Diagnostic difficulties of polycystic ovarian syndrome in adolescent girls

2013 ◽  
Vol 154 (4) ◽  
pp. 136-142 ◽  
Author(s):  
László Ságodi ◽  
László Barkai
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Adolescent Girls ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Adult Women ◽  
Ovary Syndrome ◽  
Female Population ◽  
Ovulatory Dysfunction ◽  
Diagnostic Difficulties ◽  
Diagnostic Work

Polycystic ovary syndrome is a heterogeneous disorder characterized by chronic ovulatory dysfunction and hyperandrogenism. It occurs in 6–8% of the female population in the reproductive age. The syndrome may be associated with various metabolic disorders which may impair the quality of life and life expectancy of patients. The diagnosis in adults is usually established by the presence of three criteria. Polycystic ovary syndrome can be also identified in adolescent girls. Although the clinical, hormonal and metabolic features are similar to those found in adult women, it may be difficult to distinguish normal adolescents from those with polycystic ovary syndrome. Irregular menstruation, anovulatory cycles, and acne are not uncommon in adolescents, and polycystic ovary syndrome may mimic physiological anovulation in adolescents. There is a high probability of polycystic ovary syndrome if anovulatory cycles persist for more than 2 years. The diagnosis of polycystic ovary syndrome in adolescents may require a unique set of criteria, however, there are no generally accepted recommendations for the diagnostic work-up. The authors propose that hyperandrogenemia is often the most reliable finding in this age group, and it may be prudent to define adolescent polycystic ovary syndrome according to the Rotterdam consensus criteria. Obesity in adolescent girls may increase the severity of symptoms of polycystic ovary syndrome and this underlines the importance of early diagnosis and treatment. Orv. Hetil., 2013, 154, 136–142.

POLYCYSTIC OVARY SYNDROME (ARTAVA KSHAYA): GENETIC AND NONGENETIC ETIOPATHOLOGY AND DIAGNOSIS: AN AYURVEDIC NARRATIVE REVIEW

2021 ◽  
Vol 12 (4) ◽  
pp. 161-165
Author(s):  
Rakhi Sahu ◽  
Awanish Jaiswal ◽  
Anurag Pandey ◽  
Ramanand Tiwari
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Adolescent Girls ◽  
Polycystic Ovary ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Reproductive Age ◽  
Therapeutic Interventions ◽  
Adult Women ◽  
Ovary Syndrome ◽  
Diagnostic Features

Polycystic ovary syndrome (PCOS) is a common heterogeneous endocrine disorder and about 6% to 20% of women are affected in their reproductive age. Clinical manifestations arise during the early pubertal years, and it’s characterized by irregular menstrual cycles, anovulation, acne, Oligomenorrhea/Amenorrhea, Hirsutism, and frequently infertility. Despite recent advancements in technologies in the scientific world pathophysiology of PCOS is still challenging and initially, most available clinical data communicated findings and outcomes is only in adult women. After that, the Rotterdam criteria are most accepted for adult women and adolescent girls. The diagnostic features for adolescent girls are based on classical tried e.g., menstrual irregularity, clinical hyperandrogenism, and/or hyperandrogenemia. Whereas findings of pelvic ultrasound are significant in adult women but least significant in adolescent girls. Mental health disorders including depression, anxiety, bipolar disorder also occur more frequently in both adolescent girls and women with PCOS. Ayurveda gives prime importance to maintain the healthiness of women and literature provides many references related to signs and symptoms of PCOS in the same way and hence PCOS correlated with Artava kshaya. This review aims to display comprehensive knowledge regarding the pathogenesis of PCOS and Artava Kshaya. The efforts made here will enable earlier identification of girls and adult women with a high propensity to develop PCOS. The timely implementation of individualized therapeutic interventions will improve the overall management of PCOS, prevent associated comorbidities, and improve quality of life. This review emphasizes the various etiological aspects and screening recommendations currently in use to prevent and manages PCOS.

scholarly journals HOW POLYCYSTIC OVARY SYNDROME (PCOS) AFFECTS THE FERTILITY POTENTIAL OF REPRODUCTIVE AGE FEMALES: REVIEW

2019 ◽  
Vol 1 (2) ◽  
pp. 77-84
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Embryonic Development ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Implantation Failure ◽  
Ovary Syndrome ◽  
Young Females ◽  
Ovulatory Dysfunction ◽  
Hormonal Dysfunction ◽  
Fertility Potential

