RITTIK PAUL

2019521625048

POLYSYSTIC OVERIAN SYNDROME :A COMMON

DISEASE
BY
NAME-RITTIK PAUL
ID-2109521625048
MAJOR-MBBS(2019)
INTRODUCTION:

Polycys c ovary syndrome (PCOS) is a common condi on that affects how a woman's ovaries work.The 3 main
features of PCOS are:

irregular periods – which means your ovaries do not regularly release eggs (ovula on)

excess androgen – high levels of "male" hormones in your body, which may cause physical signs such as excess
facial or body hair

polycys c ovaries – your ovaries become enlarged and contain many fluid-filled sacs (follicles) that surround the
eggs (but despite the name, you do not actually have cysts if you have PCOS)

If you have at least 2 of these features, you may be diagnosed with PCOS.

POLYCYSTIC OVARIES

Polycys c ovaries contain a large number of harmless follicles that are up to 8mm (approximately 0.3in) in size.
The follicles are underdeveloped sacs in which eggs develop. In PCOS, these sacs are o en unable to release an
egg, which means ovula on does not take place.It's difficult to know exactly how many women have PCOS, but
it's thought to be very common, affec ng about 1 in every 10 women in the UK.More than half of these women
do not have any symptoms.

SYMPTOMS:

If you experience symptoms of polycys c ovary syndrome (PCOS), they'll usually become apparent in your late
teens or early 20s.Not all women with PCOS will have all of the symptoms, and each symptom can vary from mild
to severe.Some women only experience menstrual problems or are unable to conceive, or both.Common
symptoms of PCOS include:

irregular periods or no periods at all

difficulty ge ng pregnant (because of irregular ovula on or no ovula on)

excessive hair growth (hirsu sm) – usually on the face, chest, back or bu ocks

weight gain

thinning hair and hair loss from the head

 RITTIK PAUL
2019521625048

oily skin or acne

You should talk to your GP if you have any of these symptoms and think you may have PCOS.

Fer lity problems

PCOS is one of the most common causes of female infer lity. Many women discover they have PCOS when they're
having difficulty ge ng pregnant.During each menstrual cycle, the ovaries release an egg (ovum) into the uterus
(womb). This process is called ovula on and usually occurs once a month.

But women with PCOS do not ovulate or ovulate infrequently, which means they have irregular or absent periods
and find it difficult to get pregnant.

RISKS IN LATER LIFE

Having PCOS can increase your chances of developing other health problems in later life.

For example, women with PCOS are at increased risk of developing:

type 2 diabetes – a lifelong condi on that causes a person's blood sugar level to become too high

depression and mood swings – because the symptoms of PCOS can affect your confidence and self-esteemhigh
blood pressure and high cholesterol – which can lead to heart disease and stroke

sleep apnoea – overweight women may also develop sleep apnoea, a condi on that causes interrupted breathing
during sleep

Women who have had absent or very irregular periods (fewer than 3 or 4 periods a year) for many years have a
higher than average risk of developing cancer of the womb lining (endometrial cancer).

But the chance of ge ng endometrial cancer is s ll small and can be minimised using treatments to regulate
periods, such as the contracep ve pill or an intrauterine system (IUS).

CAUSE:-

The exact cause of polycys c ovary syndrome (PCOS) is unknown, but it's thought to be related to abnormal
hormone levels.

Resistance to insulin

Insulin is a hormone produced by the pancreas to control the amount of sugar in the blood. It helps to move
glucose from blood into cells, where it's broken down to produce energy.Insulin resistance means the body's
ssues are resistant to the effects of insulin. The body therefore has to produce extra insulin to compensate.High
levels of insulin causes the ovaries to produce too much testosterone, which interferes with the development of
the follicles (the sacs in the ovaries where eggs develop) and prevents normal ovula on.nsulin resistance can
also lead to weight gain, which can make PCOS symptoms worse, as having excess fat causes the body to produce
even more insulin.
 RITTIK PAUL
2019521625048

Hormone imbalance

Many women with PCOS are found to have an imbalance in certain hormones, including:raised levels of
testosterone – a hormone o en thought of as a male hormone, although all women usually produce small
amounts of itraised levels of luteinising hormone (LH) – this s mulates ovula on, but may have an abnormal
effect on the ovaries if levels are too highlow levels of sex hormone-binding globulin (SHBG) – a protein in the
blood that binds to testosterone and reduces its effect.raised levels of prolac n (only in some women with PCOS)
– a hormone that s mulates the breast glands to produce milk in pregnancy.The exact reason why these
hormonal changes occur is not known.

It's been suggested that the problem may start in the ovary itself, in other glands that produce these hormones,
or in the part of the brain that controls their produc on. The changes may also be caused by the resistance to
insulin.

