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 Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances

2014 ◽  
Vol 58 (2) ◽  
pp. 182-187 ◽  
Author(s):  
Poli Mara Spritzer
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Diagnostic Criteria ◽  
Polycystic Ovary ◽  
Pharmacological Therapy ◽  
Lifestyle Changes ◽  
Reproductive Age ◽  
Metabolic Dysfunction ◽  
Metabolic Disturbances ◽  
Ovary Syndrome ◽  
Individual Woman

Polycystic ovary syndrome (PCOS) is a common condition in women at reproductive age associated with reproductive and metabolic dysfunction. Proposed diagnosed criteria for PCOS include two out of three features: androgen excess, menstrual irregularity, and polycystic ovary appearance on ultrasound (PCO), after other causes of hyperandrogenism and dysovulation are excluded. Based on these diagnostic criteria, the most common phenotypes are the “classic PCOS” – hyperandrogenism and oligomenorrhea, with or without PCO; the “ovulatory phenotype” – hyperandrogenism and PCO in ovulatory women; and the “non-hyperandrogenic phenotype”, in which there is oligomenorrhea and PCO, without overt hyperandrogenism. The presence of obesity may exacerbate the metabolic and reproductive disorders associated with the syndrome. In addition, PCOS women present higher risk for type 2 diabetes and higher prevalence of cardiovascular risk factors that seems to be associated with the classic phenotype. The main interventions to minimize cardiovascular and metabolic risks in PCOS are lifestyle changes, pharmacological therapy, and bariatric surgery. Treatment with metformin has been shown to improve insulin sensitivity, lowering blood glucose and androgen levels. These effects are more potent when combined with lifestyle interventions. In conclusion, besides reproductive abnormalities, PCOS has been associated to metabolic comorbidities, most of them linked to obesity. Confounders, such as the lack of standard diagnostic criteria, heterogeneity of the clinical presentation, and presence of obesity, make management of PCOS difficult. Therefore, the approach to metabolic abnormalities should be tailored to the risks and treatment goals of each individual woman.

scholarly journals Environmental exposure to triclosan and polycystic ovary syndrome: a cross-sectional study in China

BMJ Open ◽  
2018 ◽  
Vol 8 (10) ◽  
pp. e019707 ◽  
Author(s):  
Jiangfeng Ye ◽  
Wenting Zhu ◽  
Han Liu ◽  
Yuchan Mao ◽  
Fan Jin ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Clinical Manifestations ◽  
Endocrine Disrupting Compounds ◽  
Cross Sectional Study ◽  
Reproductive Age ◽  
Sectional Study ◽  
Ovary Syndrome ◽  
Cross Sectional ◽  
Pcos Group

ObjectivesPolycystic ovary syndrome (PCOS) is the most common endocrinopathy of women at reproductive age. Although the aetiology of PCOS remains unclear, potential effects of environmental endocrine-disrupting compounds on the development of PCOS have drawn increasing attention. The aim of the current study was to examine the association between triclosan (TCS) and PCOS, and explore possible mechanisms on how TCS may contribute to the development of clinical manifestations of PCOS.DesignCross-sectional study.SettingThis study was conducted in one tertiary-level hospital located in Zhejiang, China.ParticipantsA total of 674 infertile women at 18–45 years of age were recruited in 2014–2015. Participants with (n=84) and without (n=212) PCOS with urinary TCS concentration available were included in the analyses.MethodsUrinary TCS concentration was measured using a high-performance liquid chromatography–electrospray ionisation tandem mass spectrometry. Logistic regression model was used to examine the association between TCS and PCOS. Fractional polynomial regression models were built to fit the potential non-linear relationship between TCS concentrations and luteinising hormone (LH) and LH/follicle stimulate hormone (FSH).ResultsThe PCOS group had significantly higher level of TCS concentration than the non-PCOS group (the median of TCS (IQR), μg/g creatinine: 1.49 (0.68–3.80) vs 1.06 (0.52–3.02), p=0.0407). Compared with the lowest tertile, the highest tertile of TCS concentration was associated with an increased odd of PCOS (OR 2.12, 95% CI 1.12 to 3.99). After adjusting for potential confounders, the significant association remained (OR 1.99, 95% CI 1.05 to 3.79). Positive relationships were found between TCS levels and LH and LH/FSH ratio in non-PCOS participants.ConclusionsTCS exposure at a relatively low level is associated with PCOS in Chinese women. Further epidemiological studies are needed to confirm our finding, which may have important public health implications.

