Polycystic Ovary Syndrome (PCOS): A Comprehensive Review

Shivaleela S. Sarawad

Assistant Professor, BLDEA'S College of Nursing, Jamkhandi, Karnataka, State. India.

*Corresponding Author E-mail: shivaleela.238@gmail.com

ABSTRACT:

Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine illness that affects people of reproductive age and is characterized by a variety of clinical, hormonal, and metabolic aspects. This review article aims to provide a comprehensive overview of the PCOS epidemiology, aetiology, clinical presentation, diagnostic standards, and therapeutic choices. Worldwide estimates of PCOS prevalence among women of reproductive age range from 5% to 20%. This syndrome is well known for being complex in nature, encompassing both genetic predisposition and environmental influences. Menstrual abnormalities, hyperandrogenism, and an ultrasound showing polycystic ovarian morphology are frequent clinical symptoms. Several sets of diagnostic criteria, such as the Rotterdam criteria and the National Institutes of Health standards, are available, but accurate diagnosis is still essential. Insulin resistance, dyslipidemia, and obesity are among the metabolic disorders that are more likely to develop in people with PCOS. Long-term health effects include an increased risk of type 2 diabetes, cardiovascular disease, and infertility. Improvements in hormonal imbalances, metabolic abnormalities, and fertility outcomes are the main goals of therapeutic interventions, which are individualized to the patient's presentation and goals and include both lifestyle changes and pharmaceutical therapies. this review collects the most recent research results and clinical insights to enhance the understanding of PCOS among healthcare professionals.

KEYWORDS: Polycystic Ovary Syndrome, PCOS, hyperandrogenism, insulin resistance, hormonal imbalance, infertility, metabolic syndrome, lifestyle modifications, personalized medicine.

INTRODUCTION:

Worldwide, women's health is affected by the complicated endocrine illness known as polycystic ovary syndrome (PCOS). Its aetiology and clinical symptoms have been thoroughly investigated since it was initially characterised by Stein and Leventhal in 1935. Hyperandrogenism, irregular menstrual periods, and polycystic ovaries on ultrasound imaging are all symptoms of PCOS¹.

What do you mean by Polycystic ovary syndrome (PCOS)?

An abnormal number of androgens, male sex hormones that are typically present in women in modest amounts, are produced by the ovaries in patients with polycystic ovarian syndrome (PCOS). The term polycystic ovarian syndrome refers to a group of tiny cysts (fluid-filled sacs) that develop in the ovaries.

Causes Polycystic ovarian syndrome (PCOS)?

Though the exact aetiology is unknown, PCOS frequently runs in families.

· It is connected to the body's aberrant hormone levels, which include excessive insulin levels.

· A hormone called insulin regulates the body's sugar levels.

· In order to overcome their body's resistance to insulin, many PCOS patients create higher quantities of insulin.

· As a result, hormones like testosterone are produced and activated more frequently.

· The quantity of insulin your body generates also rises when you are overweight or fat².

Pathophysiology:

PCOS's exact cause is still unknown, however it is thought that a mix of hormonal, environmental, and genetic variables play a role in its emergence. A typical finding in PCOS patients is insulin resistance and hyperinsulinemia, which can result in compensatory hyperandrogenism and ovarian dysfunction. The significance of inflammation and dysfunctional adipose tissue in the aetiology of PCOS has also been underlined by recent study³.

Clinical Presentation:

A wide range of symptoms, which might vary from person to person, are present with PCOS.

1. Regular menstrual cycles or no periods (oligo/anovulation) are common clinical characteristics.

2. Hyperandrogenism is characterized by elevated levels of male hormones, which cause male-pattern baldness, acne, and hirsutism (excessive hair growth).

3. On ultrasound, swollen ovaries with numerous tiny follicles are indicative of polycystic ovaries⁴.

Diagnosis:

Due to its many presentations, PCOS can be difficult to diagnose. There have been many proposed diagnostic criteria, with the Rotterdam criteria being the most popular. The Rotterdam criteria state that two of the following three characteristics must be present in order to diagnose PCOS:

· Oligo/anovulation,

· Clinical or biochemical symptoms of hyperandrogenism,

· Polycystic ovaries on ultrasonography,

· It's crucial to rule out other illnesses like thyroid problems and hyperprolactinemia that resemble PCOS⁵.

Management:

The management of PCOS is individualized to take into account each person's unique symptoms and concerns. It is advised to make lifestyle changes, such as dietary changes and regular exercise, to enhance insulin sensitivity and metabolic health in general. Hyperandrogenism and irregular menstruation can be successfully treated with pharmacological therapies, such as oral contraceptives, anti-androgens, and insulin sensitizers.

Future Directions:

Current studies are still looking for new treatment targets and unravelling the intricate pathophysiology of PCOS. With the use of phenotypic features and genetic predisposition, personalised medicine advancements may result in more specialised methods to diagnosis and therapy. Also under inquiry and deserving of more study are the long-term cardiovascular and metabolic concerns linked to PCOS⁶.

CONCLUSION:

A common endocrine condition with a wide range of clinical symptoms is polycystic ovary syndrome. Improving the quality of life for those who are affected requires an understanding of its pathophysiology as well as the application of suitable diagnostic and treatment approaches. To address the issues caused by PCOS, further study is required, as is cooperation between physicians, researchers, and legislators.

REFERENCES:

1. Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016; 2: 16057.

2. Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012; 33(6): 981-1030.

3. Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol. 1935; 29(2): 181-191.

4. Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 1997; 18(6): 774-800.

5. Domecq JP, Prutsky G, Mullan RJ, et al. Lifestyle modification programs in polycystic ovary syndrome: systematic review and meta-analysis. J Clin Endocrinol Metab. 2013; 98(12): 4655-4663.

6. Teede HJ, Misso ML, Costello MF, et al. International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Clin Endocrinol (Oxf). 2018; 89(3): 251-268.

Received on 21.08.2023 Modified on 11.09.2023

Int. J. of Advances in Nur. Management. 2023; 11(4):264-265.

DOI: 10.52711/2454-2652.2023.00059