Literature Review Polycystic Ovarian Syndrome Health And Social Care Essay

Literature check over Polycystic Ovarian Syndrome Health And Social consider Essay look backward of books is an essential step in the phylogeny of a research project. The capital purpose is to gain abroad mise en scene or understanding of the information that is cogitate to the research problem.Review of literature of the present content was arranged in the fol dispiriteding headingReview cogitate to to polycystic ovarian syndrome.Review relate to prevalenceReview colligate to Quality of animatenessReview related to attempt factors.Review related to treatment.. Review related to poly cystic ovarian syndrome.Polycystic ovary syndrome (PCOS), also known as Stein Leventhal Syndrome, was first described in 1935. PCOS, which whitethorn also be referred to as polycystic ovary disease (PCOD) is the almost common hormonal disorder implant in premenopausal women. PCOS affects 7% of women from all races and nationalities.Typically, PCOS symptoms first appear in adolescence, no rmally around the state of menstruation. Occasionally, whatsoever women do not become PCOS symptoms until their early to mid-20s. One of the most common symptoms of PCOS is irregular periods. Polycystic ovary syndrome (PCOS) becomes symptomatic during adolescence and affects at least 5% of productive-age women. PCOS is a heterogeneous syndrome of unexplained chronic hyperandrogenic hormoneism and oligo-anovulation, with a polycystic ovary being an alternative diagnostic criterion. Ab erupt half of cases lack some of the classic Stein-Leventhal syndrome features of menstrual irregularity, hirsuteness, corpulency, and polycystic ovaries. Whether the syndrome net be diagnosed in the absence of hyperandrogenism is controversial, and the softwargon documentation of hyperandrogenemia can be problematic. The broad spectrum of the disorder seems to encompass atypical cases of hyperandrogenemia with commutation fleshiness and features of insulin unsusceptibility instead of hirsutism or anovulation.Functional ovarian hyperandrogenism (FOH) is usually the source of the androgen excess. It is characterized by 17-hydroxyprogesterone (17PROG) hyperresponsiveness to the gonadotropin stimulation of GnRH supporter or human chorionic gonadotropin testing and subnormal suppressibility of blood plasma testosterone upon supr benal gland suppression by glucocorticoid. It is often accompanied by running(a) adrenal hyperandrogenism, characterized by 17-hydroxypregnenolone or dehydroepiandrosterone (DHEA) hyperresponsiveness to ACTH in atypical PCOS, the restore source of androgen excess whitethorn be functional adrenal hyperandrogenism. The underlying defect seems to be a constitutive dysreglulaton of steroidogenic cadres (9). Intrinsic granulosa cell dysfunction is also present. LH excess appears to contri exactlye to 50-75% of cases. Evidence is accumulating that it arises from androgen interfering with the progesterone negative-feedback effect on LH secretion. However , the possibility of primary fundamental mechanisms for LH excess remains, particularly in adolescent PCOS . change magnitude evidence suggests that PCOS arises as a complex mark with contributions from both transmitted and nonheritable factors. Polygenic influences appear to account for most 70% of the discrepancy in pathogenesis. Nearly half of sisters of women with PCOS pay off an elevated plasma testosterone level, although just now half of them are symptomatic. Polycystic ovaries appear to be transmitted as a dominant trait, usually asymptomatic but often accompanied by a subclinical PCOS type of ovarian dysfunction. Central obesity and insulin resistance seem to play important roles in PCOS, perhaps by accentuating steroidogenic dysregulation but perhaps more fundamentally because PCOS is closely related to these features in parents. gestational factors acquit also been incriminated the syndrome has been associated with spunky birth weight in effectual mothers and can arise from fetal programming by androgen excess. In view of these indications for congenital origins of the syndrome, it is not surprising that thither is increasing acknowledgment of risk factors for PCOS in childishnessMinerva Pediatr (2010) Polycystic Ovary syndrome (PCOS) is a complex disorder, involving primarily ovarian hyperandrogenism in distaffs and linked with insulin resistance in the majority of cases. Clinical features are widely variable and include a combination of menstrual irregularities, acne, hirsutism, and alopecia. Although it typically presents around puberty, several risk factors during childhood may help snarf a high index of suspicion for the disclosement of PCOS in adolescents. The pathophysiology of PCOS fluid remains unknown and probably includes a combination of genetic factors, insulin resistance and environmental factors. A thorough diagnostic work up is required in suspected cases and several management modalities have been