scholarly journals Clinical features of polycystic ovary syndrome phenotypes in women with normogonadotropic anovulation in reproductive age

2019 ◽  
Vol 68 (3) ◽  
pp. 7-14
Author(s):  
Elena I. Abashova ◽  
Maria A. Shalina ◽  
Elena V. Misharina ◽  
Natalia N. Tkachenko ◽  
Olga L. Bulgakova
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Carbohydrate Metabolism ◽  
Clinical Features ◽  
Endometrial Hyperplasia ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Chronic Endometritis

Hypothesis/aims of study. Polycystic ovary syndrome (PCOS) is a common disease, the frequency of which ranges from 8 to 13% in women of reproductive age. PCOS is a complex polygenic endocrine disorder with reproductive, metabolic, and psychological features. Currently, four PCOS phenotypes are identified that are associated with metabolic disorders, insulin resistance, impaired glucose tolerance (IGT), diabetes mellitus, and an increase in the number of risk factors for cardiovascular diseases. The aim of this study was to investigate the clinical features of PCOS phenotypes in women with normogonadotropic anovulation in reproductive age. Study design, materials, and methods. The study included 60 women of reproductive age from 24 to 37 years (mean age 28 ± 4 years) with PCOS and normogogonadotropic, normoprolactinemic anovulation. We studied the levels of anti-mullerian, follicle-stimulating, luteinizing hormone, prolactin, estradiol, and androgens from days 2 to 5 of the menstrual cycle. The serum progesterone level was studied by ELISA using test systems manufactured by Alkor Bio Ltd. (Russia) on days 20–23 of the menstrual cycle for three consecutive cycles. The average level of progesterone in the blood on days 20–23 of the menstrual cycle was 3.1 ± 1.5 nM. Echographic methods for diagnosing polycystic ovaries were used. All women included in the study underwent hysteroscopy on days 18–22 of the menstrual cycle, followed by a histological and immunohistochemical study of the endometrium. Results. In women with anovulatory PCOS phenotypes, phenotype A (classical) was detected in 32 (53.3%) women; phenotype B (anovulatory) in 18 (30%) women; phenotype D (non-androgenic) in 10 (16.7%) women with. In 32 (53.3%) patients, changes in carbohydrate metabolism (IGT) were found. Clinical and biochemical manifestations of androgen-dependent dermopathy (acne, oily seborrhea, and hirsutism) were significantly (p < 0.05) more often observed in PCOS patients with phenotypes A (84.4%) and B (88.9%) than in women with phenotype D (30%). In the majority (93.8%) of patients with IGT, the androgenic-anovulatory PCOS phenotypes were detected: phenotype A in 20 (62.5%) women and phenotype B in 10 (31.3%) women. Phenotype D (non-androgenic) was present only in two women with PCOS and IGT. As a result of complex histological and immunohistochemical studies of endometrial biopsy specimens, chronic endometritis was detected in 44 (73.3%) examined women with PCOS and simple glandular endometrial hyperplasia was diagnosed in 13 (21.7%) PCOS patients. The incidence of chronic endometritis and simple glandular endometrial hyperplasia in women with normogonadotropic anovulation and PCOS directly depended (r = 0.35; p < 0.05) on disorders of carbohydrate metabolism and was detected more often in patients with PCOS and IGT. Conclusion. The differential approach to the examination of patients with various PCOS phenotypes allows personalizing the therapy of this disease and determining the complex of preventive measures to improve the quality of life of women of reproductive age.

scholarly journals Features of Chronic Endometritis in Women of Reproductive Age with Polycystic Ovary Syndrome

2021 ◽  
Vol 5 (6) ◽  
pp. 27-36
Author(s):  
E. M. Sharifulin ◽  
I. A. Igumnov ◽  
O. V. Krusko ◽  
A. V. Atalyan ◽  
L. V. Suturina
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Chronic Endometritis

scholarly journals Lipid profile in women of reproductive age with various polycystic ovary syndrome phenotypes

