Update on diagnosis and treatment

Polycystic ovaries are slightly larger than normal ovaries and have twice the number of follicles (fluid-filled spaces within the ovary that release the eggs when you ovulate). These are the member of symptoms which are related to imbalance of certain hormones that effect the women across the globe of reproductive age group. It is a condition that effects your periods, fertility hormones & aspects of your appearance. Its effects vary widely from 2 to 26 in every hundred women.
The signs of PCOS are the dermatological features which take place are as: Hirsuitism, Balding, oily skin, acne, skin discoloration (acanthosis nigricans) and with this there are menstrual disorder which may vary from complete absence of mensuration up to 35 days or more (oligomenorrhea) to heavy bleeding that is (menorrhagia).This can be put with this that the women with these disturbances i.e. irregularity in periods have a 91% chance of having PCOS & among those with PCOS are 15 times more Prone to infertility. There are other effects which has other health implications such as: Psychological-Depression, anxiety, mood swings.
Sleep disorders-sleep apnea and with the presentation of metabolic disorders, like insulin resistances, Type 2 diabetes is obesity. Risk Factors – There are reports and which says there are four main risk factors and may includes others too. Genetics – If a close family member, such as mother, sister you have a chance of developing PCOS. Diet is the most alarming risk factor one must ponder over, as diet has been found a major contributing factor for PCOS. The fat & protein portion from our daily diet can form advanced glycation end products (AGE’S) & these compounds are considered that they increase bodily stress & inflammation which has been linked to diabetes & cardiovascular disease.
Lifestyle – Everyday habits greatly & immensely effect its development and severity. People who acquire sedentary life style with no exercise fall into this category as exercise helps to reduce the symptoms such as; depression, inflammation, excess weight.
Environmental exposure risk-Environmental exposure’s poses a threat there is some evidence that environmental toxins play a role in disrupting reproductive health, Endocrine disrupting chemical may lead to the issues. The endocrine disrupting chemicals may lead be found in everyday products we use, consists of plastics bottles, containers, adulterate food, pesticides. Preventions – Currently there is no cure for it but symptoms can be managed with lifestyle modifications and medications which includes increasing lifestyle changeover from sendentary to minimal exertions.
Along with eating a high-fibre diet with lots of vegetable and fruits, whole grains but also avoiding or reducing intake of processed food, trans fat. Furthermore, on medication front low androgens oral contraceptives, and inositol supplement which can manage symptoms such as Hirsutism, acne, difficulty in conceiving. Metformin several reports in PCOS patients including restoring ovulation, reducing weight and reducing the risk of type-2 diabetes Miletus. There are immense researches but yet there are some gaps remaining to interlink with the reducing symptoms and for curing PCOS. Pathogenesis: The pathogenesis of polycystic ovary syndrome is not known, and potential etiologies are explored in a recent review. Both genetic and lifestyle factors contribute to the development of polycystic ovary syndrome phenotype. Studies have evaluated potential contributors, including abnormal gonadotropin secretion, insulin resistance, and ovarian factors. Sleep Apnea: obstructive sleep apnea is associated with insulin resistance and type2 diabetes as well as polycystic ovary syndrome.
A retrospective study demonstrated an increase in sleep disordered breathing (17.0% vs 0.6%, P <.001) and excessive daytime sleepiness (80.4% vs 27.0%, p<.001) in 53 polycystic ovary syndrome women compared with 452 premenopausal controls. The risk and severity of obstructive sleep apnea in polycystic ovary syndrome is strongly correlated with insulin resistance. Treatment with at least 4 hours per night of continuous positive airway pressure improves insulin sensitivity, decrease norepinephrine levels and diastolic blood pressure, and lowers cardiac sympathetic activity. Thus, it is important to screen patients with polycystic ovary syndrome for symptoms of sleep apnea (daytime sleepiness, snoring, witnessed apneic episodes, morning headaches), and refer for a sleep study if indicated. Adherence to continuous positive airway pressure treatment may improve metabolic parameters in these patients.
CONCLUSION: Recognizing polycystic ovary syndrome in women presenting with oligo-ovulation and hyperandrogenism offers an important opportunity to begin a life-long conversation about prevention and treatment of a condition that has a multi-system impact on affected women. Recognition offers the chance for providers and patients to engage in discussions about prevention and early treatment of metabolic derangements. It leads to discussions about cycle control both for convenience and to prevent endometrial hyperplasia, and opens the door to conversations about mood, eating, and body image, as well as cosmetic concerns, fertility and sleep. Each of these is critically important to the health and well-being of patients with this common condition.