scholarly journals Prevalence, Symptomatology and Herbal Management of Polycystic Ovarian Syndrome

2020 ◽  
Author(s):  
Sabira Sultana ◽  
Naheed Akhter ◽  
Muhammad Akram ◽  
Syed Muhammad Ali Shah ◽  
Naveed Munir ◽  
...  

Polycystic Ovarian Syndrome (PCOS) is multi-organ syndrome that affects 6–25% of females during reproductive age. It disrupts normal hormone levels of females and affects adrenal hormone and sex hormones along with pituitary hormones including adrenocorticotropic, growth hormone and gonadotropins hormones. It results in several secondary characteristics in females such as infertility, hormonal imbalance, oligomenorrhea, amenorrhea, obesity and hirsutism. Polycystic ovarian syndrome is associated with mental and reproductive disorder and almost 4–18% mature female students are affected by polycystic ovarian syndrome. Female affected by polycystic ovarian syndrome have increased risk of infertility, ovarian cancer, skin problems and psychological problems such as anxiety, depression and changes in sleep along with mood swings. This chapter discusses the Prevalence, Symptomatology and Management of Polycystic Ovarian Syndrome. For the management of PCOS, the role of some medicinal plants including Asparagus racemosus, Tinospora cordifolia, Foeniculum vulgare, Ocimum tenuiflorum, Actaea racemosa, and Lepidium meyenii have also been discussed in addition to other treatment modalities. The literature data was searched out and compiled using relevant original research articles and reviews published and indexed in Google Scholar, Scientific Information Database, Elsevier, PubMed and Science Direct.

2021 ◽  
Vol 14 (3) ◽  
pp. 1305-1308
Author(s):  
Muhjah Falah Hassan ◽  
Pallav Sengupta ◽  
Sulagna Dutta

Polycystic ovarian syndrome (PCOS) is the most common cause of anovulatory fertility problems in women of reproductive age, with a prevalence as high as 40% to 75%. There are different treatment modalities for increasing the chance of pregnancy in PCOS patients. Since most of the PCOS patients suffer from ovulatory problems, therapeutic efforts are focused mainly towards restoring normal ovulation. However, even after pharmacological interventions to ameliorate ovulatory irregularities, women with polycystic ovary are still at high risk of fetal loss. Thus, assisted reproductive techniques (ARTs) have become popular approaches which significantly increase the chances of successful pregnancy in these women, bypassing the conditions of PCOS. The present mini-review ‘pinpoints’ on the suitability of ARTs for PCOS patients who fail to ovulate following the conventional infertility treatment. The article also briefly explains how intracytoplasmic sperm injection (ICSI), the most effectiveART, correlates with better biological parameters, fertilization rate and better quality of embryos in PCOS women.


Author(s):  
Reenoo Jauhari ◽  
Prashant Mathur ◽  
Vineeta Gupta

Polycystic ovarian syndrome (PCOS) is the commonest cause of anovulatory infertility. Depending on the population studied between 5 and 18% of women of reproductive age suffer from PCOS, however not all of them are anovulatory or experience subfertility. PCOS has been associated with numerous reproductive and metabolic abnormalities. Despite enormous advances in the management of reproductive dysfunction, insight into the metabolic implications of PCOS is limited by the lack of uniform diagnostic criteria, the heterogeneity of the condition and the presence of confounders including obesity. Obesity clearly has a role in long term health and may best predict both reproductive and metabolic dysfunction as well as negatively affect the response to treatment in women with PCOS. Diabetes, cardiovascular disease and cancer are also at the forefront of any risk assessment or comprehensive treatment strategy for these women. Lifestyle modifications including dietary changes, increased exercise and weight loss are appropriate first line interventions for many women with PCOS. Pharmaceuticals including metformin, lipid lowering agents and oral contraceptives should be tailored to the individual’s risk profile and treatment goals. The fertility treatment in women with subfertility and PCOS aimed to safely induce monofollicular ovulation resulting in the birth of a singleton child. Women with PCOS undergoing fertility treatment are at risk of multi-follicular development as well as ovarian hyper-stimulation syndrome (OHSS), so they must be carefully counselled and monitored during fertility treatment. It is imperative that prior to embarking on fertility treatment, a patient’s health and weight is optimised. This chapter will explore the latest evidence for fertility treatments for women with PCOS.