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.

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 5α-dihydrotestosterone treatment induces metabolic changes associated with polycystic ovary syndrome without interfering with hypothalamic leptin and glucocorticoid signaling

2016 ◽  
Vol 68 (3) ◽  
pp. 473-481
Author(s):  
Marina Nikolic ◽  
Natasa Velickovic ◽  
Ana Djordjevic ◽  
Biljana Bursac ◽  
Djuro Macut ◽  
...  
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Day Treatment ◽  
Reproductive Age ◽  
Female Rats ◽  
Leptin Resistance ◽  
Polycystic Ovaries ◽  
Metabolic Disturbances ◽  
Inflammatory Signaling ◽  
Ovary Syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age. It is a heterogenous disorder, with hyperandrogenism, chronic anovulation and polycystic ovaries as basic characteristics, and associated metabolic syndrome features. Increased secretion of leptin and leptin resistance are common consequences of obesity. Leptin is a hormone with anorexigenic effects in the hypothalamus. Its function in the regulation of energy intake and consumption is antagonized by glucocorticoids. By modulating leptin signaling and inflammatory processes in the hypothalamus, glucocorticoids can contribute to the development of metabolic disturbances associated with central energy disbalance. The aim of the study was to examine the relationship between hypothalamic leptin, glucocorticoid and inflammatory signaling in the development of metabolic disturbances associated with PCOS. The study was conducted on an animal model of PCOS generated by a continual, 90-day treatment of female rats with 5?-dihydrotestosterone (DHT). The model exhibited all key reproductive and metabolic features of the syndrome. mRNA and/or protein levels of the key components of hypothalamic glucocorticoid, leptin and inflammatory pathways, presumably contributing to energy disbalance in DHT-treated female rats, were measured. The results indicated that DHT treatment led to the development of hyperphagia and hyperleptinemia as metabolic features associated with PCOS. However, these metabolic disturbances could not be ascribed to changes in hypothalamic leptin, glucocorticoid or inflammatory signaling pathways in DHT-treated rats.

scholarly journals Ovarian stromal hyperthecosis

2014 ◽  
Vol 95 (5) ◽  
pp. 692-696
Author(s):  
A A Khasanov ◽  
V I Zhuravleva ◽  
I O Lipatova
Keyword(s):  
Breast Cancer ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Ovarian Tissue ◽  
Clinical Manifestations ◽  
Final Diagnosis ◽  
Severe Form ◽  
Reproductive Age ◽  
Women Of Reproductive Age ◽  
Ovary Syndrome

The review analyzes the data on pathogenesis, prevalence, pathomorphology, clinical manifestations, diagnosis and treatment of ovarian stromal hyperthecosis. This condition is characterized by severe hyperandrogenism and impaired glucose tolerance, and it is mostly occurs in postmenopausal women. Main cause of androgenic hyperproduction in women of reproductive age - the polycystic ovary syndrome - is thoroughly studied; standards for diagnostics and treatment for such patients are developed. Little is known about stromal hyperthecosis, which is a more rare cause of hyperandrogenism that had been considered as a severe form of polycystic ovary syndrome. However, it became an independent nosological form after a detailed study of the pathomorphology. Currently, there are no generally accepted diagnostic criteria for stromal hyperthecosis. This is not only because the disease is rare, but also due to the difficulty of making the final diagnosis. Patients with stromal hyperthecosis are at high risk for developing malignancies - endometrial cancer or breast cancer. So, the need for further investigation and developing treatment approaches is undoubted. In majority of cases, the diagnosis of stromal hyperthecosis is set on histological examination of ovarian tissue from patients with idiopathic severe hyperandrogenism, infertility or cancer. The practicing obstetrician-gynecologist must be aware of this condition to suspect the ovarian stromal hyperthecosis when its typical clinical features manifest, to perform meticulous laboratory and instrumental investigation and to choose the correct management tactics for such patients.