suggested. Sinc e various colossal term complications and comorbidities are associated with PCOS early diagnosis and therapeutic intervention is warranted in these cases.Review Related To PrevalencePembe AB, Abeid MS (2009). The aim of this con was to make up ones mind prevalence of polycystic ovaries (PCO) and associated clinical and biochemical features among women with asepsis attending gynaecological outpatients subdivision (GOPD) at Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania. All women with infertility attending the GOPD from 11th September 2006 to 15th February 2007 were recruited to the reputation. Information on socio-demographic, obstetric and menstrual characteristics was collected. Anthropometric measurement, clinical examination of acne and hirsutism, vaginal ultrasonography for PCO and biochemical analysis of luteinizing hormone (LH), follicle stimulating hormone (FSH) and testosterone were performed all 102 women who attended the GOPD during the memorise peri od due to infertilityw ere recruited. Two women were excluded after diagnosis of pregnancy do by hormonal assay and ultrasonography thus remaining with snow women for analysis. Oligomenorrhoea and acne were significantly higher in a group of women with PCO than among women with normal ovaries. The hatch hirsutism score though was not significant, was higher in women with PCO than in women with normal ovaries (5.1 +/-2.7 vs 4+/-2.4, PKoivunen R. (1999) conducted study somewhat prevalence of polycystic ovaries in healthy women. The prevalence of polycystic ovaries varies with age. The findings are more common in women vulcanized 35 years or younger than in those aged 36 years or older. It remains unclear of women with polycystic ovaries will later develop fall-blown polycystic ovary syndrome however, the hormonal parameters and clinical findings among women with polycystic ovaries mimized those will polycystic ovarian syndrome.Enhrman DA, Cavagham MK, Barnes RB, (1999) prevalence of stricken glucose gross profit margin and diabetes in women with polycystic ovary syndrome obese women with polycystic ovary syndrome have the highest risk of glucose intolerance. Among women with polycystic ovary syndrome, 35% will have impaired glucose tolerance and 10% will be diabetic in the lead age 40. Hyperandrogenemia may have a role in the study of glucose intolerance or be a marker of insulin resistance. Conversion from impaired glucose tolerance to NIDDM appears to be accelerated in women with polycystic ovary syndrome.Review related to prime(prenominal) of lifeMoran L, el.a.l (2010) conducted a observational, cross sectional study in young woman. He assess the mental features in young women with and without PCOS. Women with PCOS present worsened quality of life (p=0.033 ) and greater anxiety (p= 0.01)and low (p=0.023) than women without PCOS related to BMI status. Women with PCOS were more likely to perceive themselves as at risk of obesity (p=0.012) and inf ertility (p=0.0001), and perceived greater splendor in reducing future(a) risk of prediabetes (p=0.027), gestationl diabetes (p=0.039),type2 diabetes (p= 0.01) , heart disease (p=0.005),obesity(p=0.0007),and infertility(p=0.023) than women without PCOS. Women with PCOS were more likely to have fears about future health related to weight gain (p=0.045 ), loss of muliebrity (p =0.035) , loss of sexuality (p =0.003) and infertility (p=0.019) than women without PCOS. Worsened quality of life, anxiety and depression in young women with PCOS is related to BMI. Risk perception is appropriately high in PCOS, yet perceived risk of future metabolic complications are less common than those related to weight gain and infertility.Judy Griffin Mc Cook, et al conducted on a cross sectional, regarding quality of life in women with polycystic ovarian syndrome. The results of this study indicate that women with PCOS have the greatest concern in the area of weight, followed by menstrual problems and infertility. These concerns are directely reflected in their objective life experiences. Women with PCOS clearly need education and support regarding the effect of their quality of life.Sigrid elsenbruch el.al They conducted a survey method the sample was collected from out patients clinics of the devision of endocrinology ,department of medicine at the university of essen, based on referrals from gynecologists in the surrounding area or patients attracted by the clinics home page. They reason out that the pronounced psychological and psychosocial problems affecting health related to quality of life of patients with PCOS. Although an effective medical treatment aimed at alter PCOS related symptoms will also strike down psychological distress and modify sexual self worth , consideration of both the medical and psychological situation with the availability of an additional help group are likely to further improve life satisfaction and coping of affected women. female horse E el. al conducted a cross