Lect 2-polycystic ovarian syndrome
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Lect 2-polycystic ovarian syndrome
- 17. hypothalamus pituitary ovary GnRH LH androgens Androgens block inhibitory effect of progesterone X
- 20. DIAGNOSTIC CRITERIA AND CLINICAL MANIFESTATIONS
Hinweis der Redaktion
- ACCESS Medical Group D220/PCOS CME Slide Kit November 22 2002 References 1. Bauer J, et al. Epilepsy Res . 2000;41:163-167. 2. Dunaif A, et al. Annu Rev Med . 2001;52:401-419. 3. Franks S. N Engl J Med . 1995;333:853-861.
- ACCESS Medical Group D220/PCOS CME Slide Kit November 22 2002 Clinical Features of PCOS. Menstrual Irregularity. PCOS is a disorder characterized by menstrual irregularity and hyperandrogenemia. Menstrual irregularity: This problem may manifest itself at puberty with a delayed menarche followed by the onset of irregular periods or as the breakdown of a previously regular cycle within a few years and is often associated with weight gain. 1 Anovulation in PCOS is usually chronic and presents as oligomenorrhea or amenorrhea around the time of the onset of menstruation. 2 It has been reported that 50% of women with PCOS are obese, and 20% of these obese women will have either impaired glucose tolerance or type 2 diabetes by the age of 40 years. 1 Other conditions associated with PCOS include infertility, endometrial hyperplasia or malignancy, hypertension, coronary artery disease, and adverse lipid profiles. 3 References 1. Duncan S. Epilepsia . 2001;42(suppl 3):60-65. 2. Lobo RA, et al. Ann Int Med . 2000;132:989-993. 3. Ernst CL, et al. J Clin Psychiatry . 2002;63(suppl 4):42-55.
- ACCESS Medical Group D220/PCOS CME Slide Kit November 22 2002 Clinical Features of PCOS. Hyperandrogenism. Hyperandrogenemia is a key feature of PCOS, and it may appear as hirsutism, acne, male pattern balding, and/or male distribution of body hair. 1 Reference 1. Lobo RA, et al. Ann Intern Med . 2000;132:989-993.
- ACCESS Medical Group D220/PCOS CME Slide Kit November 22 2002
- ACCESS Medical Group D220/PCOS CME Slide Kit November 22 2002
- ACCESS Medical Group D220/PCOS CME Slide Kit November 22 2002
- Total testosterone may be normal, OCPs may lower total testosterone.
- Polycystic ovaries not required for Dx. Only need 2 of these 3 criteria so far.
- Not an official diagnosis
- Need 4 menses annually to minimize risk endometrial CA. Metformin: addressing insulin resistance will decrease the effects of elevated insulin levels on SHBG, gonadotropins, and ovarian cells.
- Outcomes: extrapolated from general population: no specific study of TZDs on insulin resistance in PCOS women. Improves fertility/ovuluation, known to improve insulin resistance in rest of population, so it MUST work by extrapolation.
- Outcomes: extrapolated from general population: no specific study of TZDs on insulin resistance in PCOS women. Improves fertility/ovuluation, known to improve insulin resistance in rest of population, so it MUST work by extrapolation.
- ASA, statins, ACE-I/BB for HTN; manage like DM (already a CAD equivalent)!