SEARCH · PubMed Health

Results for “PCOS”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,441 records · Page 80Linked to original sources

PubMed1997

The outcome of an in vitro fertilization program in women with polycystic ovary syndrome.

The objective of this study was to examine the efficacy of D-triptorelin in the long protocol and follicle-stimulating hormone (FSH) in an IVF-embryo transfer program in a group of patients with polycystic ovary syndrome (PCOS) who had earlier failed to respond or did not conceive after clomiphene citrate (CC)/human menopausal gonadotropin (hMG) or 'flare up' gonadotropin-releasing hormone agonist (GnRHa)/hMG stimulation. Eighty-nine women with PCOS (based on typical ultrasound criteria) had 1-3 treatment cycles without success. The stimulation protocol was changed to D-triptorelin given in midluteal phase and when pituitary desensitization was achieved, FSH administration was started. The clinical pregnancy rate per transfer in this 'negatively selected' group of PCOS patients was 29%. This was the same as the rate for a group of women with tubal factor, as was the spontaneous miscarriage rate. Although the use of GnRH agonists in the long protocol increases the costs of treatment, the number of cancelled cycles is reduced. The pregnancy rate increased in this group of women with PCOS.

Chorionic Gonadotropin↗

PubMed1997

Effect of growth hormone suppression on the serum levels of ovarian and adrenal sex steroid hormones in normal women and in women with polycystic ovary syndrome.

We investigated the acute effect on the serum levels of ovarian and adrenal sex steroid hormones of the suppression of growth hormone during oral glucose tolerance test (OGTT). A standard 75 g OGTT was performed in 11 healthy women and eight women with polycystic ovary syndrome (PCOS). Another five controls were given a sham loading of oral distilled water. Blood samples were obtained immediately before and at 30-minute intervals after glucose or sham loading. Significant progressive declines in testosterone, estradiol, dehydroepiandrosterone sulfate (DHEAS) and growth hormone levels were observed during OGTT in both groups. In the PCOS and normal groups, respectively, at 120 min, testosterone levels were 75.8% and 64.4% of the baseline (0-time) value, estradiol levels were 83.4% and 83.1%, DHEAS levels were 79.3% and 79.1%, and growth hormone levels were 33.9% and 21.2%. Significant positive correlations were observed between the level of growth hormone and each of the testosterone, estradiol and DHEAS levels in both the groups. The area under the curve for growth hormone was significantly smaller in the PCOS group than in the normal group. Gonadotropins were not changed at any time during OGTT. It appears that growth hormone may modify ovarian and adrenal sex steroidogenic responses to tropic hormones directly or via local insulin-like growth factor-I. Women with PCOS may be relatively deficient in growth hormone, a deficiency which may play a role in the pathophysiology of ovulatory disturbance.

Adult↗

PubMed1988

Androstenedione concentrations following dexamethasone suppression: correlation with clomiphene responsiveness in women with polycystic ovary syndrome.

It is difficult to predict clomiphene responsiveness in women with polycystic ovary syndrome (PCOS) but it has been suggested that women with evidence of excess adrenal androgen are less likely to respond to clomiphene. To investigate this further we performed a short Synacthen test following overnight dexamethasone suppression, using 11 beta-hydroxyandrostenedione (11-OHA) as a specific marker of adrenal androgen secretion in women with anovulatory infertility due to PCOS (n = 19) compared with a normal group (n = 7). Women with PCOS were subsequently divided into 2 groups according to whether or not they ovulated after clomiphene. On day 1 blood was taken at 9.00 hours for measurement of androstenedione (A), 11-OHA and cortisol, and 1 mg dexamethasone was given at 22.00 hours. On day 2 blood was taken at 9.00 hours and at 30 and 60 minutes after intravenous administration of 250 micrograms Synacthen. Before dexamethasone was given, concentrations of A but not of 11-OHA or cortisol were significantly higher in women with PCOS than in controls but there was no difference in A levels between clomiphene responders and non-responders. After 1 mg dexamethasone had been given, concentrations of A, 11-OHA and cortisol were suppressed in all 3 groups and there were no differences between the groups in the post-dexamethasone concentrations of 11-OHA or cortisol.(ABSTRACT TRUNCATED AT 250 WORDS)

Amenorrhea↗

PubMed2004

Polycystic ovarian syndrome: diagnosis and management.

