Polycystic Ovary Syndrome in the Adolescent

Adolescent Women ◽

First Line Therapy

The typical PCOS phenotype of anovulation, androgen excess, and polycystic ovarian morphology can overlap with normal adolescence, thus making the diagnosis more difficult. Early recognition of adolescents at a risk for PCOS allows for earlier intervention with the potential for improved cardiovascular and metabolic health. Mental health issues and poor quality of life are frequently associated with PCOS in adolescent women and, therefore, should be identified and addressed. As with many issues confronting the adolescent, peer and family support should be encouraged. Lifestyle changes and weight loss should be thought of as first-line therapy for young women with PCOS. Combined hormonal contraceptives remain the medical therapy of choice for the treatment of menstrual irregularity, hirsutism, acne, and contraception. Metformin and spironolactone may be considered, with metformin particularly beneficial in young women with metabolic abnormalities. This review contains 2 tables and 50 references. Key Words: antiandrogens, antimüllerian hormone, hirsutism, hyperandrogenism, hyperinsulinemia, insulin resistance, menstrual irregularity, obesity, oral contraceptive pills, polycystic ovary

Das polyzystische Ovarsyndrom: Aktuelle Evidenz und praktische Empfehlungen

Diabetologie und Stoffwechsel ◽

10.1055/a-0891-9131 ◽

2020 ◽

Vol 15 (01) ◽

pp. 37-47

Author(s):

Susanne Reger-Tan ◽

Christian Böing ◽

Dagmar Führer-Sakel

Keyword(s):

Polycystic Ovary ◽

Treatment Strategies ◽

Lifestyle Changes ◽

Success Rates ◽

Childbearing Age ◽

Vein Thrombosis ◽

Recommended Treatment ◽

Estrogen Dose ◽

Therapeutic Lifestyle Changes

AbstractPolycystic ovary syndrome (PCOS) is one of the most common endocrinopathies in women of childbearing age. Due to hyperandrogenism and chronic anovulation affected women may suffer from hirsutism, androgenetic alopecia, acne, menstrual disturbance and sub-/infertility. Furthermore underlying insulin resistance promotes hyperandrogenemia, overweight and risk for diabetes. Therefore, routine evaluation of glycemic status is recommended. Treatment strategies are based on therapeutic lifestyle changes and focus on patient-important complaints. First line pharmacologic treatment for infertility in women with PCOS is letrozole. Clomiphene and metformin can be used alternatively with lower success rates. Women seeking medical advice for hyperandrogenism can be offered oral contraceptive pills with the lowest effective estrogen dose without any preference of a certain gestagen. Risk for deep vein thrombosis should be taken into account when choosing estrogen dose and type of gestagen. Antiandrogen substances such as spironolactone should only be prescribed in combination with safe contraception due to their risk of fetal undervirilisation. Additionally, substance specific risks should be considered. Baseline treatment of overweight or metabolic issues includes behaviour modification, weight reduction and physical activity. Additional benefit can be reached by combination of lifestyle changes with metformin. Studies indicate a positive effect of inositol and antidiabetic substances like liraglutide and empagliflozin but should be regarded as experimental therapies.

Clinical Profiles, Occurrence, and Management of Adolescent Patients with HAIR-AN Syndrome

The Scientific World JOURNAL ◽

10.1100/tsw.2004.106 ◽

2004 ◽

Vol 4 ◽

pp. 507-511 ◽

Cited By ~ 11

Author(s):

Hatim A. Omar ◽

Stephanie Logsdon ◽

Jessica Richards

Keyword(s):

Insulin Resistance ◽

Young Women ◽

Polycystic Ovary ◽

Common Disease ◽

Contraceptive Pills ◽

Common Causes ◽

Adolescent Clinic ◽

Better Than

The syndrome of hyperandrogenism, insulin resistance, and acanthosis nigricans (HAIR-AN) is a subphenotype of the polycystic ovary syndrome. It is one of the most common causes of menstrual problems, hyperandrogenic symptoms, and insulin resistance among young women. Review of clinical data in an outpatient adolescent clinic showed that of the 1,002 young women (ages 10—21 years) attending the clinic over a 2-year period, 50 (5%) were diagnosed with HAIR-AN syndrome. Mean age of the patients was 15.5, initial mean weight at diagnosis was 94.5 kg, and the mean BMI was 33.33 kg/m2. Patients were treated with a weight-stabilization and -reduction program, oral contraceptive pills, and in most cases metformin. Of the patients, 80% were compliant with the follow-up and treatment regimen, 60% maintained or reduced their weight, 95% had regular menstrual cycles, and in most patients, the acne and/or hirsutism were the same or better than at the start of treatment. We conclude that HAIR-AN syndrome is a common disease in young women and multifaceted, aggressive treatment appears to be effective in reducing the severity of symptoms and preventing further consequences.