2018 ◽  
Vol 25 (15) ◽  
pp. 1792-1804 ◽  
Author(s):  
Silvana R. Ferreira ◽  
Alicia B. Motta

Background: The endometrium is one of the most important female reproductive organs. Polycystic ovarian syndrome (PCOS) is a reproductive and endocrine pathology that affect women of reproductive age. PCOS negatively affects the endometrium, leading to implantation failure and proliferative aberrations. Methods: We conducted a search at the http://www.ncbi.nlm.nhi.gov/pubmed/electronic database using the following key words: endometrial steroid receptors, endometrium, uterine function, endometrium and PCOS, implantation window, implantation and PCOS, implantation markers, inflammation, oxidative stress. We selected the articles based on their titles and abstracts, then we analyzed the full text and classified the articles depending on the information provided according to the sections of the present review. Results: The endocrine and metabolic abnormalities displayed in women with PCOS promote complex effects on the endometrium, leading to a low rate of implantation and even infertility. Women with PCOS show alterations in the Hypothalamic-Pituitary- Ovarian axis, which results in constant circulating levels of estrogen, similar to those at the early follicular phase, and a deficiency in the withdrawal of estrogen and progesterone. Besides this deficiency in the withdrawal of estrogen and progesterone, the insulin/ glucose pathway, adhesion molecules, cytokines and the inflammatory cascade, together with the establishment of a pro-oxidative status, lead to an imbalance in the uterine function, which in turn leads to implantation failure or even endometrial cancer. Conclusion: Women with PCOS display a dysregulation of the Hypothalamic-Pituitary- Ovarian axis, which alters the steroid pathway. In addition, the deficiency in the withdrawal of estrogen and progesterone in the endometrium results in abnormal endometrial cellular proliferation. The imbalance in adipose tissue observed in PCOS patients reinforces the increase in circulating hormones. The present review describes the role of hormones, metabolites, cytokines, adhesion molecules and the insulin/glucose pathway related to the uterine endometrium in women with PCOS and their role in implantation failure and development of endometrial cancer.


2017 ◽  
Vol 9 (4) ◽  
pp. 336-340 ◽  
Author(s):  
Richa Singh ◽  
Meenal Jain ◽  
Poonam Yadav ◽  
Sarvesh Awasthi ◽  
Pallavi Raj

ABSTRACT Introduction The polycystic ovary syndrome (PCOS) is the most common condition associated with chronic anovulation affecting 4 to 6% of reproductive age women. Aim To compare the effectiveness of laparoscopic ovarian drilling (LOD) for ovulation induction with gonadotropins in clomiphene-resistant PCOS in terms of ovulation, pregnancy, live birth, abortion, multiple pregnancies, and complication like ovarian hyperstimulation syndrome (OHSS). Setting and design A prospective hospital-based randomized trial. Materials and methods It was a prospective study, which was carried out from January 2012 to May 2015. Totally, 89 women were evaluated in the study, out of which 44 women were in gonadotropin group and 45 were in LOD group. Statistical analysis Standard statistical analysis was done and significance of difference in results was tested by chi-square test. Results Ovulation rate in gonadotropin group was 75.0% at 6 months, whereas in LOD group, it was 20% at 3 months and was increased up to 66.66% after addition of clomiphene citrate and gonadotropin. The primary outcome in terms of pregnancy in gonadotropin group was 45.45% after 6 cycles and in LOD group was 11.11% after 3 cycles and 40.00% after 6 cycles with supplementation of clomiphene citrate and gonadotropin. Conclusion The ongoing pregnancy rate from ovulation induction with LOD alone was significantly less but if supplemented by clomiphene citrate and gonadotropin, it seems equivalent to ovulation induction with gonadotropin, but the former procedure carries a lower risk of multiple pregnancies. How to cite this article Yadav P, Singh S, Singh R, Jain M, Awasthi S, Raj P. To Study the Effect on Fertility Outcome by Gonadotropins vs Laparoscopic Ovarian Drilling in Clomiphene-resistant Cases of Polycystic Ovarian Syndrome. J South Asian Feder Obst Gynae 2017;9(4):336-340.


