A Review of the Gut-Uterine Axis in Persian Medicine Literature: Implications in Polycystic Ovary Syndrome

2020 ◽  
Author(s):  
Ayeh Naghizadeh ◽  
Mohammad Ali Zareian ◽  
Maliheh Tabarrai
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Holistic Approach ◽  
Mutual Relationship ◽  
Menstrual Disorders ◽  
Reproductive Systems ◽  
Ovary Syndrome ◽  
Disease States ◽  
Persian Medicine ◽  
Digestive Disorders

Persian medicine (PM) takes a holistic approach towards diagnosis and management of disease states, focusing on the connections between body systems and organs. Menstrual disorders are of utmost importance in women, as they may lead to dysfunctions in other body systems. Deeming a mutual relationship between the gastrointestinal and female reproductive systems, PM physicians believed in a gut-uterine axis to exist. Ehtebas-e Tams (ET), meaning menstrual retention, is not an exception, being accompanied by gastrointestinal morbidities including digestive disorders, nausea, heartburn, food craving and pica, reduced appetite, abdominal pain, and bloody diarrhea. Considering polycystic ovary syndrome (PCOS) as an instance of ET, we searched studies to investigate these correlations. While a number of the mentioned ET symptoms were confirmed by contemporary studies, others had not been investigated widely and are yet to be elucidated. Conducting studies to clarify such correlations has implications in improved diagnosis and novel modes of treatment.

MENSTRUAL DISORDERS AND ANDROGEN-RELATED TRAITS IN YOUNG WOMEN WITH TYPE 1 DIABETES MELLITUS: A CLINICAL STUDY

2020 ◽  
Vol 26 (11) ◽  
pp. 1269-1276
Author(s):  
Stavroula A. Paschou ◽  
Andromachi Vryonidou ◽  
Marina Melissourgou ◽  
Ioanna Kosteria ◽  
Dimitrios G. Goulis ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Type 1 Diabetes ◽  
Polycystic Ovary Syndrome ◽  
Type 1 Diabetes Mellitus ◽  
Young Women ◽  
Polycystic Ovary ◽  
Menstrual Disorders ◽  
Ovary Syndrome ◽  
Pcos Group

Objective: To investigate possible causes of menstrual disorders and androgen-related traits in young women with type 1 diabetes mellitus (T1DM). Methods: Fifty-three women with T1DM (duration 8.0 ± 5.6 years), 41 women with (polycystic ovary syndrome) PCOS, and 51 controls matched for age (19.4 ± 4.3 years vs. 21.2 ± 2.7 years vs. 20.8 ± 3.1 years; P>.05) and body mass index (BMI) (22.2 ± 2.7 kg/m2 vs. 21.9 ± 2.0 kg/m2 vs. 21.4 ± 1.9 kg/m2; P>.05) were prospectively recruited. Results: Two women (3.8%) in the T1DM group had not experienced menarche (at 15.5 and 16.6 years); of the rest, 23.5% had oligomenorrhea, 32.1% hirsutism, and 45.3% had acne. The age at menarche was delayed in the T1DM group compared to controls (12.7 ± 1.3 vs. 12.0 ± 1.0 years; P = .004), while no difference was observed with the polycystic ovary syndrome (PCOS) group (12.4 ± 1.2 years). There were no differences in total testosterone (0.43 ± 0.14 ng/mL vs. 0.39 ± 0.14 ng/mL; P>.05), dehydroepiandrosterone sulfate (DHEA-S) (269 ± 112 μg/dL vs. 238 ± 106 μg/dL; P>.05) or Δ4-androstenedione (2.4 ± 1.3 ng/mL vs. 1.9 ± 0.5 ng/mL; P>.05) concentrations between T1DM and controls. However, patients with T1DM had lower sex hormone binding globulin (SHBG) concentrations than controls (61 ± 17 nmol/L vs. 83 ± 18.1 nmol/L; P = .001), which were even lower in the PCOS group (39.5 ± 12.9 nmol/L; P = .001 compared with T1DM). The free androgen index (FAI) was higher in the PCOS group compared with both other groups (T1DM vs. PCOS vs. controls: 2.53 ± 0.54 vs. 7.88 ± 1.21 vs. 1.6 ± 0.68; P<.001). FAI was higher in patients with T1DM compared to controls as well ( P = .038). There was no difference in DHEA-S concentrations between T1DM and PCOS patients (269 ± 112 μg/dL vs. 297 ± 100 μg/dL; P>.05). Conclusion: Menstrual disorders and androgen-related traits in young women with T1DM may be attributed to an increase in androgen bioavailability due to decreased SHBG concentrations. Abbreviations: Δ4A = Δ4-androstenedione; BMI = body mass index; CI = confidence interval; CV = coefficient of variation; DHEA-S = dehydroepiandrosterone sulfate; FAI = free androgen index; HbA1c = glycated hemoglobin; PCOS = polycystic ovary syndrome; RIA = radioimmunoassay; SHBG = sex hormone binding globulin; T1DM = type 1 diabetes mellitus

scholarly journals Effects of oral contraceptives on the quality of life of women with polycystic ovary syndrome: a crossover randomized controlled trial

