PREVALENCE AND RISK FACTOR OF POLYCYSTIC OVARIAN SYNDROME
Abstract
ABSTRACT
Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder in women. Its clinical manifestation varies from mild to severe
disturbance of reproductive and metabolic functions. PCOS is clinical and public health importance because it is affecting up to one in five women
of reproductive age. It is an X-linked dominant condition and has diverse clinical implications such as psychological features (anxiety, depression),
reproductive features (hirsutism and hyperandrogenism), and impaired glucose tolerance. It is widely dependent on environmental, genetic, ethnicity
factors including lifestyle and body weight. Weight loss improves the endocrine profile and increases chances of ovulation and pregnancy. It can
be treated with medications such as clomiphene citrate, tamoxifen, aromatase inhibitors, and gonadotrophins. The last option for fertilization is
in vitro fertilization when other treatment fails. Its prevalence is estimated at 4-8% from studies performed in Spain and USA. Lifestyle including diet,
exercise, and behavior therapy improves fertility. PCOS has unique interactions with the ever increasing obesity prevalence worldwide as obesityinduced
insulin resistance
significantly
aggravates
all the
features
of PCOS.
Education
about
how
PCOS
affects
long-term
health should
be provided
to
women
with this disorder
to
feel
physical
and psychological
benefits so that they
could engage
themselves
more
with their health care
providers.
Keywords: Polycystic ovarian syndrome, Hyperinsulinemia, Hormone disbalance, Hirsutism, Ovarian cyst, Obesity, Sleep disorders.
Downloads
References
REFERENCES
Teede H, Deeks A, Moran L. Polycystic ovary syndrome: A
complex condition with psychological, reproductive and metabolic
manifestations that impacts on health across the lifespan. BMC Med
;8:41.
Diamanti-Kandarakis E, Kouli CR, Bergiele AT, Filandra FA,
Tsianateli TC, Spina GG, et al. A survey of the polycystic ovary
syndrome in the Greek island of Lesbos: Hormonal and metabolic
profile. J Clin Endocrinol Metab 1999;84(11):4006-11.
Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR,
Azziz R. Prevalence of the polycystic ovary syndrome in unselected
black and white women of the southeastern United States: A prospective
study. J Clin Endocrinol Metab 1998;83(9):3078-82.
March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ,
Davies MJ. The prevalence of polycystic ovary syndrome in a
community sample assessed under contrasting diagnostic criteria. Hum
Reprod 2010;25:544-51.
Alvarez-Blasco F, Botella-Carretero JI, San Millán JL,
Escobar-Morreale HF. Prevalence and characteristics of the polycystic
ovary syndrome in overweight and obese women. Arch Intern Med
;166(19):2081-6.
Azziz R, Sanchez LA, Knochenhauer ES, Moran C, Lazenby J,
Stephens KC, et al. Androgen excess in women: Experience with over
consecutive patients. J Clin Endocrinol Metab 2004;89(2):453-62.
Clark AM, Thornley B, Tomlinson L, Galletley C, Norman RJ. Weight
loss in obese infertile women results in improvement in reproductive
outcome for all forms of fertility treatment. Hum Reprod 1998;13:1502-5.
Legro RS, Strauss JF. Molecular progress in infertility: Polycystic
ovary syndrome. Fertil Steril 2002;78(3):569-76.
Doi SA, Al-Zaid M, Towers PA, Scott CJ, Al-Shoumer KA. Ovarian
steroids modulate neuroendocrine dysfunction in polycystic ovary
syndrome. J Endocrinol Invest 2005;28(10):882-92.
Legro RS, Castracane VD, Kauffman RP. Detecting insulin resistance
in polycystic ovary syndrome: Purposes and pitfalls. Obstet Gynecol
Surv 2004;59(2):141-54.
VrbÃková J, Cibula D, Dvoráková K, Stanická S, Sindelka G, Hill M,
et al. Insulin sensitivity in women with polycystic ovary syndrome.
J Clin Endocrinol Metab 2004;89(6):2942-5.
