. Results: After isoflavone intervention, predicted stool metagenomic pathways, microbial alpha diversity, and glucose homeostasis in PCOS improved resembling the profile of the control group at baseline. In the whole cohort, larger equol production was associated with lower androgen as well as fertility markers. Conclusion: The dynamics in our metabolic, microbiome, and predicted metagenomic profiles underline the importance of external phytohormones on PCOS characteristics and a potential therapeutic approach or prebiotic in the future.

scholarly journals Depression Due to Polycystic Ovary Syndrome in Adolescents

2021 ◽  
pp. 224-227
Author(s):  
Pratheek R. Kashyap ◽  
Rakesh Kumar Jha ◽  
Praful Patil
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Psychological Health ◽  
Polycystic Ovary ◽  
Self Esteem ◽  
Reproductive Age ◽  
Future Research ◽  
Ovary Syndrome ◽  
Small Cyst ◽  
Psychiatric Issues

Introduction: Polycystic ovary syndrome(PCOS) is a common endocrinal disorder of reproductive age, that cause enlarged ovaries with small cyst on the outer edges with infrequent or prolonged menstrual cycles, excess hair growth, acne and obesity, which is nowadays prevailing among females at adolescent stage. About 5-10% of women among the general population of in the world are affected by PCOS. There is an increase in the prevalence of PCOS among the women and young girls of reproductive age, where they experience depression because of PCOS particularly. The exact cause of PCOS is unknown. The early diagnosis and treatment along with weight loss may reduce the long term complications of PCOS. It is not only a problem associated with reproduction, but also has associated vital metabolic and psychological health risks. Aim: Depression Due to Polycystic Ovary Syndrome in Adolescents Conclusion: In comparison to safe controls, adolescents with PCOS had lower self-esteem, more anxiety, and more depressive symptoms. Future research is required to look into the psychiatric issues that affect adolescents with PCOS.

Features of the functional state of the pituitary-ovarian systems in women with polycystic ovary syndrome at different periods of reproductive age

2020 ◽  
Vol 75 (6) ◽  
pp. 653-660
Author(s):  
O. V. Krusko ◽  
L. F. Sholokhov ◽  
L. V. Belenkaya ◽  
M. A. Rashidova ◽  
I. N. Danusevich ◽  
...  
Keyword(s):  
Luteinizing Hormone ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Follicle Stimulating Hormone ◽  
Reproductive Age ◽  
Sex Steroid ◽  
Control Group ◽  
Ovary Syndrome ◽  
Steroid Binding ◽  
Stimulating Hormone

Background. PCOS is one of the most common endocrinological pathologies in women of reproductive age, manifested by a wide range of clinical manifestations. There are many unresolved issues related to the pathogenesis, diagnosis and treatment of this pathological condition in different periods of reproductive age. Aim the objective of the study was to identify the features of the functioning of the pituitary-ovarian system in women with PCOS at different periods of reproductive age. Methods. Study was performed in 20172019 at the FSPSI SCFHHRP, and involved women aged 1845 years. The study groups included women (a group of women with PCOS and a control group) in the follicular phase from 1 to 12 days of the menstrual cycle. As a result of the survey, a group of 44 women with PCOS and a group of 56 healthy women were formed. PCOS was diagnosed according to ESHRE/ASRM criteria (Rotterdam, 2003). Next, subgroups of women in early reproductive age from 35 to 45 years were formed: a group of women with PCOS (n = 29) and a control group (n = 22). And groups of women in late reproductive age from 35 to 45 years were formed: a group of women with PCOS (n = 15) and a control group (n = 34). Conducted: questionnaire survey, general and gynecological examination, ultrasound examination of the pelvic organs, laboratory tests, statistical data analysis. Results. In women with polycystic ovary syndrome of early reproductive age (1835 years), we detected an increase in the level of testosterone by 2 times, DHEA-S by 1.3 times, 17-OH-progesterone by 2 times, sex steroid-binding globulin by 1.4 times, in comparison with control group. The ratio of luteinizing hormone to follicle-stimulating hormone increased by 52%. In women with polycystic ovary syndrome of late reproductive age (3545 years), we detected an increase in the level of testosterone by 1.5 times, 17-OH-progesterone by 1.9 times, luteinizing hormone by 1.4 times, sex steroid-binding globulin by 1.6 times, in comparison with control group, without any significant differences in DHEA-S. At the same time, the ratio of luteinizing hormone to follicle-stimulating hormone increased by 60%. Conclusion. The hormonal profile of women with PCOS of early and late reproductive period is characterized by series of age-related changes in the pituitary-ovarian system, which should be taken into account in preventive and therapeutic measures.