Polycystic ovary syndrome (PCOS) is one of the major causes of decreased fertility in young females. Multiple extra- and intra-ovarian factors which are worked together or separately are responsible for sub-fertility. However, still, ovulatory dysfunction is the cornerstone that occurs as a result of hormonal dysfunction and consequently affects oocytes' quality, embryonic development and finally, implantation failure with a significant number of females seek assisted reproduction for getting pregnancy.

scholarly journals Promotion of reproductive and metabolic health - current trends in the treatment and prevention of polycystic ovary syndrome in different periods of life

2021 ◽  
Vol 47 (3) ◽  
pp. 130-149
Author(s):  
Joanna Smyczyńska
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Diagnostic Criteria ◽  
Polycystic Ovary ◽  
Hormonal Contraception ◽  
Reproductive Age ◽  
Metabolic Effects ◽  
Adult Women ◽  
Ovary Syndrome ◽  
Treatment And Prevention

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders and causes of infertility in women in reproductive age. Diagnostic criteria of PCOS in adult women include: ovulation disorders, hyperandrogenism and  polycystic ovaries. According to most recommendations, 2 out of these 3 criteria are confirm the diagnosis of PCOS. In girls during puberty and in the first years after menarche, different diagnostic criteria of menstrual disorders should be taken into account (variable length of menstrual cycles, monophasic cycles) and the limited usefulness of ultrasound examination for PCOS diagnosis within 8 years after menarche. Fairly extensive differential diagnosis is also necessary, especially – exclusion of adrenal hyperandrogenism. Moreover, the diagnostic criteria of PCOS do not take into account the metabolic disorders found in most patients (obesity, insulin resistance, type 2 diabetes), which should be diagnosed as early as possible and treated appropriately. This is especially true for teenagers, in whom the unequivocal diagnosis of PCOS or its exclusion may be very difficult. Current recommendations regard hormonal contraception as the first-line therapy in PCOS, in both adult women and adolescents. Together with its beneficial effect on the reduction of hyperandrogenism and obtaining regular bleeding (which in fact are not menstruations), the unfavorable metabolic effects of hormonal contraception are emphasized, as well as the inadequacy of its use if it is expected to achieve or restore ovulation and fertility. The latest reports indicate the legitimacy of treatment aimed at correcting disorders of carbohydrate metabolism and its greater effectiveness compared to the use of oral contraceptives in both adult women and girls with PCOS. In the pharmacotherapy of insulin resistance, metformin is of fundamental importance, the use of pioglitazone, GLP-1 receptor agonists or inositols is also proposed. Adequate lifestyle and dietary modification are of major importance in the treatment and prevention of PCOS. The mechanisms of "inheritance" of PCOS and insulin resistance with the participation of epigenetic modifications are still better understood, taking into account the effects of exposure to androgen excess in utero, intrauterine growth retardation, and maternal obesity and hyperalimentation. This creates new possibilities for PCOS prophylaxis.

Options for generating polycystic ovary syndrome based on experimental findings in animal models

2020 ◽  
Vol 69 (4) ◽  
pp. 89-100
Author(s):  
Maria I. Yarmolinskaya ◽  
Elena I. Abashova ◽  
Olga L. Bulgakova
Keyword(s):  
Animal Models ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Indirect Methods ◽  
Ovulatory Dysfunction ◽  
Ovarian Morphology ◽  
Genetic Interventions ◽  
Experimental Findings

Polycystic ovary syndrome (PCOS) is a common endocrine pathology that affects 814% of women of reproductive age. The leading signs of the disease are hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. Over the past decades, a variety of animal models have been developed to study the etiology and pathogenesis of PCOS, including chemical, hormonal, and genetic interventions. However, a large number of experimental techniques differ even in the framework of a single model. In this review article, we summarized PCOS animal models using both direct hormonal effects and indirect methods.

Cardiovascular Risk in Postmenopausal Women with Polycystic Ovary Syndrome

2019 ◽  
Vol 17 (6) ◽  
pp. 579-590 ◽  
Author(s):  
Eleni Armeni ◽  
Irene Lambrinoudaki
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Clinical Manifestations ◽  
Reproductive Age ◽  
Metabolic Disturbances ◽  
Cvd Risk ◽  
Ovary Syndrome ◽  
Female Population ◽  
Previous Diagnosis ◽  
Aging Women

Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting women of reproductive age. The hormonal alterations of PCOS have been linked with a higher risk of metabolic disturbances in young, reproductively active women. However, it remains to be clarified whether the presence of PCOS increases the risk of cardiovascular disease (CVD) later in life. Aging ameliorates the clinical manifestations of PCOS; hyperandrogenaemia and metabolic abnormalities, however, persist beyond the menopause. On the other hand, aging and menopause increase CVD risk in the general female population. The results of the limited available studies in aging women with a previous diagnosis of PCOS demonstrate early atherosclerosis. However, studies addressing clinical CVD outcomes in women with PCOS report inconsistent findings. A possible explanation for this heterogeneity is the difficulty in diagnosing PCOS after the menopausal transition, due to the absence of validated diagnostic criteria for this population. Larger prospective studies of women diagnosed during their reproductive years will shed more light on the longer-term CVD implications of PCOS.