Polycystic ovarian syndrome (PCOS) affects 4% to 12% of women of reproductive age. The lack of well-defined diagnostic criteria makes identification of this common disease confusing to many clinicians. Also, with the varied manifestations of the disorder a patient may present to any one of several providers: an internist, family practitioner, nurse practitioner, pediatrician, gynecologist, dermatologist, or endocrinologist. Furthermore, the most distressing aspect of PCOS for any given patient may change over time, from hirsutism as a teenager to infertility as a young adult--potentially requiring several different providers along the way. It is important, therefore, that those caring for these patients understand not only the management issues pertinent to their specialty, but also appreciate the other potential health risks in these women. Recent insights into the pathophysiology of PCOS have shown insulin resistance to play a substantial role and as such have brought the long-term issues of type 2 diabetes mellitus and its resultant increased risk of coronary artery disease to the forefront. No longer can irregular menses and/or hirsutism be thought of as benign nuisances. This review will focus on the two most confusing aspects of PCOS for the practicing provider--diagnosis/differential diagnosis and treatment options. Special attention is given to the role of insulin resistance and the potential utility of insulin sensitizers in management. The benefit and utmost importance of lifestyle modification for the long-term health of these women is stressed as well. It is hoped that some clarity in this regard will allow more women to not only be diagnosed and managed properly for their presenting symptoms (hirsutism, irregular menses, etc.), but also to be educated and managed for the continuing health risk of insulin resistance throughout their lives.

Diagnosis, Differential↗

PubMed2005

Diagnosis and treatment of polycystic ovarian syndrome and insulin resistance.

PCOS is a complex syndrome that includes clinical and biochemical evidence of hyperandrogenism and hyperinsulinism. Adolescents with PCOS are affected by the diagnosis with both short-term and long-term consequences. Adolescents with PCOS report lower self-esteem and quality of life, based on standard assessments, when compared with age matched peers. These young women also are concerned about future fertility, which may affect psychological well being and health behaviors. In addition, patients with PCOS are at an increased risk for development of insulin resistance, type 2 diabetes, metabolic syndrome, and cardiovascular disease. Therefore, this identified at-risk group requires rigorous evaluation, treatment and long-term counseling and management by healthcare providers.

Cardiovascular Diseases↗

PubMed2006

[Polycystic ovary syndrome: an example of obesity-related cardiovascular complication affecting young women].

Polycystic ovary syndrome (PCOS) is a good example of obesity-related cardiovascular complication affecting young women. PCOS is not only considered a reproductive problem but rather represents a complex endocrine, multifaceted syndrome with important health implications. Several evidences suggest an increased cardiovascular risk of cardiovascular disease associated with this syndrome, characterized by an impairment of heart structure and function, endothelial dysfunction and lipid abnormalities. All these features, probably linked to insulin-resistance, are often present in obese PCOS patients. Cardiovascular abnormalities represent important long-term sequelae of PCOS that need further investigations.

Biomarkers↗

PubMedDate not supplied

Polycystic ovary syndrome and severe nonalcoholic steatohepatitis: beneficial effect of modest weight loss and exercise on liver biopsy findings.

OBJECTIVE: To report a case of biopsy-documented nonalcoholic steatohepatitis (NASH), which improved appreciably through moderate exercise and weight loss in a young woman with polycystic ovary syndrome (PCOS) and insulin resistance. METHODS: We present a detailed case report, including laboratory and pathologic findings. In addition, we review the recent literature regarding the association of insulin resistance with NASH and PCOS. RESULTS: A 24-year-old woman was referred to the Duke Gastroenterology Clinic for evaluation of long-term high serum aminotransferase levels. She also reported a history of chronically irregular menses, infertility, and hirsutism and was diagnosed with PCOS. Subsequent glucose tolerance testing suggested the presence of insulin resistance. Liver biopsy findings were consistent with severe nonalcoholic steatohepatitis. Under the supervision of her physician and an exercise physiologist, the patient initiated a diet and exercise program that resulted in an 11.5% weight loss during approximately 8 months and yielded normalization of her aminotransferase levels. A repeat liver biopsy done 13 months after the initial biopsy revealed a substantial decrease in steatosis and a reduction in inflammation. CONCLUSION: Women with PCOS and insulin resistance have an increased risk of developing many of the consequences of the dysmetabolic syndrome, including type 2 diabetes, hypertension, and hyperlipidemia. This case report suggests that fatty liver and NASH may be other important diseases to identify in such women. It also demonstrates the improvement in this condition with moderate exercise and weight loss.