2020 ◽  
Author(s):  
Mina Amiri ◽  
Fatemeh Nahidi ◽  
Razieh Bidhendi-Yarandi ◽  
Davood Khalili ◽  
Maryam Tohidi ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Polycystic Ovary Syndrome ◽  
Sexual Function ◽  
Oral Contraceptives ◽  
Polycystic Ovary ◽  
Menstrual Disorders ◽  
Ovary Syndrome ◽  
Randomized Controlled ◽  
Self Image

Abstract Background and objective A limited number of studies have evaluated the effects of oral contraceptives (OCs) on the quality of life (QOL) of polycystic ovary syndrome (PCOS) patients. This study aimed to compare the effects of using OCs containing levonorgestrel (LNG) and those containing desogestrel (DSG), cyproterone acetate (CPA) or drospirenone (DRSP) for 6 months on the QOL with PCOS. Methods In this crossover randomized controlled 6-arm trial, 200 eligible patients with PCOS scheduled for OC therapy were randomly assigned to one of the 6 study arms. All 6 arms include two 6-month treatment periods, one period with OCs containing LNG, and the other with each of the 3 OCs containing DSG, CPA, or DRSP. Outcomes of interest were the total score of QOL and its domains, which were assessed using a specific and valid health‐related quality of life questionnaire for PCOS, which is consisted of six domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity– menstrual disorders.Results Finally, a total of 88 patients were analyzed for this study. The results showed that use of OCs containing DSG, CPA, and DRSP for 3 months was not associated with significant differences in the total scores of QOL compared to those OCs containing LNG, whereas, after 6 months of treatment, patients treated with OCs containing CPA had more improvements in their total scores of QOL, in comparison to OCs containing LNG (P < 0.042). We found no significant differences in QoL domains, including psychosocial–emotional, self-image, fertility, sexual function, hirsutism, and obesity-menstrual disorders after 3- 6 months of treatment with DSG, CPA, or DRSP, compared to LNG. The sequence and period effects were not significant in any of the analyses at 3 and 6 months of treatment. The carry-over effect was not significant for most outcomes assessed. Conclusions This crossover study demonstrated non-inferiority of OCs with newer generation progestins on different domains of QOL, in comparison with older compounds, although usage of products containing CPA was significantly associated with more improvement in total QOL of PCOS patients, compared to those containing LNG after 6-month of treatment. Clinical Trial Registration Number: IRCT201702071281N2.

scholarly journals The Treatment with Complementary and Alternative Traditional Chinese Medicine for Menstrual Disorders with Polycystic Ovary Syndrome

2021 ◽  
Vol 2021 ◽  
pp. 1-19
Author(s):  
Yuehui Zhang ◽  
Xiaozhu Guo ◽  
Shuting Ma ◽  
Haoyue Ma ◽  
Hang Li ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Polycystic Ovary Syndrome ◽  
Alternative Medicine ◽  
Traditional Medicine ◽  
Polycystic Ovary ◽  
World Health ◽  
Menstrual Disorders ◽  
Ovary Syndrome ◽  
The World ◽  
Complementary And Alternative

Polycystic ovary syndrome (PCOS) is a frequent gynecological female endocrinopathy, characterized by chronic anovulation, hyperandrogenism, and insulin resistance (IR). Menstrual disorders are one of the main clinical manifestations of PCOS. Other symptoms include hirsutism and/acne. At present, the treatment of PCOS with irregular menstruation is mainly based on oral contraceptives, but there are some side effects and adverse reactions. In recent years, more and more attention has been paid to the complementary and alternative medicine (CAM), which has been widely used in clinical practice. Modern Western medicine is called “conventional medicine” or “orthodox medicine,” and the complementary and alternative medicine is called “unconventional medicine” or “unorthodox medicine.” CAM includes traditional medicine and folk therapy around the world. Around 65–80% of world health management business is classified into traditional medicine by the World Health Organization, which is used as alternative medicine in Western countries. In our country, Chinese medicine, acupuncture, and other therapies are commonly used due to their significant efficacy and higher safety. Therefore, this review aims to summarize and evaluate the mechanisms and the effect of current complementary replacement therapy in the treatment of menstrual disorders caused by PCOS, so as to provide guidance for the following basic and clinical research.

