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.

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.

scholarly journals Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls

2019 ◽  
Vol 3 (8) ◽  
pp. 1545-1573 ◽  
Author(s):  
Selma Feldman Witchel ◽  
Sharon E Oberfield ◽  
Alexia S Peña
Keyword(s):  
At Risk ◽  
Polycystic Ovary Syndrome ◽  
Diagnostic Criteria ◽  
Adolescent Girls ◽  
Polycystic Ovary ◽  
Therapeutic Interventions ◽  
Normal Female ◽  
Adult Women ◽  
Care Providers ◽  
Ovary Syndrome

AbstractPolycystic ovary syndrome (PCOS) is a heterogeneous disorder characterized by hyperandrogenism and chronic anovulation. Depending on diagnostic criteria, 6% to 20% of reproductive aged women are affected. Symptoms of PCOS arise during the early pubertal years. Both normal female pubertal development and PCOS are characterized by irregular menstrual cycles, anovulation, and acne. Owing to the complicated interwoven pathophysiology, discerning the inciting causes is challenging. Most available clinical data communicate findings and outcomes in adult women. Whereas the Rotterdam criteria are accepted for adult women, different diagnostic criteria for PCOS in adolescent girls have been delineated. Diagnostic features for adolescent girls are menstrual irregularity, clinical hyperandrogenism, and/or hyperandrogenemia. Pelvic ultrasound findings are not needed for the diagnosis of PCOS in adolescent girls. Even before definitive diagnosis of PCOS, adolescents with clinical signs of androgen excess and oligomenorrhea/amenorrhea, features of PCOS, can be regarded as being “at risk for PCOS.” Management of both those at risk for PCOS and those with a confirmed PCOS diagnosis includes education, healthy lifestyle interventions, and therapeutic interventions targeting their symptoms. Interventions can include metformin, combined oral contraceptive pills, spironolactone, and local treatments for hirsutism and acne. In addition to ascertaining for associated comorbidities, management should also include regular follow-up visits and planned transition to adult care providers. Comprehensive knowledge regarding the pathogenesis of PCOS will enable earlier identification of girls with high propensity to develop PCOS. Timely implementation of individualized therapeutic interventions will improve overall management of PCOS during adolescence, prevent associated comorbidities, and improve quality of life.

scholarly journals Promotion of reproductive and metabolic health - current trends in the treatment and prevention of polycystic ovary syndrome in different periods of life

2021 ◽  
Vol 47 (3) ◽  
pp. 130-149
Author(s):  
Joanna Smyczyńska
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Diagnostic Criteria ◽  
Polycystic Ovary ◽  
Hormonal Contraception ◽  
Reproductive Age ◽  
Metabolic Effects ◽  
Adult Women ◽  
Ovary Syndrome ◽  
Treatment And Prevention

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders and causes of infertility in women in reproductive age. Diagnostic criteria of PCOS in adult women include: ovulation disorders, hyperandrogenism and  polycystic ovaries. According to most recommendations, 2 out of these 3 criteria are confirm the diagnosis of PCOS. In girls during puberty and in the first years after menarche, different diagnostic criteria of menstrual disorders should be taken into account (variable length of menstrual cycles, monophasic cycles) and the limited usefulness of ultrasound examination for PCOS diagnosis within 8 years after menarche. Fairly extensive differential diagnosis is also necessary, especially – exclusion of adrenal hyperandrogenism. Moreover, the diagnostic criteria of PCOS do not take into account the metabolic disorders found in most patients (obesity, insulin resistance, type 2 diabetes), which should be diagnosed as early as possible and treated appropriately. This is especially true for teenagers, in whom the unequivocal diagnosis of PCOS or its exclusion may be very difficult. Current recommendations regard hormonal contraception as the first-line therapy in PCOS, in both adult women and adolescents. Together with its beneficial effect on the reduction of hyperandrogenism and obtaining regular bleeding (which in fact are not menstruations), the unfavorable metabolic effects of hormonal contraception are emphasized, as well as the inadequacy of its use if it is expected to achieve or restore ovulation and fertility. The latest reports indicate the legitimacy of treatment aimed at correcting disorders of carbohydrate metabolism and its greater effectiveness compared to the use of oral contraceptives in both adult women and girls with PCOS. In the pharmacotherapy of insulin resistance, metformin is of fundamental importance, the use of pioglitazone, GLP-1 receptor agonists or inositols is also proposed. Adequate lifestyle and dietary modification are of major importance in the treatment and prevention of PCOS. The mechanisms of "inheritance" of PCOS and insulin resistance with the participation of epigenetic modifications are still better understood, taking into account the effects of exposure to androgen excess in utero, intrauterine growth retardation, and maternal obesity and hyperalimentation. This creates new possibilities for PCOS prophylaxis.