Moran L, Teede H. Metabolic features of the reproductive phenotypes
of polycystic ovary syndrome. Hum Reprod Update 2009;15(4):477 88.
Kiddy DS, Sharp PS, White DM, Scanlon MF, Mason HD, Bray CS,
et al. Differences in clinical and endocrine features between obese and
non-obese subjects with polycystic ovary syndrome: An analysis of 263
consecutive cases. Clin Endocrinol (Oxf) 1990;32(2):213-20.13.
Shaw LJ, Bairey Merz CN, Azziz R, Stanczyk FZ, Sopko G,
Braunstein GD, et al. Postmenopausal women with a history of
irregular menses and elevated androgen measurement at high risk
of worsening cardiovascular event -free survival: Results from the
National Institutes of Health--National Heart, Lung, and Blood Institute
sponsored Women’s Ischemia Syndrome Evaluation. J Clin Endocrinol
Metab 2008;93(4):1276-84.
Moran LJ, Pasquali R, Teede HJ, Hoeger KM, Norman RJ. Treatment
of obesity in polycystic ovary syndrome: A position statement of the
androgen excess and polycystic ovary syndrome society. Fertil Steril
;92(6):1966-82.
Balen A, Michelmore K. Prevalence of polycystic ovaries in
the women with anovulation and idiopathic hirsutism. Oxford J
;17(9):2219-27.
Asunción M, Calvo RM, San Millán JL, Sancho J, Avila S,
Escobar-Morreale HF. A prospective study of the prevalence of the
polycystic ovary syndrome in unselected Caucasian women from
Spain. J Clin Endocrinol Metab 2000;85:2434-8.
Balen A. Pathogenesis of polycystic ovary syndrome – The enigma
unravels? Lancet 1999;354(9183):966-7.
Balen A. Polycystic ovary syndrome and cancer. Hum Reprod Update
;7(6):522-5.
Balen AH, Conway GS, Kaltsas G, Techatrasak K, Manning PJ,
West C, et al. Polycystic ovary syndrome: The spectrum of the disorder
in 1741 patients. Hum Reprod 1995;10(8):2107-11.
Botsis D, Kassanos D, Pyrgiotis E, Zourlas PA. Sonographic incidence
of polycystic ovaries in a gynecological population. Ultrasound Obstet
Gynecol 1995;6(3):182-5.
Carmina E, Koyama T, Chang L, Stanczyk FZ, Lobo RA. Does
ethnicity influence the prevalence of adrenal hyperandrogenism and
insulin resistance in polycystic ovary syndrome? Am J Obstet Gynecol
;167(6):1807-12.22.
Clarke AM, Ledger W, Galletly C, Tomlinson L, Blaney F, Wang X,
et al. Weight loss results in significant improvements in pregnancy
and ovulation rates in anovulatory obese women. Hum Reprod
;10(10):2705-12.
Clayton RN, Ogden V, Hodgkinson J, Worswick L, Rodin DA, Dyer S,
et al. How common are polycystic ovaries in normal women and what
is their significance for the fertility of the population? Clin Endocrinol
(Oxf) 1992;37(2):127-34.
Conway GS, Honour JW, Jacobs HS. Heterogeneity of the polycystic
ovary syndrome: Clinical, endocrine and ultrasound features in
patients. Clin Endocrinol (Oxf) 1989;30(4):459-70.
Dewailly D, Robert Y, Helin I, Ardaens Y, Thomas-Desrousseaux P,
Lemaitre L, et al. Ovarian stromal hypertrophy in hyperandrogenic
women. Clin Endocrinol (Oxf) 1994;41(5):557-62.
Badawy A, Elnashar A. Treatment option for PCOD. Int J Women’s
Health 2011;3:25-35.
Speroff L, Fritz MA. Anovulation and the polycystic ovary. Clin
Gynecol Endocrinol Infertil J 2005;470:470-83.
Azziz R. Diagnostic criteria for polycystic ovary syndrome:
A reappraisal. Fertil Steril J 2005;83(3):1343-6.