A Comprehensive PCOS Research and Guideline Translation Program to Improve Practice

2021 ◽  
Vol 39 (03/04) ◽  
pp. 161-166
Author(s):  
Vijayanand A. Ramasamy ◽  
Rhonda M. Garad ◽  
Jacqueline A. Boyle
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Consumer Satisfaction ◽  
Research Collaboration ◽  
Polycystic Ovary ◽  
The United States ◽  
Reproductive Age ◽  
Research Translation ◽  
Evidence Based ◽  
Health Providers ◽  
Ovary Syndrome

AbstractPolycystic ovary syndrome (PCOS) is a common and complex endocrinopathy affecting reproductive-age women with a reported prevalence of 8 to 13%. To address the knowledge, practice, consumer satisfaction, and research gaps, an international research collaboration was formed to develop the first “International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2018).” This article describes an effective research translation program to disseminate the guideline internationally to women and health providers. To date, this had led to 75,197 views and almost 36,000 downloads of the PCOS guideline, and 43,000 views and 10,600 downloads of a suite of PCOS resources. AskPCOS app, the first freely accessible, evidence-based PCOS app, has 9,910 users (between 400 and 800 users per month), 23,447 sessions, and 87,801 screen viewings. Fifty-four percent of returning users are from across 137 countries, with the most users in Australia, the United States, the United Kingdom, the Netherlands, and India. Extensive global uptake of the PCOS guideline and compendium of resources was augmented by extensive formative consumer and health professional consultation, end-user engagement across the evidence-creation spectrum, co-design, and quality improvement.

Effects of synbiotic supplementation and lifestyle modifications on women with polycystic ovary syndrome

2021 ◽  
Author(s):  
Izabela Chudzicka-Strugała ◽  
Anna Kubiak ◽  
Beata Banaszewska ◽  
Barbara Zwozdziak ◽  
Martyna Siakowska ◽  
...  
Keyword(s):  
Placebo Group ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Controlled Trial ◽  
Reproductive Age ◽  
Control Group ◽  
Lifestyle Modifications ◽  
Ovary Syndrome ◽  
Double Blind ◽  
Synbiotic Supplementation

Abstract Context Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of reproductive age. Objective This study was designed to evaluate effects of lifestyle modifications and synbiotic supplementation on PCOS. Design A randomized (1:1) double-blind, placebo-controlled trial. Setting Academic hospital. Patients or Other Participants Overweight and obese women with PCOS were identified according to the Rotterdam criteria. Evaluations were performed at baseline and repeated after 3 months of treatment. Intervention Lifestyle modifications in combination with synbiotic supplementation or placebo. Main Outcome Measures Change in BMI and testosterone level. Results In the Placebo Group, a 5% decrease in BMI was accompanied by significant decreases of the waist, hip, and thigh circumferences. The Synbiotic Group experienced an 8% decrease in BMI, which was significantly greater than that in the Control Group (P=0.03) and was accompanied by decreases in the waist, hip, and thigh circumferences. Testosterone did not decrease significantly in the Placebo Group (decrease of 6%), while in the Synbiotic Group it decreased by 32% (P<0.0001). The decrease of testosterone was significantly greater in the Synbiotic Group than in the Placebo Group (P=0.016). Conclusions Synbiotic supplementation potentiated effects of lifestyle modifications on weight loss and led to significant reduction of serum testosterone.

Modern treatment of hyperandrogenic conditions in women of reproductive age

2020 ◽  
pp. 66-70
Author(s):  
T.G. Romanenko ◽  
◽  
T.N. Ignatiuk ◽  
E.A. Molthanova ◽  
◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Control Group ◽  
Combination Drug ◽  
Ovary Syndrome ◽  
Group I ◽  
Group Ii ◽  
Functional Hyperandrogenism ◽  
Antiandrogen Therapy