scholarly journals Phenotype and Metabolic Disorders in Polycystic Ovary Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Olgierd Gluszak ◽  
Urszula Stopinska-Gluszak ◽  
Piotr Glinicki ◽  
Renata Kapuscinska ◽  
Hanna Snochowska ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Tolerance Test ◽  
Reproductive Age ◽  
Total Testosterone ◽  
Obese Women ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
Female Population ◽  
Group A

The polycystic ovary syndrome (PCOS) is one of the most frequent endocrinopathies in women. Its incidence is assessed at 6–8% of the female population in the reproductive age. It is characterised by oligomenorrhea (Oligo), hyperandrogenism (HA), and the presence of polycystic ovaries (PCOs). Carbohydrate and lipid metabolism is being disturbed in many women with PCOS. The pathogenesis of PCOS is still unexplained. Following the main criteria of diagnosis (Rotterdam Consensus 2003), Dewailly, Welt and Pehlivanov divided the patients with PCOS into 4 phenotype groups: A, B, C, and D. In our studies of 93 patients with PCOS, we found (1) the most frequent appearance (60,2%) of the phenotype A [Oligo + HA + PCO]; (2) an increased androstenedione concentration in a group with HA (A, B, C); (3) an increased HOMA-β and insulin concentration after 30 min an oral 75 g glucose tolerance test (OGTT) in a group of obese women with BMI>30 kg/m2; (4) high levels of total testosterone, total cholesterol, and LDL cholesterol concentrations in a group A with classic phenotype of PCOS: Oligo + HA + PCO—increasing the risk of development of cardiovascular diseases, type 2 diabetes, or metabolic syndrome. The average androstenedione concentrations could be a good diagnostic and prognostic parameter.

scholarly journals Effects of vitex agnes castus on hormonal imbalances in Polycystic Ovary Syndrome

2017 ◽  
Vol 6 (8) ◽  
pp. 2051
Author(s):  
Sugantha Saul
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Albino Rats ◽  
Phytochemical Analysis ◽  
Ovary Syndrome ◽  
Female Population ◽  
Positive Effects ◽  
Hormonal Imbalance ◽  
Agnus Castus

Background: The polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women. Its incidence is assessed at 6-8% of the female population in the reproductive age. It is caused by an imbalance of the female sex hormones and higher levels of male hormones called androgens.Methods: In women with PCOS, the ovaries make more androgens than normal. High levels of these hormones affect the development and release of eggs during ovulation. Hence the hormonal imbalance were studied in three groups. In the present study ,8mg of estradiol valerate was used to induce PCOS in female albino rats. The levels of leutinizing hormone, follicle stimulating hormone, testosterone, dehydroepiandrosterone sulphate, Estradiol, Progesterone, and Prolaction were studied.Results: The phytochemical analysis of vitex agnus castus was carried out and the positive effects of vitex agnus castus on the hormonal irregularities of PCOS were also studied. The present findings indicated that vitex agnus castus was found to be rich in phytochemicals.Conclusions: The hormonal levels highly reflect the underlying hormonal imbalance in PCOS and the results obtained in the present study also proved that vitex agnus castus is more efficient in reversing the adverse effects of hormonal imbalance of PCOS.

scholarly journals PAPSS2 gene molecular analysis in 46,XX patients with idiopathic hyperandrogenism

2019 ◽  
Author(s):  
Luana Gavioli dos Santos ◽  
Mara Sanches Guaragna ◽  
Taís N. Mazzola ◽  
Sofia Helena Valente de Lemos Marini ◽  
Gil Guerra Júnior ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Sanger Sequencing ◽  
Gene Sequence ◽  
Polycystic Ovary ◽  
Adult Women ◽  
Androgen Excess ◽  
Ovary Syndrome ◽  
Endocrine Disorder ◽  
Pathogenic Variants ◽  
Ovulatory Dysfunction

Androgen excess is the most common endocrine disorder of adult women. Polycystic ovary syndrome and idiopathic hyperandrogenism (IH) are the first and the second most common androgen disorder, respectively. Women with IH may present with hirsutism, ovulatory dysfunction, infertility and even virilization and masculinization. Mutations in PAPSS2 gene were recently published as a genetic cause of IH. Therefore, the aim of this study was to analyse the PAPSS2 gene sequence in 10 patients with diagnosis of IH.After PAPSS2 gene Sanger sequencing in ten IH patients, no pathogenic variants were identified. We identified rare heterozygous SNVs in three patients, however they are present in databases with no correlation with androgen excess.