Adult↗

PubMed2004

4: Polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common condition characterised by menstrual abnormalities and clinical or biochemical features of hyperandrogenism. Features of PCOS may manifest at any age, ranging from childhood (premature puberty), teenage years (hirsutism, menstrual abnormalities), early adulthood and middle life (infertility, glucose intolerance) to later life (diabetes mellitus and cardiovascular disease). While pelvic ultrasound examination is useful, many women without PCOS have polycystic ovaries; ultrasound evidence is not necessary for the diagnosis. Testing for glucose intolerance and hyperlipidaemia is wise, especially in obese women, as diabetes mellitus is common in PCOS. Lifestyle changes as recommended in diabetes are fundamental for treatment; addition of insulin-sensitising agents (eg, metformin) may be valuable in circumstances such as anovulatory infertility. Infertility can be treated successfully in most women by diet and exercise, clomiphene citrate with or without metformin, ovarian drilling, or ovulation induction with gonadotrophins; in-vitro fertilisation should be avoided unless there are other indications.

Adolescent↗

PubMed1997

[Effects of K+ channel openers on voltage-dependent K+ channel behavior in airway smooth muscle of guineapig].

In order to determine whether the K+ channel openers (PCOs), which are suggested to open K+ channels and to relax bronchial smooth muscle, would directly activate voltage-dependent K+ channels, single channel currents were studied on cell-attached and inside-out patches of smooth muscle acutely dissociated from bronchi of guinea-pig. The resting membrane potentials measured in whole-cell recording configuration showed no difference with control when cromakalim and lemakalim were applied extracellularly, which, however increased the conductance values of K+ channels with depolarization from 75.2 +/- 5.1 pS to 85.9 +/- 11.8 pS and 82.1 +/- 5.5 pS, respectively. The channels kinetics were also affected by PCOs. Mean open time (tau o) and open probability increased, in which the effects of lemakalim was stronger than that of cromakalim. Both PCOs elicited the multichannel activities in some patches. It is suggested that PCOs could evoke K+ channels with depolarization and stimulate K+ efflux, which may affect the excitability of muscle cells.

Animals↗

PubMed1999

Efficacy of laparoscopic ovulation induction in polycystic ovary syndrome.

This prospective study was aimed to evaluate the efficacy of laparoscopic ovarian electrocoagulation in women with PCOS. Twenty-three PCOS women who had refractory to clomiphene citrate attending the Reproductive Endocrinology Unit, Ramathibodi Hospital between March 1995 and June 1998 were enrolled in the study. In all patients, electrocoagulation on the ovarian surface of both ovaries was performed through laparoscope under general anesthesia. Two patients were lost to follow-up for unknown reasons. The remaining 21 women had a mean age of 30.3 +/- 3.9 years (range 21-39) and mean duration of infertility of 4.1 +/- 2.8 years (range 1-11). There was no intra-operative and post-operative complication. After surgery, ovulation was documented in 16 out of 18 (88.9%) patients. Fifteen (71.4%) patients became pregnant. Fourteen pregnancies (93.3%) occurred within 9 months after surgery. Twelve women (80%) became pregnant in spontaneous cycles without any treatment. The outcomes of pregnancies were 10 live births, 3 ongoing pregnancies and 2 abortions. This study reveals the high efficacy of ovarian electrocoagulation in infertile women with PCOS. High pregnancy and low abortion rates are convincing. This surgical technique should be the treatment of choice for women with CC-resistant PCOS.

Adult↗

PubMedDate not supplied

Hyperinsulinemia does not influence androgens/estrogens ratio in patients with polycystic ovarian syndrome.