2020 ◽  
Vol 11 (4) ◽  
pp. 644-649
Author(s):  
Saroj Kumari ◽  
Sarvesh Kumar Singh ◽  
Kshipra Rajoria ◽  
Avadhesh Kumar

Polycystic ovarian syndrome (PCOS) is a probably fastest growing endocrinological disorder in females of reproductive age. In PCOS, follicular growth is influenced by hormonal imbalance during the ovarian cycle, leads to affected follicles remain in the ovary. The prevalence of PCOS is estimated 6-10% globally and 3.7% - 22.5% in Indian female population, which is relatively high. It is characterised by hyperandrogenism, anovulation and polycystic ovaries which clinically manifests in the terms of amenorrhea or oligomenorrhea, hirsutism, acne, infertility etc. In present scenario, incidence of this disease increasing exponentially due to sedentary lifestyle and faulty dietary habits. This particular disease is not described word to word in Ayurveda. Associated features of PCOS are closely resembling with Bandhya Yonivyapada, Artavavahasrotasa-Vidhha Lakshana, Nastartava and Ksheenaartava described by Acharya Sushruta and Pushpghani Jatharini and Vikuta Jatharini mentioned by Acharya Kashyap. Maximum congruence of PCOS can be established with Bandhya Yonivyapada. The purpose of this study is to understand Nastartava which is the cardinal feature of Bandhya. Word Artava has been used exclusively in Samhita in context of menstrual blood, ovum and ovarian hormones. Therefore Amenorrhea, anovulation, hormonal dysfunction is considered exposed manifestations of Nastartava. Possible line of treatment is stipulated with Nidanaparivarjan, herbal drugs and Panchakarma procedures. Keywords- Ayurveda, Artava, Nastartava, PCOS, Herbal drugs, Panchakarma


Author(s):  
Chaitali Maitra ◽  
Ramesh Chandra Gupta ◽  
Rishika Raj

Introduction: Polycystic Ovarian Syndrome (PCOS) is a common endocrine disorder in the women of reproductive age. Studies show that there is an intensive relationship between insulin and gonadal function. As per Rotterdam Criteria, there are four major phenotypes of PCOS with different presentation. Early detection of Insulin Resistance (IR) and consequential prevention of Metabolic Syndrome (MS) associated with PCOS may lead to better prospect for the disease. Aim: To find the pattern of IR in all the phenotypes of PCOS in relation to Waist Hip Ratio (WHR), Body Mass Index (BMI) and Testosterone and thereby, providing data for designing phenotype specific treatment of the disease. Materials and Methods: In this cross-sectional observational study, fasting insulin and fasting glucose were analysed to calculate Homeostasis Model Assessment (HOMA-IR) and Testosterone for total 144 female subjects of reproductive age group (18-40 years). Subjects were classified in to four groups as per Rotterdam Criteria. Complete PCOS (PCO-COM), PCO with Oligo/Anovulation (PCO-O), Anovulation with Hyperandrogenism (O-HA), and PCO with Hyperandrogenism (PCO-HA). Regression analysis was done to find the relation among the study variables. Analysis of Variance (ANOVA) was used to analyse the significant variance among the groups. Results: IR was found to be maximum among O-HA phenotype (2.4±0.37) and lowest among PCO-HA phenotypes (1.3±0.22). Regression analysis shows that there exist significant associations between IR and BMI (t=4.96, p=0.001) as well as between IR and WHR (t=2.97, p=0.003). No independent association between testosterone and IR was observed. Conclusion: Significant difference of IR, WHR, and BMI was observed among the four phenotypes of PCOS. Due to increased IR, O-HA and PCO-COM phenotypes are more predisposed to Cardiometabolic consequences of PCOS.


2019 ◽  
Vol 3 (5) ◽  

The Polycystic ovarian syndrome affects 6-15 % of reproductive age women worldwide. And recently the changing life styles and rising obesity worldwide have contributed to a rise in the incidence of PCOS. Though there are many issues with PCOS post conception. PCOS women are at increased risk of early pregnancy loss which is approx. three fold as compared to the women without PCOS. After successfully crossing the first trimester, they are at risk of developing pre- eclampsia, GDM, preterm birth and birth of small for gestational age infant. Also higher incidence of multiple pregnancies is there and the risks associated with them. All these leading to higher rate of c -section delivery. So, proper understanding of these risks, informing and counseling the patients regarding them facilitate closer maternal and fetal surveillance and help improving the outcome of pregnancy.