2021 ◽  
Vol 69 (6) ◽  
pp. 7-16
Author(s):  
Elena I. Abashova ◽  
Maria I. Yarmolinskaya ◽  
Olga L. Bulgakova ◽  
Elena V. Misharina
Keyword(s):  
Insulin Resistance ◽  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Glucose Tolerance ◽  
Impaired Glucose Tolerance ◽  
Lipid Profile ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome

Hypothesis/Aims of study. Dyslipidemia is a common metabolic disorder and is an atherogenic factor in the development of cardiovascular disease in women with polycystic ovary syndrome. Currently, four phenotypes of polycystic ovary syndrome are distinguished, associated in varying degrees of severity with dyslipidemia, insulin resistance, impaired glucose tolerance, and diabetes mellitus on one hand and chronic inflammation and oxidative stress on the other. Hyperandrogenic phenotypes (A, B, C) in polycystic ovary syndrome are associated with the development of adverse metabolic disorders and associated complications. The aim of this study was to evaluate the lipid profile in the serum of women of reproductive age with various polycystic ovary syndrome phenotypes. Study design, materials and methods. The study included 86 women of reproductive age from 22 to 37 years old (average age was 26.6 4.3 years), who, in accordance with polycystic ovary syndrome phenotypes (A, B, C, D), were divided into four groups. We studied the levels of anti-Mllerian hormone, follicle-stimulating and luteinizing hormones, prolactin, estradiol, and androgens from days 2 to 5 of the menstrual cycle. The levels of progesterone in the blood serum were determined by the enzyme immunoassay on days 20 to 23 of the menstrual cycle for three consecutive cycles. We also used echographic methods for diagnosing polycystic ovaries. All women underwent a biochemical blood test with an assessment of the lipid profile parameters (total cholesterol, triglycerides, high-density lipoproteins (HDL), and low-density lipoproteins, LDL). Besides, an oral glucose tolerance test was assessed with the study of plasma glucose and insulin levels on an empty stomach and two hours after ingestion of 75 g of glucose, the HOMA-IR index being used to assess insulin resistance. Results. Phenotype A was found in 40 (46.5%) women with polycystic ovary syndrome, phenotype B in 22 (25.6%), phenotype C in 10 (11.6%), and phenotype D (non-androgenic) in 14 (16.3%) patients with PCOS. Of those 42 (48.8%) individuals had changes in carbohydrate metabolism (impaired glucose tolerance), of whom 39 (92.8%) women had androgenic polycystic ovary syndrome phenotypes (A, B, C). Both non-androgenic phenotype D and impaired glucose tolerance were found in 7.2% of cases. In women with hyperandrogenic polycystic ovary syndrome phenotypes, both the fasting and stimulated insulin levels were increased significantly comparing to the non-androgenic anovulatory phenotype (p 0.05). The HOMA-IR index in women with phenotypes A, B and C was significantly (p 0.05) higher than in patients with non-androgenic phenotype D. When evaluating the lipid profile parameters, no significant differences in cholesterol level and atherogenic coefficient in women with various polycystic ovary syndrome phenotypes were found. The levels of triglycerides and LDL were significantly (p 0.05) higher in women with androgenic phenotype B compared to those in patients with non-androgenic phenotype D and they correlated significantly (p 0.05) with the serum levels of androgens and sex hormone-binding globulin (SHBG). Patients with androgenic polycystic ovary syndrome phenotypes (A and B) had significantly (p 0.05) decreased HDL levels that correlated negatively (r = 0.29; p 0.05) with the levels of free testosterone and SHBG, when compared to the same parameters in women with non-androgenic phenotype D. In women with androgenic polycystic ovary syndrome phenotypes (A, B, C), a significant correlation (r = 0.27; p 0.05) between the levels of stimulated insulin and SHBG were found, and a direct relation (r = 0.32; p 0.05) between those parameters and increased levels of triglycerides and LDL was also revealed. Conclusion. In women with hyperandrogenic and anovulatory polycystic ovary syndrome phenotypes A and B, atherogenic dyslipidemia and impaired carbohydrate metabolism were significantly more pronounced, when compared with patients with non-androgenic phenotype D. A differential and personalized approach to the examination of patients with various polycystic ovary syndrome phenotypes is an important step in the prevention of the risks of developing cardiovascular diseases in women of reproductive age.