scholarly journals Polycystic Ovary Syndrome: A Brief Review with Recent Updates

2020 ◽  
Vol 7 (2) ◽  
pp. 84-99
Author(s):  
Shahana Shermin ◽  
Aysha Noor ◽  
Samsad Jahan
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Health Workers ◽  
Polycystic Ovary ◽  
Signs And Symptoms ◽  
Reproductive Age ◽  
Treatment Modalities ◽  
Public Health Issue ◽  
Ovary Syndrome ◽  
Significant Public Health ◽  
Meta Analyses

Polycystic ovary syndrome (PCOS) is a chronic, complex and the most common endocrine disorder observed in women of reproductive age. This syndrome is heterogeneous by nature and is characterized by a combination of signs and symptoms of androgen excess and ovarian dysfunction. It is a significant public health issue. PCOS is associated with many comorbidities and also has a number of long-term metabolic and other consequences. The prevalence is quite high and is increasing day by day. It is a syndrome to be prevented by awakening awareness both in health workers and patients. There are many areas of controversies starting from its diagnosis, pathogenesis, consequences and treatment modalities. This review is an attempt to summarize the evolution of the diagnosis and current management guidelines and also to look into the future approaches. An extensive search was made through the Cochrane database, available systematic reviews and meta-analyses and recent international guidelines for providing an updated scientific overview of PCOS. Delta Med Col J. Jul 2019 7(2): 84-99

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.

Optimal management of polycystic ovary syndrome in adolescence

2015 ◽  
Vol 100 (11) ◽  
pp. 1076-1083 ◽  
Author(s):  
Natalie Hecht Baldauff ◽  
Silva Arslanian
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Signs And Symptoms ◽  
Sleep Apnoea ◽  
Treatment Modalities ◽  
Hormonal Contraceptives ◽  
Lifestyle Modifications ◽  
Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a heterogeneous disorder of reproduction and metabolism, which emerges at puberty, and is characterised by a wide spectrum of signs and symptoms of hyperandrogenism, anovulation, hyperinsulinaemia and associated comorbidities. Unlike adult PCOS, there are no agreed-upon diagnostic criteria for adolescent PCOS, but hyperandrogenaemia remains the sine qua non for its diagnosis. Many adolescent girls with PCOS are overweight/obese, and have a heightened risk for comorbidities such as dysglycaemia, dyslipidaemia, fatty liver disease, sleep apnoea and cardiovascular disease. Therefore, early and accurate diagnosis is essential for implementation of appropriate treatment and management. Available treatments include lifestyle modifications, hormonal contraceptives and insulin sensitisers. However, there are limited data on the best treatment modalities in adolescents. The objective of this review is to describe the clinical manifestations of PCOS in adolescents and the appropriate diagnostic work-up. The optimal treatment modalities based on a review of the available adult and adolescent literature will be discussed.

scholarly journals A Study on Physical and Physiological Impact of Polycystic Ovary Syndrome

2021 ◽  
Vol 69 (2) ◽  
Author(s):  
Sathish Kumar B.P ◽  
Dr. Sayantan Ghosh ◽  
Dr. Lipika Das ◽  
Dr. Aksa Merin Jose
Keyword(s):  
Menstrual Cycle ◽  
Polycystic Ovary Syndrome ◽  
Healthy Lifestyle ◽  
Polycystic Ovary ◽  
Reproductive Organs ◽  
Reproductive Age ◽  
Therapeutic Interventions ◽  
Polycystic Ovaries ◽  
Ovary Syndrome ◽  
Metabolic Complications

Polycystic ovary syndrome is a relatively common hormonal disorder that causes a number of different symptoms in women of reproductive age. In such conditions, enlarged ovaries containing multiple small cysts (polycystic ovaries), are found. Although most women with PCOS have polycystic ovaries, some affected women do not. Common to all women with PCOS is an irregularity in menstrual cycle and the presence of excess male hormones (androgen). It disrupts the functioning of the reproductive organs that produce progesterone and estrogen, the hormones that regulate the menstrual cycle. A prospective observational study was carried out in 125 inpatients, after taking written informed consent from patients those who met the study criteria. A total of 125 patients were enrolled in the study, it was observed that 17.74% have experienced moderate depression, 18.54% patients experienced major irregular menstrual period problem, 2-25% of the patients were dealing with body weight, and 6.45% patients were identified that the growth of visible hair on the upper lip as a major problem. It was also found that 8.87% of patients experienced major menstrual cramps and patients were found worried about PCOS and hence disturbing their quality of life. Various long-term complication and co morbidities have been associated with PCOS and early diagnosed and therapeutic interventions are needed. PCOS is a chronic disease with manifestations across the life span and represents a major health and economic burden. Management should focus on support, education, addressing physiological factors and strongly emphasizing healthy lifestyle with targeted medical therapy as required. Addressing hyperandrogenism is clinically important and monitoring for and managing longer-term metabolic complications including dyslipidemia, IGT, DM2, cardiovascular risk factors, is crucial. Overall, further research is needed in this complex condition.