2021 ◽  
Vol 02 ◽  
Author(s):  
Ankita Wal ◽  
Pranay Wal ◽  
Nikita Saraswat ◽  
Simran Wadhwa

Background: The review gives a brief about PCOS and the symptoms related to the disease. Around 2.2 to 26% cases of PCOS are present globally. The disorder generally occurs in the reproductive age group women. The review has a mention of few herbs which can be used to correct the diseased condition. The various herbs have positive effect on the diseased condition and can be used to cure symptoms like hypothyroidism, hyperplasia, obesity, diabetes, Menorrhagia, sleep disturbances, cardiovascular problems, hyperlipidemia, hirsutism, infertility, irregular menstrual cycle, etc. The search engines used are PubMed, various review articles, etc. Methods: The method involved in the review includes various medicinal herbs that have seen to affect women having various gynecological disorders like Poly Cystic Ovarian Syndrome, Uterine Fibroids, and Endometriosis. Materials: The herbs included in the review include Bauhinia variegata useful in hormone imbalance, Phyllanthus emblica, Terminalia bellirica, Terminalia chebula, and Commiphora wightii are used to regulate the hormones, Cinnamon cassia acts as an anti-oxidant, Tribulus terrestris improves reproductive dysfunction, Hypericum perforatum regulates depression, Commiphora myrrha prevents menorrhagia, Nigella sativa controls cholesterol, Saraca asoca has estrogenic action, Asparagus racemosus promotes folliculogenesis, Tinospora cordifolia regulates menstrual flow, Ocimum sanctum as an anti-oxidant. Conclusion:: The plants taken had positive effect on women with PCOS without causing any side-effects. The natural herbs used for the treatment of PCOS did not have any side effects and treated the diseased condition naturally. The review is to understand the natural plants available for the treatment of the disease naturally. The herbs can be used individually or can be used in combination.


2017 ◽  
Vol 19 (1) ◽  
pp. 49-53
Author(s):  
Rabia Farooq

Polycystic ovarian syndrome (PCOS) is a metabolic disease and a common endocrine system disorder among women of reproductive age. Infrequent or prolonged menstrual periods, excess hair growth, acne, and obesity can occur in women with PCOS. Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications. Now a days PCOS is also the cause of infertility. India is PCOS capital of the world. PCOS management is necessary to reduce its long time complications.J MEDICINE Jan 2018; 19 (1) : 49-53


Author(s):  
Sukhleen Kaur ◽  
Sunil K. Gupta ◽  
Sunil K. Juneja ◽  
Sukhjot Kaur ◽  
Monika Rani

Background: Polycystic ovarian syndrome (PCOS) is one of the most frequently encountered endocrine disorders that occurs in as many as 4 to 10% of women of reproductive age group. It presents with a series of skin changes including acne, hirsutism, seborrhea, androgenetic alopecia (AGA) and acanthosis nigricans. Aim of the study was to determine the prevalence and frequency of different cutaneous manifestations in PCOS patients and to correlate them with the degree of hormonal abnormalities.Methods: A total 100 patients with features of PCOS who presented to department of dermatology, gynecology (January 2018-December 2019) with cutaneous manifestations were recorded and diagnosis of PCOS was made using Rotterdam’s criteria. Pregnant women and diagnosed cases of any other endocrine disorder were excluded. Hirsutism was assessed using Ferriman-Gallwey score and AGA according to Ludwig’s classification. Serum hormonal profile including FSH, LH, prolactin, testosterone (free), DHEAS, TSH, FBS, fasting insulin were done. Insulin resistance was determined by calculating HOMA-IR score.Results: Among cutaneous manifestations of PCOS, hirsutism (85%) was the most common finding followed by acne (73%), seborrhea (50%), AGA (36%), acanthosis nigricans (29%) and acrochordons (9%). The most common hormonal abnormality was insulin resistance in 53% patients, followed by raised free testosterone in 19% and serum prolactin in 18% patients. A statistically significant association was present between AGA and insulin resistance, hirsutism and raised prolactin levels, seborrhea and raised body mass index (p < 0.05).Conclusions: Dermatological manifestations of PCOS play a significant role in making the diagnosis and constitute a substantial portion of the symptoms experienced by women with this syndrome.


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