New about the pathogenesis and treatment of polycystic ovary syndrome

Russian Journal of Woman and Child Health ◽

10.32364/2618-8430-2021-4-1-17-22 ◽

2021 ◽

Vol 4 (1) ◽

pp. 17-22

Author(s):

N.V. Artymuk ◽

◽

O.A. Tachkova ◽

Keyword(s):

Vitamin D ◽

Ovulation Induction ◽

Polycystic Ovary ◽

Clomiphene Citrate ◽

Lifestyle Changes ◽

Reproductive Age ◽

Therapeutic Modality ◽

Hormonal Contraceptives ◽

Ovary Syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age that is characterized by reproductive and metabolic disorders. Mental issues, hypothalamic-pituitary dysfunction, ovarian dysfunction, mitochondrial dysfunction, obesity, and vitamin D deficiency account for infertility in PCOS. This paper reviews recent studies on pathogenesis and treatment approaches to this disease. Recognized therapeutic modalities for PCOS are addressed, i.e., rational diet, combined hormonal contraceptives, ovulation induction using clomiphene citrate and/or metformin, ovarian drilling, assisted reproductive technology, and alternative approaches (e.g., herbal therapy, traditional Chinese medicine, vitamin D, coenzyme Q, salubrinal, and the combination of simvastatin and metformin). Inositols are a promising therapeutic modality that improves menstrual and reproductive function (presumably via their impact on carbonic and lipid metabolism) and the quality of oocytes and embryos. KEYWORDS: polycystic ovary syndrome, pathogenesis, treatment, myo-inositol, ovulation induction, drilling, combined oral contraceptives, lifestyle changes. FOR CITATION: Artymuk N.V., Tachkova O.A. New about the pathogenesis and treatment of polycystic ovary syndrome. Russian Journal of Woman and Child Health. 2021;4(1):17–22. DOI: 10.32364/2618-8430-2021-4-1-17-22.

Obesity, menstrual irregularity and polycystic ovary syndrome in young women with type 1 diabetes: A population‐based study

Clinical Endocrinology ◽

10.1111/cen.14281 ◽

2020 ◽

Vol 93 (5) ◽

pp. 564-571

Author(s):

Eleanor P. Thong ◽

Frances Milat ◽

Anju E. Joham ◽

Gita D. Mishra ◽

Helena Teede

Keyword(s):

Type 1 Diabetes ◽

Young Women ◽

Polycystic Ovary ◽

Population Based ◽

Menstrual Irregularity ◽

Ovary Syndrome ◽

Population Based Study

Effects of the Insulin Sensitizer Pioglitazone on Menstrual Irregularity, Insulin Resistance and Hyperandrogenism in Young Women with Polycystic Ovary Syndrome

Journal of Pediatric and Adolescent Gynecology ◽

10.1016/j.jpag.2013.09.015 ◽

2014 ◽

Vol 27 (3) ◽

pp. 177-182 ◽

Cited By ~ 11

Author(s):

Gaspare Stabile ◽

Irene Borrielli ◽

Alfredo Carducci Artenisio ◽

Lucia Maria Bruno ◽

Salvatore Benvenga ◽

...

Keyword(s):

Insulin Resistance ◽

Young Women ◽

Polycystic Ovary ◽

Menstrual Irregularity ◽

Ovary Syndrome ◽

Insulin Sensitizer

Faculty Opinions recommendation of Comparative study of the therapeutic effects of oral contraceptive pills containing desogestrel, cyproterone acetate, and drospirenone in patients with polycystic ovary syndrome.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.717978515.793471100 ◽

2013 ◽

Author(s):

Richard Anderson ◽

Raymond Li

Keyword(s):

Oral Contraceptive ◽

Comparative Study ◽

Cyproterone Acetate ◽

Polycystic Ovary ◽

Therapeutic Effects ◽

Ovary Syndrome ◽

Contraceptive Pills

Antidiabetic Properties of Medicinal Mushrooms with Special Reference to Phellinus Species: A Review

The Natural Products Journal ◽

10.2174/2210315510666200124124540 ◽

2020 ◽

Vol 10 ◽

Author(s):

Thekkuttuparambil A Ajith ◽

Kynoor K Janardhanan

Keyword(s):

Nutritional Value ◽

Modern Medicine ◽

Lifestyle Changes ◽

Controlled Clinical Trials ◽

Chronic Complications ◽

Medicinal Mushrooms ◽

Beneficial Effects ◽

First Line Therapy ◽

Public Health Challenge ◽

Microvascular Diseases

: Diabetes remains the major public health challenge to 21st century. It is strongly related to lifestyle changes. Most chronic complications of diabetes are macrovascular and microvascular diseases resulting from the existing hyperglycemic status. Failure of first line therapy which is based on diet modifications and exercise, conventional treatment using antihyperglycemic agents with different mechanisms of action will be implemented for type II diabetes in modern medicine. Higher Basidiomycetes mushrooms are highly praised for their nutritional value and pharmacological properties. They have long been used traditionally for the maintenance of health, prevention and treatment of various human ailments. Reports indicate the beneficial effects of medicinal mushrooms in diabetes treatments. However, scientific evidences are insufficient to make definitive conclusions on the efficacy of individual medicinal mushrooms. Mushrooms belong to the genera Phellinus such as Phellinus linteus, Phellinus ribis, Phellinus rimosus and Phellinus igniarius. They possess significant hypoglycemic effect in experimental diabetic models. However, well-designed controlled clinical trials are needed to establish their safety and bioactivity.