Lakhani K, Prelevic GM, Seifalian AM, Atiomo WU, Hardiman P.
Polycystic ovary syndrome, diabetes and cardiovascular disease: Risks
and risk factors. J Obstet Gynaecol 2004;24(6):613-21.
Ehrmann DA. Polycystic ovarian syndrome. Engl J Med
;12:1223-36.
Dunaif A. Insulin resistance and the polycystic ovary syndrome:
Mechanism and implications for pathogenesis. Endocr Rev
;18(6):774-800.
Azziz R, Carmina E, Dewailly D. Position statement: Criteria
for defining polycystic ovary syndrome as a predominantly
hyperandrogenic syndrome: An androgen excess society guideline.
J Clin Endocrinol Metab 2006;91(11):4237-45.
Adams JM, Taylor AE, Crowley WF Jr, Hall JE. Polycystic ovarian
morphology with regular ovulatory cycles: Insights into the
pathophysiology of polycystic ovarian syndrome. J Clin Endocrinol
Metab 2004;89(9):4343-50.
Barber TM, Franks S. Metabolism characteristics of women with
polycystic ovaries and oligo-amenorrhoea but normal androgen level:
Implication for the management for the management of polycystic
ovarian syndrome. Oxford J 2007;66(4):513-7.
Pasquali R, Pelusi C, Genghini S, Cacciari M, Gambineri A. Obesity
and reproductive disorder in women. Hum Reprod J 2003;9(4):359-72.
Boomsma CM, Eijkemans MJ, Hughes EG, Visser GH, Fauser BC,
Macklon NS. A meta-analysis of pregnancy outcomes in women with
polycystic ovary syndrome. Hum Reprod Update 2006;12(6):673-83.37.
Gjønnaess H. Ocarian electrocautery in the treatment of women
with polycystic ovarian syndrome. Acta Obstet Gynecol Scand
;73(5):407-12.
Patel SM, Nestler JE. Fertility in polycystic ovary syndrome. Endocrinol
Metab Clin North Am 2006;35:137-55, vii.
Reaven GM. The insulin resistance syndrome: Definition and dietary
approaches to treatment. Annu Rev Nutr 2005;25(1):391-406.
Bruner B, Chad K, Chizen D. Effects of exercise and nutritional
counseling in women with polycystic ovary syndrome. Appl Physiol
Nutr Metab 2006;31(4):384-91.
Moran LJ, Brinkworth G, Noakes M, Norman RJ. Effects of lifestyle
modification in polycystic ovarian syndrome. Reprod Biomed Online
;12(5):569-78.
Escobar-Morreale HF, Botella-Carretero JI, Alvarez-Blasco F,
Sancho J, San Millán JL. The polycystic ovary syndrome associated
with morbid obesity may resolve after weight loss induced by bariatric
surgery. J Clin Endocrinol Metab 2005;90(12):6364-9.
Homburg R. Clomiphene citrate – end of an era? A mini-review. Hum
Reprod 2005;20(8):2043-51.
Legro RS, Barnhart HX, Schlaff WD, Carr BR, Diamond MP,
Carson SA, et al. Clomiphene, metformin, or both for infertility in the
polycystic ovary syndrome. N Engl J Med 2007;356(6):551-66.
Messinis IE. Ovulation induction: A mini review. Hum Reprod
;20(1):2688-97.
Sam S, Dunaif A. Polycystic ovary syndrome: Syndrome XX? Trends
Endocrinol Metab 2003;14(8):365-70.
Grundy SM. Obesity, metabolic syndrome, and coronary atherosclerosis.
Circulation 2002;105(23):2696-8.
Harborne LR, Sattar N, Norman JE, Fleming R. Metformin and weight
loss in obese women with polycystic ovary syndrome: Comparison of
doses. J Clin Endocrinol Metab 2005;90(8):4593-8.
Glueck CJ, Wang P, Goldenberg N, Sieve-Smith L. Pregnancy outcomes
among women with polycystic ovary syndrome treated with metformin.
Hum Reprod 2002;17(11):2858-64.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.