scholarly journals Polycystic Ovary Syndrome: Important Underrecognised Cardiometabolic Risk Factor in Reproductive-Age Women

2015 ◽  
Vol 2015 ◽  
pp. 1-17 ◽  
Author(s):  
Dinka Pavicic Baldani ◽  
Lana Skrgatic ◽  
Roya Ougouag
Keyword(s):  
Cardiovascular Disease ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Low Grade ◽  
Metabolic Disturbances ◽  
Ovary Syndrome ◽  
Intrinsic Factors ◽  
Low Grade Inflammation

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder amongst women of reproductive age. Although PCOS is diagnosed exclusively based on reproductive criteria, it is also a metabolic disorder. Insulin resistance, impaired glucose tolerance, type 2 diabetes mellitus, obesity, and dyslipidemia are more common in women with PCOS than in age-comparable women without PCOS. Many of the metabolic abnormalities that manifest in PCOS are worsened by the concurrent incidence of obesity. However, some of these metabolic perturbations occur even in lean women with PCOS and therefore are rightfully recognized as intrinsic to PCOS. The intrinsic factors that produce these metabolic disturbances are reviewed in this paper. The consequences of obesity and the other metabolic aberrations are also discussed. The metabolic perturbations in PCOS patients lead to chronic low-grade inflammation and to cardiovascular impairments that heighten the risk of having cardiovascular disease. Even though many studies have shown an elevation in surrogate biomarkers of cardiovascular disease in PCOS women, it is still not clear to what extent and magnitude the elevation precipitates more frequent and earlier events.

scholarly journals Pentraxin 3 – a potential link between inflammation, obesity and cardiovascular complications in polycystic ovary syndrome

2018 ◽  
Vol 72 ◽  
pp. 634-641
Author(s):  
Wojciech Gruszka ◽  
Katarzyna Wyskida ◽  
Jerzy Chudek ◽  
Magdalena Olszanecka-Glinianowicz
Keyword(s):  
Adipose Tissue ◽  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Cardiovascular Complications ◽  
Reproductive Age ◽  
Pentraxin 3 ◽  
Metabolic Disturbances ◽  
Ovary Syndrome ◽  
Ptx3 Level ◽  
Potential Link

Polycystic ovary syndrome (PCOS) is the most frequently diagnosed endocrine disorder among women in reproductive age. Metabolic disturbances in PCOS include among others increased incidence of insulin resistance and hyperinsulinemia, type 2 diabetes, dyslipidemia, pre-thrombotic state, hypertension, sleep apnea, atherosclerosis and cardiovascular diseases. Adipose tissue disturbances, including inflammation, were shown to play an important role in the development of both endocrine and metabolic disturbances, accelerating the progression of arteriosclerosis, which leads to premature cardiovascular disease development in PCOS. Pentraxin 3 (PTX3) seems to be one of the factors linking obesity and cardiovascular complications observed in PCOS. PTX3 belongs to a family of long pentraxin proteins. It primarily plays a role in acute immunological response; however, some data suggests that it may also be involved in oocyte maturation. In contrast to the short pentraxin, C-reactive protein, which is primarily produced in the liver, PTX3 is produced locally in the site of the inflammation by several types of cells, for example, adipose tissue during development of inflammation. Increased PTX3 expression was found in visceral fat tissue in obese subjects, and was shown to be under TNF-α control. PTX3 expression has not been tested in PCOS women, yet. Up to now there are only 5 studies investigating PTX3 in PCOS. Only in one study PTX3 level in PCOS women was increased compared to the control groups, in two other studies – decreased, and in two – similar. Also, the association between PTX3, PCOS and obesity remains uncertain. Further research, including ones with a greater number of subjects, especially obese and older women, are necessary to assess the role of PTX3 as a potential link between the inflammation, obesity and polycystic ovary syndrome.

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