sectional study of female adolescents and to determine whether clinically observed or self -perceived severity of affection attect their HRQL (Health related quality life) they concluded that adolescents with PCOS experience lower HRQL compared with healthy adolescents. Polycystic ovarian syndrome and perceived severity of illness negatively affect HRQL in adolescents. This study suggests a need to develop interventions to reduce the distress that patients with PCOS may calculate to adolescents and young adult.Susanne Hahn, el. al A Comparative study was conducted in out patient clinic of The Department Of Medicine, university of Duisburg Essen, Germany. The result of the study was PCOS patients showed significant reductions in quality of life, increased psychological disturbances, and decreased sexual satisfaction when healthy controls. BMI and hirsutism scores, but not the social movement of acne , were associated with visible aspect of quality of life and sexual satisfaction. No clear effect of androgens or insulin resistance on psychosocial variables was detected. Similarly, the type of menstrual cycle disturbances or infertility had no preserve on psychological well being.Review related to risk factorsRobert L. Rosenfield et al 2007 in this study state that risk factors for PCOS can be recognise in childhood. This study concluded that immature pubarche patients appear to carry about a 15 -20 % risk of developing PCOS. It seems likely that the risk is relatively high in those with exaggerated adrenarche and relatively low in those with workaday premature adrenarche or idiopathic premature pubarche. PCOS is a complex trait with a large hereditary component. There fore, the presence of PCOS, or central obesity, diabetes, or other insulin resistant features in a parent should combine the concern about risk for PCOS if the child presents other risk factors.Bulent O. Yildiz, et.al (2005) The study was conducted at a terti ary care center. Population prevalence of PCOS accord to body mass index (BMI) and change in BMI of PCOS patients over measure were measured. The results suggest that the risk of PCOS is only minimally increased with obesity, although the degree of obesity of PCOS patients has increased, similar to that observed in the general population. These data indicate that obesity in PCOS reflects environmental factors to a great extent.Meher un Nisal (2009) A cross sectional analytical study was conducted in Qassim University Clinic, in the year of 2007 -2009 . They concluded that obesity plays an important role in the genesis and maintenance of polycystic ovarian disease. PCOD is the conduct cause of anovultory infertility in females and affects 1 in 10 women of reproductive age. PCOD is strongly associated with obesity.Angela Kerchner, B.A., el .al (2009) coducted a prospective longitudinal study cocluded that on that point is a significant risk mood disorders in women with polycystic ovarian syndrome. The relentless high rate of depression and other mood disorders are presents in young women with PCOS.Rosenfield RL. The University of Chicago Pritzker School of Medicine, Department of Pediatrics (2007) conducted a study on polycystic ovary syndrome (PCOS) appears to arise as a complex trait with contributions from both heritable and nonheritable factors. Polygenic influences appear to account for about 70% of the variance in pathogenesis. In view of this evidence for congenital contributions to the syndrome, childhood manifestations may be expected. The objective has been to review the evidence that risk factors for PCOS can be maked in childhood. Congenital virilizing disorder are bonny or low birth weight for gestation age premature adrenarche, particularly exaggerated adrenarche atypical sexual precocity or unregenerate obesity with acanthosis nigricans, metabolic syndrome, and pseudo-cushing syndrome or pseudo-acromegaly in early childhood have been iden tified as independent prepubertal risk factors for the development of PCOS. During adolescence, PCOS may masquerade as physiological adolescent anovulation. Asymptomatic adolescents with a polycystic ovary once in a while (8%) have subclinical PCOS but often (42%) have a subclinical PCOS type of ovarian dysfunction, the prognosis for which is unclear. Identifying children at risk for PCOS offers the prospect of ultimately preventing some of the long-term complications associated with this syndrome once our understanding of the basis of the disorder improves. fecund steril (2009) conducted a prospective longitudinal study in university they state that there is a significant risk for mood disorders in women with polycystic ovarian syndrome. They be that a high conversion risk for depression over a 1 to 2 year period under scores the importance of routine screening and ravening treatment of mental health disorders in this population.Duleba AJ, Ahmed IM (2010) observational study to evaluate urinary albumin excretion (UAE) in normotensive and non