PCOS is definitely an endocrine and metabolic disorder. It is considered in different woman with acne, hirsutism, menstrual irregularity, or obesity.
Patients with PCOS, have anovulation, i.e. they could not create a follicle cyclically. They may therefore present with primary amenorrhea (i.e. no periods whatsoever), too little periods (oligomenorrhea) or secondary amenorrhea i.e. lack of periods for 6 months or more. Some might also have excessive, frequent and irregular bleeding (dysfunctional uterine bleeding).
Resistance to insulin, and rise in insulin levels is surely an important consider PCOS. Obesity occurs in approximately one-half of patients with PCOS. The waist:hip ratio could be greater than 0.85.
The reason behind PCOS is unknown, but there’s a possibility that PCOS might be a complex genetic disorder where the genetic factor interacts with assorted environmental factors to result in imbalance within the hormones.
The decides PCOS relies upon clinical and biochemical criteria. It is suspected within the of adolescents with hirsutism, acne, menstrual irregularity, or obesity. The diagnosis is further confirmed if excess androgen is demonstrated by laboratory testing. Androgen panel is made up of plasma total testosterone, free testosterone, and another androgens like DHEA sulfate. Plasma-free testosterone will be the single most sensitive test with the detection of androgen excess. DHEA sulfate may be the main marker of androgens that will from adrenals. Cortisol and thyroid function tests are indicated in obese patients to exclude other reasons behind obesity.
Pelvic ultrasound shows you will of a polycystic ovary. i.e. multiple(a lot more than 10) small follicles with a lot more stroma.
A baseline lipid panel plus a glucose tolerance test are very important as PCOS is related to insulin resistance. The fasting glucose concentration is poor predictor on the two-hour level in PCOS. Two-hour blood glucose over 140 mg/dL indicates insulin resistance and this also is important in the treatment perspective.
The management of PCOS relies upon the symptoms. The choice of treatment depends on the individual patient’s symptoms and goals.
Reduction in weight by eating and working out is essential initial step.
Menstrual irregularity needs to be treated in patients with PCOS because chronic anovulation is associated to comprehend risk of developing endometrial hyperplasia and carcinoma.
Combined Oral contraceptive pills (COCP) therapy usually may be the first-line cure for women with menstrual irregularity. They regularize the cycles very effectively as well as normalize androgen levels.
Cosmetic treating abnormal and excessive growth of hair is offered to patients. It is effective and safe but won’t correct the actual problems. Therefore each of them offer only temporary relief. The usual methods are depilation (e.g. shaving, hair removing creams), epilation (eg, plucking, waxing), destruction in the dermal papilla (eg, electrolysis or laser therapy.
Treatment with COCP will cause significant improvement in acne and arrests growth of hirsutism.
Antiandrogens are occasionally prescribed in conjunction with COCP in severe hirsutism. Insulin-lowering agents for example metformin, thiazolidinediones and D-chiro-inositol are widely-used to correct the insulin resistance. This improves ovulation and hormonal profile in patients with PCOS.
Patients with PCOS who wish child bearing , nor conceive naturally might need ovulation drugs and assisted reproductive ways to help them conceive.