OBJECTIVE: The ratio of androgens to estrogens in patients with polycystic ovarian syndrome (PCOS) and controls was evaluated in order to investigate whether hyperinsulinemia might induce hyperandrogenemia by decreasing androgen catabolism. STUDY DESIGN: Forty women were divided into four groups according to the presence of PCOS, insulin resistance, and normal or abnormal body mass index (BMI); each group consisted of 10 women. Group I comprised patients with PCOS, insulin resistance, and abnormal BMI. Group II consisted of patients with PCOS, without insulin resistance, and with normal BMI. Group III consisted of healthy women (controls) with abnormal BMI. Group IV consisted of healthy women with normal BMI. RESULTS: We found that: (1) the mean fasting insulin levels of groups II, III, and IV were significantly lower than those of group I (P < .001); (2) serum testosterone levels were significantly lower in groups III and IV than in group I and II; (3) there were no significant differences in serum estradiol and estrone levels between women of all groups; (4) women of groups III and IV had significantly lower ratios of testosterone to estradiol at time 0 compared to patients of groups I and II. CONCLUSION: Our results support the view that since hyperinsulinemia induces hyperandrogenism, the increase of androgens should not be attributed to the decrease of androgen catabolism.

Adolescent↗

PubMed1998

[Lipoprotein lipids in polycystic ovarian syndrome: independent associations with androgen excess and insulin resistance].

OBJECTIVE: To investigate the relationship between androgen excess, insulin resistance and altered lipoprotein lipids in polycystic ovarian syndrome (PCOS). METHODS: Both basal and luternizing hormone-releasing hormone (LHRH, 100 micrograms) induced responses of circulating testosterone (T), triglycerides (TG), high-density lipoprotein-cholesterol (HDL-C) and apoprotein A1 (apo A1) were measured in two PCOS groups with similar T levels (LH/FSH > or = 3, Group 1, n = 15, LH/FSH < 3, Group 2, n = 15) and the control (n = 20) of matched body mass index with Group 1. Insulin resistance was assessed by fasting insulin levels. RESULTS: In basal state, the mean TG levels in women of three groups were as follows: Group 2 > Group 1 > control, while HDL-C showed the opposite. After LHRH test, mean T and TG concentrations increased and HDL-C decreased in all PCOS subjects, especially Group 2 whereas the indices remained unchanged in the controls. CONCLUSION: Our data suggest that altered lipid profiles in women with PCOS may result from the independent effects of androgen excess and insulin resistance.

Adult↗

PubMed2000

[Troglitazone for treatment of polycystic ovary syndrome].

Polycystic ovary syndrome(PCOS) is characterized by clinical symptoms such as menstrual dysfunction, unovulatory infertility, masculinization, obesity, polycystic ovary by ultrasound, and endocrine abnormalities such as hyperandrogenism, and elevated LH to FSH ratio. Recent reports suggest that insulin resistance plays an important role in the pathogenesis of PCOS, and several insulin sensitizing agents have been used for the treatment of PCOS. Troglitazone, one of the thiazolidinediones, improves not only insulin sensitivity but also hyperandrogenism and ovulatory function. Troglitazone appears to be useful in treating women with PCOS. Further investigations are needed to assess the effectiveness and safety.

Chromans↗

PubMed2000

Role of inositolphosphoglycan mediators of insulin action in the polycystic ovary syndrome.

Evidence suggests that some actions of insulin are mediated by putative inositolphosphoglycan (IPG) mediators, also known as second messengers. We review studies indicating that the IPG signaling system transduces insulin's stimulation of human thecal androgen biosynthesis, thus offering a mechanism by which insulin can stimulate ovarian androgen production even in women with PCOS whose tissues are resistant to insulin's stimulation of glucose metabolism. Furthermore, a deficiency in a specific D-chiro-inositol-containing IPG may contribute to insulin resistance in women with PCOS. In support of this idea, administration of D-chiro-inositol has been demonstrated to improve glucose tolerance, decrease serum androgens and improve ovulation in PCOS. The hypothesis is advanced that PCOS may be characterized by a defect in the conversion of myo-inositol to D-chiro-inositol, and that such a defect would contribute to both insulin resistance and hyperandrogenism in the syndrome.

Androgens↗

PubMed2000

Glucose intolerance in the polycystic ovary syndrome: role of the pancreatic beta-cell.