diabetic women with polycystic ovary syndrome in relation to their clinical, endocrine, and metabolic motiles. They concluded urinary albumin exenetion in women with pcos correlates well with other cordiovcescular events is continuous, evaluation of UAE in the presence of information and may aid in selecting appropriate patients for move aggressive treatment of likely aggravation factors, such as hyperonsu draw inmia or minimum hypertension.Want Y, et.al says that the family history of diabetes mellitus has the most effect on the clinical phenotype in women with PCOS. The family history of other diseases such as menstrual disorder, premature turn and hypertension play less significant roles. A family history of peremptory coronary heart disease does not affect the clinical phenotype of such patients. A survey of the polycystic ovary syndrome in the Greek island of Lesbos hormonal and metabolic profile.Review relat ed to TreatmentMoran LJ, Pasquali R, (2009) state that the lifestyle management should be utilise as the primary therapy in overweight and obese women with PCOS for the treatment of metabolic complications.Jeans YM, et.al (2009) they conducted a experimental study on dietetic management of women with PCOS. They concluded that 73% of overweight women were not following a diet to call down weight loss.Humphreys L, costarelli V (2008). They concluded that in spite of the fact that weight loss and weight maintenance are absolutely vital in the treatment the PCOS. In their study bees shown that the support given to PCOS patients to help reduce and control their weight is inadequate and needs to be improved.Hector F Escobar et.al. (2008). They done a case control study including 40 PCOS patients matched with 40 non hyperandrogenic women for age and body mass index. They concluded that serum OPG (Osteoprotegerin) concentrations are cut down in PCOS patients independently of obesity.Unl u C. Atabe koglu CS. (2006). They suggest that the metformin has gained popularity as first line management in clomiphone citrate resistant women with polycystic ovarian syndrome. It ovulation does not go on within several months offer treatment with metformin, affer the evaluation of all PCOS and cons related to each treatment. Laparoscopic ovarian drilling or gonadotropins may be considered as an effective option according to patients choice.Glueck CJ, et. Al. (2009 Sep) conduct a study in 20 adolescents age, or = 17(16+/- 1 yr) with polycystic ovary syndrome (PCOS), endocrinopathy and coronary heart disease (CHD) risk factors. Median weight fell from 85.5 to 78.4 kg(p=0.004), waist circumference from 91 to 84 cm (p= 0.017), triglyceride form 108 to 71 mg/dl (p=0.026), and testosterone from 45.5 to 31.5ng/dl (p=0.03). The percentage of cycles with normal menses rose from a pre-treatment median of 8% to century %, pGenazzani AD, Ricchieri F, Lanzoni C conducted a study in metform in is preferably an old drug, but it is optimal for the control of glycemia in type 2 diabetes. It was reported, 15 years ago, that insulin resistance was abnormally high in most polycystic ovary syndrome (PCOS) patients. Starting disorder over 2 years after menarche, a higher incidence of obesity, marked hyperandrogenism and insulin resistance and disorderly gonadotropine secretion in comparison with control subjects. Hyperandrogenism and insulin resistance are much more thoroughgoing(a) in obese adolescent PCOS.Beata Banasjewska MD Ph.D., Antoni J Duleba MD, Robert Z. Spacjynski, Lipids in polycystic ovarian syndrome Role of hyperinsulinemia and effects of metformin.Use of metformin in hyperinsulinemia women with PCOS is associated with a significant receipts of lipid profile these findings support the notion that metformin use may be considered prophylactic therapy aimed at lowering cardiovascular risk factors.Jeans YM et al (2009) conducted a study related to dietetic manage ment of women with polycystic ovary syndrome. Advice provided by dietitians pore on a reduction in energy intake (78%) and dietary glycaemic index (77%) often in combination. Of the women with poly cystic ovarian syndrome who were following a diet specifically for their poly cystic ovarian syndrome (57%) regimes included a low glycaemic index (34%), weight loss diets (16%) or a combination (26%). Of interest, 73% of overweight women were not following a diet with only 15% of women having seen a dietitian. Eighty-four percent of women with poly cystic ovarian syndrome who had increased physical activity (48%) self-reported an improvement in their symptoms. They concluded that women with poly cystic ovarian syndrome recognize the importance of diet, but few received dietary advice from a registered dietitian. The dietary information women with poly cystic ovarian syndrome received was often from an unregulated source. A consensus statement of evidence-based dietary advice for women w ith poly cystic ovarian syndrome is needed and would be a useful resource for dietitians.