Gene cs

PCOS some mes runs in families. If any rela ves, such as your mother, sister or aunt, have PCOS, the risk of you
developing it is o en increased.This suggests there may be a gene c link to PCOS, although specific genes
associated with the condi on have not yet been iden fied.

DIAGNOSIS CRITERIA

A diagnosis of PCOS can usually be made if other rare causes of the same symptoms have been ruled out and
you meet at least 2 of the following 3 criteria:

you have irregular periods or infrequent periods – this indicates that your ovaries do not regularly release eggs
(ovulate)

blood tests showing you have high levels of "male hormones", such as testosterone (or some mes just the signs
of excess male hormones, even if the blood test is normal)

scans showing you have polycys c ovaries

As only 2 of these need to be present to diagnose PCOS, you will not necessarily need to have an ultrasound scan
before the condi on can be confirmed.

TREATMENT

PCOS treatment focuses on managing the things that are concerning you. This could include infer lity, hirsu sm,
acne or obesity. Specific treatment might involve lifestyle changes or medica on.

Lifestyle changes

Your health care provider may recommend weight loss through a low-calorie diet combined with moderate
exercise ac vi es. Even a modest reduc on in your weight — for example, losing 5% of your body weight —
might improve your condi on. Losing weight may increase the effec veness of medica ons your provider
recommends for PCOS, and it can help with infer lity. Your health care provider and a registered die an can
work with you to determine the best weight-loss plan.
 RITTIK PAUL
2019521625048

Medica ons

To regulate your periods, your health care provider might recommend:

Combina on birth control pills. Pills that contain both estrogen and proges n decrease androgen produc on and
regulate estrogen. Regula ng your hormones can lower your risk of endometrial cancer and correct irregular
bleeding, excess hair growth and acne.

Proges n therapy. Taking proges n for 10 to 14 days every 1 to 2 months can regulate your periods and protect
against endometrial cancer. This proges n therapy doesn't improve androgen levels and won't prevent
pregnancy. The proges n-only minipill or proges n-containing intrauterine device is a be er choice if you also
wish to avoid pregnancy.

To help you ovulate so that you can become pregnant, your health care provider might recommend:

Clomiphene. This oral an -estrogen medica on is taken during the first part of your menstrual cycle.

Letrozole (Femara). This breast cancer treatment can work to s mulate the ovaries.

Me ormin. This medicine for type 2 diabetes that you take by mouth improves insulin resistance and lowers
insulin levels. If you don't become pregnant using clomiphene, your provider might recommend adding
me ormin to help you ovulate. If you have prediabetes, me ormin can slow the progression to type 2 diabetes
and help with weight loss.

Gonadotropins. These hormone medica ons are given by injec on.

If needed, talk with your health care provider about procedures that may help you become pregnant. For
example, in vitro fer liza on may be an op on.

To reduce excessive hair growth or improve acne, your health care provider might recommend:

Birth control pills. These pills decrease androgen produc on that can cause excessive hair growth and acne.

Spironolactone (Aldactone). This medica on blocks the effects of androgen on the skin, including excessive hair
growth and acne. Spironolactone can cause birth defects, so effec ve birth control is needed while taking this
medica on. This medica on isn't recommended if you're pregnant or planning to become pregnant.

Eflornithine (Vaniqa). This cream can slow facial hair growth.

Hair removal. Electrolysis and laser hair removal are two op ons for removing hair. Electrolysis uses a ny needle
inserted into each hair follicle. The needle sends out a pulse of electric current. The current damages and then
destroys the follicle. Laser hair removal is a medical procedure that uses a concentrated beam of light to remove
unwanted hair. You might need mul ple treatments of electrolysis or laser hair removal. Shaving, plucking or
using creams that dissolve unwanted hair may be other op ons. But these are temporary, and hair may thicken
when it grows back.

Acne treatments. Medica ons, including pills and topical creams or gels, may help improve acne. Talk to your
health care provider about op ons.
 RITTIK PAUL
2019521625048

CONCLUSION:-

Polycys c ovarian syndrome (PCOS) is a heterogeneous endocrine disorder with the underline indica on of
ovarian cysts, anovula on, and endocrine varia on affec ng the women. According to the World Health
Organiza on (WHO) es ma on revealed over 116 million women (3.4%) are affected by PCOS worldwide. The
predisposing risk factors include gene cs, neuroendocrine, lifestyle/environment, obesity that contributes to the
development of PCOS. The pathophysiological aspect of PCOS mainly focuses on hormonal dysfunc on, insulin
resistance, and hyperandrogenism leading to impaired folliculogenesis which arise the risk for associated
comorbidi es like endometrial cancer, type II diabetes. This review highlights a brief overview of risk and
pathophysiological treatment with drugs ac ng on anovula on, infer lity plus clinical symptoms of PCOS.