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.

The Need to Reassess the Diagnosis of Polycystic Ovary Syndrome (PCOS): A Review of Diagnostic Recommendations from the International Evidence-Based Guideline for the Assessment and Management of PCOS

2021 ◽  
Author(s):  
Sylvia Kiconco ◽  
Helena J. Teede ◽  
Ricardo Azziz ◽  
Robert J. Norman ◽  
Anju E. Joham
Keyword(s):  
Polycystic Ovary Syndrome ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Diagnostic Feature ◽  
Evidence Based ◽  
Psychological Consequences ◽  
Ovary Syndrome ◽  
Diagnostic Features ◽  
International Evidence ◽  
Evidence Based Guideline

AbstractPolycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with negative metabolic, reproductive, endocrine, and psychological consequences among women of reproductive age. The diagnosis of PCOS remains challenging due to limited and conflicting evidence regarding definitions for each of the diagnostic features. This review of the recommended PCOS assessment criteria from the international evidence-based guideline highlights the crucial need to reassess, redefine, and optimize the diagnosis of PCOS. Notably, normal values and cut-offs need to be defined for each diagnostic feature across the lifespan and diverse ethnic groups. Understanding how these features cluster together and relate to short- and long-term health outcomes in PCOS is also vital. Ultimately, greater knowledge of the natural history of PCOS is needed through well-characterized, community-based longitudinal studies, which will inform future PCOS diagnosis guidelines and optimize women's health in reproductive life.

scholarly journals Treatment of adolescent girls with polycystic ovary syndrome and insulin resistance

2018 ◽  
Vol 17 (2) ◽  
pp. 13-20
Author(s):  
E. M. Bogatyreva ◽  
G. A. Novik
Keyword(s):  
Insulin Resistance ◽  
Polycystic Ovary Syndrome ◽  
Adolescent Girls ◽  
Ethinyl Estradiol ◽  
Polycystic Ovary ◽  
Reproductive Age ◽  
Ovary Syndrome ◽  
Metabolic Complications ◽  
Study Results ◽  
Oral Preparation

Aim. Polycystic ovary syndrome is a common cause of infertility. In addition, polycystic ovary syndrome is often associated with metabolic complications. In most women hyperandrogenic manifestations occur during puberty. Early detection of polycystic ovary syndrome and associated metabolic problems can solve the problem of puberty and prevent infertility, metabolic syndrome, and diabetes mellitus type 2 in women of reproductive age. One of the objectives of the study was to evaluate the effectiveness of the simultaneous use of a combined oral preparation (ethinyl estradiol + drospirenone) and metformin in adolescent girls with polycystic ovary syndrome.Materials and methods. 113 adolescent girls with hyperandrogenism from 14 to 19 years were included. 32 of these girls aged 14–18 years with polycystic ovary syndrome were treated with medication ethinyl estradiol + drospirenone. Of these 32 patients, 20 girls with insulin resistance were obtained simultaneously with metformin. The following methods were used: examination, evaluation of hair (Ferriman-Gallwey score), pelviс ultrasound, determination of hormone status (LH, FSH, PRL, 17-OHP, E2 , TSH, DHEA-s, SHBG, T), glucose, insulin, and glucose tolerance test. The diagnostic technique used the Sultan C. criteria of polycystic ovary syndrome (2004).Results.A reduction in the frequency characteristics after treatment was shown: of laboratory hyperandrogenism 90.6% , dermopathy 65.6% , insulin resistance 43.8%, hyperinsulinemia 18.8%, ultrasonic signs of PCOS 34.4%.Conclusions. The study results confirm the efficacy of the treatment of polycystic ovary syndrome with insulin resistance during puberty by Low-dose combined oral preparation (0.03 mg ethinyl estradiol and 3 mg drospirenone) in combination with metformin. 

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