The objective: to study the effectiveness and safety of modern antiandrogen therapy in patients with polycystic ovary syndrome (PCOS). Materials and methods. Materials and methods. The first (main) study group included 39 patients with PCOS who received combination nonsteroidal antiandrogen therapy: antiandrogen drug containing flutamide (125 mg 3 times a day) and phyto drug Ovarimedin 1 capsule 2 times a day after meals for 6 months . The II (control) group included 37 patients who received a combination drug containing 35 μg of ethinylestradiol and 2 mg of cyproterone acetate for 6 months. Results. After the course of treatment, biphasic MC was preserved in 25 (64.1%) patients of group I, and in 14 (37.8%) of group II. In group I, before the treatment of stage III hirsutism was in 23 patients (58.9%), after treatment – in 6 patients (15.3%); II stage in 10 patients (25.6%) before treatment, after treatment – in 18 patients (46.1%); I stage was found in 6 patients before treatment (15.5%) and in 15 patients (38.6%) after treatment. In group II patients, stage ІІІ hirsutism was detected in 21 patients (56.7%) before treatment, and in 7 patients (18.9%) after treatment; II stage in 9 patients (24.3%) before treatment, after treatment – in 13 patients (35.1%); I stage was found in 7 patients before treatment (19.0%) and in 17 patients (45.9%) after treatment. Conclusions. Antiandrogenic nonsteroidal therapy with multicomponent herbal drug (Ovaremidine) and nonsteroidal antiandrogens may be recommended for the treatment of women with functional hyperandrogenism accompanied by hirsut syndrome, menstrual irregularities and / or infertility. Our study confirmed that the use of this therapy contributes to the effective treatment of hirsutism, the restoration of menstrual disorders and fertility in women. Differential algorithm for the treatment of hyperandrogenism of various etiologies, which can be recommended in the clinical practice of obstetricians and gynecologists. Keywords: hyperandrogenism, polycystic ovary syndrome (PCOS), menstrual cycle, infertility, hirsutism, phytotherapy.

scholarly journals Analysis of the informativeness of melatonin evaluation in polycystic ovary syndrome

2016 ◽  
Vol 13 (4) ◽  
pp. 15-20 ◽  
Author(s):  
Elena Andreeva ◽  
Yulia Absatarova ◽  
Ekaterina Sheremetyeva ◽  
Dmitriy Derkatch ◽  
Tatiana Ponomareva ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Sleep Disorders ◽  
Polycystic Ovary ◽  
Reproductive Function ◽  
Reproductive Age ◽  
Control Group ◽  
Endocrine Disorders ◽  
Ovary Syndrome ◽  
Subjective Sleep ◽  
Pcos Group

Background. Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. Recently, the role of melatonin in the pathogenesis of this syndrome became widely discussed among the scientists, because there is an evidence of its impact on the reproductive function and maturation of oocytes.Aim. To study a informativeness of melatonin determination and its relationship with sleep disorders in PCOS.Materials and methods. The study involved 120 women aged 17–35 years: 60 patients with PCOS and 60 women without this disorder as controls. The level of melatonin in the blood, saliva and its metabolite in urine – 6 sulfatoximelatonin were analyzed. To identify sleep disorders survey was conducted using a questionnaire scoring subjective sleep characteristics.Results. Sleep disorders based on subjective scoring profiles sleep characteristics were identified in PCOS group (up to 70% of patients) regardless of BMI. The level of 6-sulfatoximelatonin in urine, nocturnal melatonin levels in saliva (at 3:00 AM) and melatonin in the blood were significantly higher in patients with PCOS compared with the control group regardless of BMI. The level of melatonin in follicular fluid was lower in patients with PCOS. There was a significant correlation of melatonin levels in the blood and the degree of sleep disorders according to the questionnaire scoring subjective sleep characteristics, the level of melatonin in saliva at 3:00 AM and a 6-sulfatoximelatonin in daily urine (p = 0.046).Conclusions. PCOS is polyetiology disease, and an important role in the formation and progression in which plays melatonin. Correlation of levels of this hormone in different body fluids suggests its systemic action and direct involvement in the regulation of reproductive function.  

Women with Polycystic Ovary Syndrome: A Marginalized Population in the United States

2020 ◽  
Vol 45 (1) ◽  
pp. 40-46 ◽  
Author(s):  
Ninive Sanchez
Keyword(s):  
United States ◽  
Polycystic Ovary Syndrome ◽  
Health Care Providers ◽  
Polycystic Ovary ◽  
Public Health Problem ◽  
The United States ◽  
Standards Of Care ◽  
Major Public Health Problem ◽  
Care Providers ◽  
Ovary Syndrome

Abstract The National Institutes of Health has identified polycystic ovary syndrome (PCOS) as a major public health problem for women in the United States and recommends establishing multidisciplinary programs to improve the awareness of the public and health care providers regarding management for women with PCOS. This article argues that individuals with PCOS are marginalized due to the syndrome’s misleading name; its underrepresentation in research; lack of culturally and gender-sensitive standards of care; debates about the contraceptive mandate; and stigmatization due to symptoms that do not conform to dominant social constructs of beauty, femininity, and womanhood. The article directs readers to key publications on the assessment and treatment of patients with PCOS, discusses a case study that illustrates the role of a social worker in treating an adolescent with PCOS as part of a multidisciplinary team, and emphasizes the importance of integrating behavioral health in the treatment of patients with PCOS.

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