scholarly journals Serum zonulin is elevated in women with polycystic ovary syndrome and correlates with insulin resistance and severity of anovulation

2015 ◽  
Vol 172 (1) ◽  
pp. 29-36 ◽  
Author(s):  
Dongmei Zhang ◽  
Li Zhang ◽  
Fangzhi Yue ◽  
Yingying Zheng ◽  
Ryan Russell
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Inverse Correlation ◽  
Sensitivity Index ◽  
Model Assessment ◽  
Gut Permeability ◽  
Menstrual Disorders ◽  
Ovary Syndrome ◽  
Therapeutic Outcomes

ObjectiveEvidence suggests that increased gut permeability may be associated with polycystic ovary syndrome (PCOS). Human zonulin is currently the only physiological mediator known to reversibly regulate gut permeability by disassembling intestinal tight junctions. So far, no data on serum zonulin levels in patients with PCOS are available. This study aimed to determine circulating serum zonulin levels in women with PCOS and discuss the relationship between zonulin, insulin resistance, and menstrual disorders in this group.DesignA case–control study.MethodsThe study includes 78 women recently diagnosed with PCOS and 63 age-matched healthy controls recruited. Serum zonulin levels were determined by ELISA. Insulin resistance was assessed by homeostasis model assessment of insulin resistance (HOMA-IR) and Matsuda and DeFronzo's insulin sensitivity index (ISI).ResultsPCOS women had higher serum zonulin levels (P=0.022). After adjustment for age and BMI, zonulin levels significantly correlated with HOMA-IR and ISI. Furthermore, PCOS women with more severe menstrual disorders had significantly higher zonulin levels and displayed an inverse correlation between zonulin and the number of menstrual cycles per year (r=−0.398, P<0.001).ConclusionsSerum zonulin, a biomarker for gut permeability, is increased in PCOS women and correlates with insulin resistance and severity of menstrual disorders. It suggests that alterations in gut permeability may play a role in the pathophysiology of PCOS, and serum zonulin might be used as a biomarker for both risk stratification and therapeutic outcomes in PCOS women.

scholarly journals Cancer risk among infertile women with androgen excess or menstrual disorders (including polycystic ovary syndrome)

2010 ◽  
Vol 94 (5) ◽  
pp. 1787-1792 ◽  
Author(s):  
Louise A. Brinton ◽  
Kamran S. Moghissi ◽  
Carolyn L. Westhoff ◽  
Emmet J. Lamb ◽  
Bert Scoccia
Keyword(s):  
Cancer Risk ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Menstrual Disorders ◽  
Androgen Excess ◽  
Ovary Syndrome ◽  
Infertile Women

Wet-cupping on calf muscles in polycystic ovary syndrome: a quasi-experimental study

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Azam Meyari ◽  
Mojgan Tansaz ◽  
Fahimeh Ramezani Tehrani ◽  
Roshanak Mokaberinejad ◽  
Mahdi Biglarkhani ◽  
...  
Keyword(s):  
Experimental Study ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
P Value ◽  
Ovary Syndrome ◽  
Menstrual Cycles ◽  
Free Androgen Index ◽  
Persian Medicine ◽  
Quasi Experimental ◽  
Calf Muscles

Abstract Objectives Current modalities for treating polycystic ovary syndrome (PCOS) are not curative and using them for a long period is associated with adverse effects. According to Persian Medicine recommendations, wet cupping on calf muscles can induce menstrual bleeding. In the present study, the effect of wet-cupping (traditional bleeding from capillary vessels) was assessed on menstrual cycles (as primary outcome), hirsutism, and laboratory manifestation of PCOS. Methods A quasi-experimental study was conducted from 2016/5/21 until 2017/5/20 on 66 PCOS women within the age range of 20–40 years and a menstrual interval of at least 60 days during the last year. Participants’ calf muscles were cupped on day 26 of their last menstruation cycle following the Persian Medicine recommendations. They were followed for 12 weeks and a menstruation history and physical examination was done twice (4 and 12 weeks after wet cupping). Insulin Resistance (IR) and Free Androgen Index (FAI) were evaluated at baseline and end of the study. Results Wet-cupping on calf muscles significantly improved menstrual cycles’ frequency 0.37(95% CI: 0.13, 0.51), p-value=0.001 and hirsutism after 4 and 12 weeks of intervention were −1.9 (95% CI: −2.5, −0.5), p-value<0.001 and −1.4(95% CI: −2.1, −0.8), p-value<0.001, respectively. While it was not significant in changing the IR and FAI. About 33% of participants suffered from mild temporary discomforts (which were resolved within a few minutes of rest) and 9% reported mild long-term side effects. Conclusions It is considered that wet-cupping on calf muscles can be propounded as an optional treatment of PCOS for those not willing to use chemical medication.

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