Talk:Polycystic ovary syndrome

Article Checklist for "Polycystic ovary syndrome"

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Checklist last edited by	Kelly Patterson 11:49, 22 April 2007 (CDT)

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References: with notes

Lorenz LB. Wild RA. Polycystic ovarian syndrome: an evidence-based approach to evaluation and management of diabetes and cardiovascular risks for today's clinician. [Review] [60 refs] Clinical Obstetrics & Gynecology. 50(1):226-43, 2007 Mar. UI: 17304038

"This review systematically addresses the evidence confirming polycystic ovary syndrome (PCOS) as a cardiovascular health threat. Literature in this area is void of long-term prospective studies to adequately evaluate outcome, but there is important evidence using surrogate markers for future development of and presence of cardiovascular disease and diabetes in women with PCOS. In addition, this article reviews the evidence regarding evaluation and management of cardiovascular risk factors in the population of women with PCOS." "Although previously identified as a cause of abnormal uterine bleeding, the term polycystic ovary syndrome (PCOS) was coined in 1935 after Stein and Leventhal reported 7 women who had amenorrhea, hirsutism, obesity, and multicystic appearing ovaries. Since then, a great deal of investigation has gone into why these women have problems of irregular menses, infertility, and hirsutism."

• "Women with PCOS develop diabetes at higher rates and at younger ages than usual. The metabolic syndrome is very prevalent in women with PCOS" "Diabetes does develop earlier and more frequently in women with PCOS."despite this, unlike diabetics-"Some researchers have noted no higher morbidity or mortality rates from circulatory diseases in women with PCOS." "Because of both the high prevalence of type 2 diabetes and impaired glucose tolerance in women with PCOS, we recommend screening all PCOS women using a fasting and 2-hour oral (75 g) glucose tolerance level."
• "Central obesity associated with PCOS is possibly the single most important risk factor for the development of diabetes and cardiovascular disease."
• "Exercise is of obvious benefit in weight reduction and cardiovascular health. In a small (n=21) longitudinal study comparing homocysteine levels in exercising versus nonexercising women with PCOS, Randeva et al found a significant decline in homocysteine levels at 6 months. Patients who complied with a brisk walking regimen showed declines in homocysteine (10.06±3.22 to 7.36±1.96, P<0.001). Homocysteine levels still remained above normal compared to reference range, however. There was also a significant decrease in waist-to-hip ratio, but no decrease in BMI."
• "The use of oral contraceptives in women with PCOS is widespread, and remains a mainstay in the treatment for hirsutism and to protect the endometrium in patients who are oligoovulatory. Given studies in non-PCOS patients which have shown that oral-contraceptive use can confer a higher risk of myocardial infarction, some have questioned the possible deleterious effects of oral contraceptives on the cardiovascular health of patients with PCOS. Several small studies of oral contraceptive use in women with PCOS show worsening of insulin sensitivity, worsening of glucose tolerance in obese patients (but not in nonobese patients)"
• "The goal is to keep the blood pressure <120/80 through lifestyle approaches. Pharmacotherapy is indicated when blood pressure is >140/90. Pharmacotherapy should be initiated at even lower blood pressure cutoff levels in the setting of target organ damage or diabetes. Thiazide diuretics should be part of the regimen for most patients, unless contraindicated. Angiotensin converting enzyme inhibitors or angiotensin receptor blocker are the drugs of choice for those with the metabolic syndrome and hypertension. These should not be used if pregnancy is contemplated."

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