Women with polycystic ovary syndrome (PCOS) are at increased risk of developing diabetes mellitus type 2. Insulin resistance plays a key role in the predisposition to diabetes in PCOS; however, defects in insulin secretion also appear to contribute to its development. Since diabetes mellitus is not a universal consequence in PCOS, however, it is important to develop means to identify those women who are at highest risk. In this way, it may become possible to delay or even prevent the onset of diabetes mellitus in later life. Identification of genetic factors and use of pharmacological agents may allow early identification of those women with PCOS who are at greatest risk for development of diabetes mellitus type 2.

Dexamethasone↗

PubMedDate not supplied

[Comparison of HOMA IR with the minimal model for measuring insulin sensitivity in polycystic ovary syndrome].

BACKGROUND: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of premenopausal women. These women have insulin resistance independent of obesity; and insulin resistance is now recognized as a risk factor for the development of type 2 diabetes mellitus, hypertension and cardiovascular disease. PURPOSE: We sought, therefore, to assess whether there was correlation between a simple fasting measure of insulin sensitivity (Homeostatic Model) and the Minimal-Model in this syndrome. METHODS: Thirty-three PCOS women (aged 22.7 +/- 6.2 years and body mass index (BMI) 29.1 +/- 5.4) underwent frequently sampled i.v. glucose tolerance test (Minimal-Model). RESULTS: Seventeen patients (51.5%) had insulin sensitivity < 1.5 x 10(-4) min.-1.microU-1.mL-1. Patients with BMI > de 27 was more resistant than the BMI < or = de 27 (p = 0.004). The correlation in PCOS between Si (insulin sensitivity) and HOMA IR was found significant for all the group (p = 0.0001; RRANK = -0.76) and those women with BMI > de 27 (RRANK = -0.77; p = 0.00006), but not significant correlation was found in those with BMI < or = de 27 (RRANK = -0.43; p = 0.13). CONCLUSIONS: We conclude that the HOMA IR may be useful as a screening test for insulin resistance in overweight and obese Mexican PCOS women but not in the lean ones.

Adipose Tissue↗

PubMed2001

Biochemical and body weight changes with metformin in polycystic ovary syndrome.

OBJECTIVE: To evaluate the long-term effects of metformin on biochemical variables and body weight in polycystic ovary syndrome (PCOS). METHOD: Fifteen obese PCOS patients that attended the university clinic were included to this prospective study. These patients used 1,500 mg of metformin daily for 12 months. RESULT: We found a statistically different decrease in mean body mass index (t:4,369), (p:0.0002) at the end of the 12 months. In contrast to that there were no statistical differences in fasting serum insulin and testosterone levels. Metformin improved menstrual patterns (60% of cases) in obese PCOS patients. CONCLUSION: Hyperinsulinemia and androgen excess in obese non-diabetic women with PCOS are not improved by the administration of metformin. Metformin treatment may have improved menstrual patterns by a mechanism independent of and unrelated to insulin sensitivity or circulating insulin concentrations.

Adult↗

PubMed2002

Polycystic ovary syndrome in adolescents.

Recent findings suggest substantial metabolic sequelae to polycystic ovary syndrome (PCOS), including risk of diabetes and cardiovascular disease. Primary treatment of the metabolic sequelae should be the focus of the clinician. The definition of PCOS has been expanded from a disorder that presents at menarche and ends at menopause to a disorder that may be present from birth to senescence. The earliest recognized PCOS phenotype to date is premature pubarche characterized by excessively elevated levels of dehydroepiandosterone sulfate and hyperinsulinemia. Such girls are at high risk to develop the full PCOS phenotype, including ovarian hyperandrogenism and chronic anovulation. A fasting glucose-to-insulin ratio of < 7 is a useful index of insulin resistance in adolescents. However, each patient should be evaluated for glucose intolerance and lipid abnormalities on a regular basis by completing a 2-hour oral glucose tolerance test and a fasting lipid profile. Primary prevention of diabetes and cardiovascular disease by lifestyle modifications, regular exercise, and a balanced diet are of utmost importance, especially in adolescents who have the opportunity to establish healthy habits before entering adulthood. The role of insulin-sensitizing medications is still under study. Although no clinical trials over 6 months in duration have assessed the long-term efficacy of metformin use in adolescents, short-term trials have shown promising effects in lowering insulin secretion, improving insulin sensitivity, restoring normal menstrual cycles, and correcting lipid abnormalities.

Adolescent↗