Disorders of steroid metabolism in women of reproductive age with polycystic ovary syndrome

2021 ◽  
Author(s):  
Olga Glavnova ◽  
Ludmila Velikanova ◽  
Natalia Vorokhobina ◽  
raviliy Galakhova ◽  
Ekaterina Malevanania ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Steroid Metabolism ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome

scholarly journals Pharmacological Treatment of Obesity in Patients with Polycystic Ovary Syndrome

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Hassan Kahal ◽  
Stephen L. Atkin ◽  
Thozhukat Sathyapalan
Keyword(s):  
Cardiovascular Risk ◽  
Polycystic Ovary Syndrome ◽  
Weight Reduction ◽  
Pharmacological Treatment ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Prevalence Of Obesity ◽  
Treatment Of Obesity

Polycystic ovary syndrome (PCOS) is a common disorder affecting women of reproductive age and it is associated with increased cardiovascular risk. Obesity plays an important role in the pathogenesis of PCOS, and the majority of patients with PCOS are obese. Over the last 20 years, the prevalence of obesity has dramatically increased, with probable associated increase in PCOS. Weight reduction plays an integral part in the management of women with PCOS. In this paper, current available weight reduction therapies in the management of PCOS are discussed.

Polycystic ovary syndrome: reproductive aspects

2011 ◽  
pp. 1229-1234
Author(s):  
Sophie Catteau-Jonard ◽  
Cécile Gallo ◽  
Didier Didier
Keyword(s):  
Insulin Resistance ◽  
Metabolic Syndrome ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Therapeutic Approaches ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome ◽  
Common Cause ◽  
The Metabolic Syndrome

The polycystic ovary syndrome (PCOS) is the most common cause of anovulation and hyperandrogenism in women, affecting between 5 and 10% of women of reproductive age worldwide (1). Although this difficult topic in endocrine gynaecology is under extensive research, controversies still remain about the pathophysiology, diagnosis, and therapy of PCOS. The PCOS phenotype can be structured in three components: manifestations of anovulation, hyperandrogenism, and the metabolic syndrome (of which hyperinsulinaemia secondary to insulin resistance is the central abnormality). The latter two are addressed in other chapters. Our knowledge about the mechanism of disturbed folliculogenesis in PCOS that is responsible for its reproductive aspects has much increased these last years, thus opening new avenues for the diagnostic and therapeutic approaches.

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 Efficiency of application of metformin and its combination with combined oral ontrceptive, containing drospirenone, in women with polycystic ovary syndrome

2013 ◽  
Vol 62 (4) ◽  
pp. 55-60
Author(s):  
Yelena Leonidovna Soboleva
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Carbohydrate Metabolism ◽  
High Efficiency ◽  
Polycystic Ovary ◽  
Therapeutic Option ◽  
Combined Therapy ◽  
Combined Treatment ◽  
Ovary Syndrome ◽  
Restoration Of Fertility

The article represents results of monotherapy with metformin, as well as combined treatment with metformin and combined oral contraceptive (COC), containing drospirenone, in patients with polycystic ovary syndrome (PCOS). In general, treatment was given to 42 patients with PCOS. Combined treatment was prescribed to 18 of them. Equally high efficiency of both schemes of treatment in correction of disorders of carbohydrate metabolism was demonstrated. But efficacy of metformin alone in restoration of ovulatory menstrual cycle was low – ovulation occurred in 3 patients (13 %) and only two women (8.7 %)became pregnant. These results do not allow recommendation of monotherapy with this medication for restoration of fertility. Implication of combined therapy has shown benefits in normalization of menstrual cycle, ultrasound structure and volume of ovaries. COC with drospirenone also has antiandrogenic properties. So combination of metformin with COC, containing drospirenone, can be recommended as a first-line therapeutic option for patients with PCOS and impaired carbohydrate metabolism.

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