scholarly journals Treatment of adolescent girls with polycystic ovary syndrome and insulin resistance

2018 ◽  
Vol 17 (2) ◽  
pp. 13-20
Author(s):  
E. M. Bogatyreva ◽  
G. A. Novik
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Adolescent Girls ◽  
Ethinyl Estradiol ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Metabolic Complications ◽  
Study Results ◽  
Oral Preparation

Aim. Polycystic ovary syndrome is a common cause of infertility. In addition, polycystic ovary syndrome is often associated with metabolic complications. In most women hyperandrogenic manifestations occur during puberty. Early detection of polycystic ovary syndrome and associated metabolic problems can solve the problem of puberty and prevent infertility, metabolic syndrome, and diabetes mellitus type 2 in women of reproductive age. One of the objectives of the study was to evaluate the effectiveness of the simultaneous use of a combined oral preparation (ethinyl estradiol + drospirenone) and metformin in adolescent girls with polycystic ovary syndrome.Materials and methods. 113 adolescent girls with hyperandrogenism from 14 to 19 years were included. 32 of these girls aged 14–18 years with polycystic ovary syndrome were treated with medication ethinyl estradiol + drospirenone. Of these 32 patients, 20 girls with insulin resistance were obtained simultaneously with metformin. The following methods were used: examination, evaluation of hair (Ferriman-Gallwey score), pelviс ultrasound, determination of hormone status (LH, FSH, PRL, 17-OHP, E2 , TSH, DHEA-s, SHBG, T), glucose, insulin, and glucose tolerance test. The diagnostic technique used the Sultan C. criteria of polycystic ovary syndrome (2004).Results.A reduction in the frequency characteristics after treatment was shown: of laboratory hyperandrogenism 90.6% , dermopathy 65.6% , insulin resistance 43.8%, hyperinsulinemia 18.8%, ultrasonic signs of PCOS 34.4%.Conclusions. The study results confirm the efficacy of the treatment of polycystic ovary syndrome with insulin resistance during puberty by Low-dose combined oral preparation (0.03 mg ethinyl estradiol and 3 mg drospirenone) in combination with metformin. 

scholarly journals Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls

2019 ◽  
Vol 3 (8) ◽  
pp. 1545-1573 ◽  
Author(s):  
Selma Feldman Witchel ◽  
Sharon E Oberfield ◽  
Alexia S Peña
Keyword(s):  
At Risk ◽  
Polycystic Ovary Syndrome ◽  
Diagnostic Criteria ◽  
Adolescent Girls ◽  
Polycystic Ovary ◽  
Therapeutic Interventions ◽  
Normal Female ◽  
Adult Women ◽  
Care Providers ◽  
Ovary Syndrome

AbstractPolycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by hyperandrogenism and chronic anovulation. Depending on diagnostic criteria, 6% to 20% of reproductive aged women are affected. Symptoms of PCOS arise during the early pubertal years. Both normal female pubertal development and PCOS are characterized by irregular menstrual cycles, anovulation, and acne. Owing to the complicated interwoven pathophysiology, discerning the inciting causes is challenging. Most available clinical data communicate findings and outcomes in adult women. Whereas the Rotterdam criteria are accepted for adult women, different diagnostic criteria for PCOS in adolescent girls have been delineated. Diagnostic features for adolescent girls are menstrual irregularity, clinical hyperandrogenism, and/or hyperandrogenemia. Pelvic ultrasound findings are not needed for the diagnosis of PCOS in adolescent girls. Even before definitive diagnosis of PCOS, adolescents with clinical signs of androgen excess and oligomenorrhea/amenorrhea, features of PCOS, can be regarded as being “at risk for PCOS.” Management of both those at risk for PCOS and those with a confirmed PCOS diagnosis includes education, healthy lifestyle interventions, and therapeutic interventions targeting their symptoms. Interventions can include metformin, combined oral contraceptive pills, spironolactone, and local treatments for hirsutism and acne. In addition to ascertaining for associated comorbidities, management should also include regular follow-up visits and planned transition to adult care providers. Comprehensive knowledge regarding the pathogenesis of PCOS will enable earlier identification of girls with high propensity to develop PCOS. Timely implementation of individualized therapeutic interventions will improve overall management of PCOS during adolescence, prevent associated comorbidities, and improve quality of life.

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