Medical history (history of illness) is an important component in the diagnosis of polycystic ovary syndrome (PCO syndrome). Family history Are there any female members in your family who have hormonal disorders such as polycystic ovary syndrome? Social history Current medical history/systemic history (somatic and psychological complaints). When did you notice symptoms such as change … Polycystic Ovary Syndrome: Medical History
Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99). Hymenal atresia – lack of opening of the hymen. Laurence-Moon-Biedl-Bardet syndrome (LMBBS) – rare genetic disorder with autosomal recessive inheritance; according to clinical symptoms is divided into: Laurence-Moon syndrome (without polydactyly, i.e., without the appearance of supernumerary fingers or toes, and obesity, but with paraplegia (paraplegia) and muscle … Polycystic Ovary Syndrome: Or something else? Differential Diagnosis
The following are the most important diseases or complications that may be contributed to by polycystic ovary syndrome (PCO syndrome): Endocrine, nutritional, and metabolic diseases (E00-E90). Anovulatory cycles (cycles without ovulation; approximately 30%). Diabetes mellitus type 2 Hyperlipidemia (lipid metabolism disorder) Metabolic syndrome* Reduced insulin sensitivity (sensitivity of body cells or insulin receptors to insulin) … Polycystic Ovary Syndrome: Complications
A comprehensive clinical examination is the basis for selecting further diagnostic steps: General physical examination – including blood pressure, pulse, body weight, height [obesity (overweight)]; furthermore: Inspection (viewing): skin and mucous membranes, abdominal wall and inguinal region (groin area) [seborrhea (oily skin); objective evaluation of distribution/quantity of hair: increased hairiness of terminal hair (long hair) … Polycystic Ovary Syndrome: Examination
1st-order laboratory parameters-obligatory laboratory tests. LH, FSH [often there is increased LH/FSH quotient > 1] Prolactin [low serum prolactin level is considered a risk marker for metabolic risk] Testosterone* DHEAS* SHBG* * Androstenedione Plasma insulin Oral glucose tolerance test (oGTT)* * * * Definition of hyperandrogenemia: total testosterone level > 2.08 nmol/l or as serum … Polycystic Ovary Syndrome: Test and Diagnosis
Therapeutic target Reduction of androgen formation in the ovaries and/or adrenal cortices. Therapy recommendations Therapy recommendations are based on the patient’s wishes, as well as the clinical symptoms that are in the foreground: Anticonception request Skin symptomatology (acne, alopecia, hirsutism). Insulin resistance / metabolic syndrome Desire to have children Cycle regulation The type of therapy, … Polycystic Ovary Syndrome: Drug Therapy
Mandatory medical device diagnostics. Vaginal ultrasonography (ultrasound using an ultrasound probe inserted into the vagina) – Polycystic ovaries are present if at least one ovary (ovary) has a volume of at least 10 ml (milliliters) on ultrasound and/or 12 follicles (egg sacs) of two to nine milliliters each are present. Note: Polycystic ovaries are often … Polycystic Ovary Syndrome: Diagnostic Tests
Wedge excision of both ovaries (surgical removal of a wedge from both ovaries) (obsolete): for a long time, wedge excision of the ovaries, described by Stein and Leventhal, was considered the gold standard for treating anovulation in PCO syndrome. The postoperative pregnancy rate was approximately 60%. In the 1960s and 1970s, this surgical procedure was … Polycystic Ovary Syndrome: Surgical Therapy
To prevent polycystic ovary syndrome (PCO syndrome), attention must be paid to reducing individual risk factors.Behavioral risk factors Overweight (BMI ≥ 25; obesity).
The following symptoms and complaints may indicate polycystic ovary syndrome (PCO syndrome): Leading symptoms Oligomenorrhea (menstrual period disorder: cycle length > 35 days and ≤ 90 days) to amenorrhea to amenorrhea (secondary; absence of menstruation > 90 days. Androgenization (v. a. Hirsutism/abnormal increase of male hair: chin, upper lip, chest, pubic region, thighs; androgenetic alopecia/hair … Polycystic Ovary Syndrome: Symptoms, Complaints, Signs
Pathogenesis (disease development) The cause of polycystic ovary syndrome is not yet fully understood. It is likely that a genetic disposition underlies it. This causes a chromosomal miscoding that leads to a defect in the insulin receptor and thus to insulin resistance (reduced effectiveness of the body’s own insulin at the target organs skeletal muscle, … Polycystic Ovary Syndrome: Causes
General measures Aim for normal weight! Diet and exercise should be at the forefront of therapeutic measures! Often, weight reduction alone already leads to a normalization of the cycle and follicle maturation (egg maturation); significant improvements are seen in follicle-stimulating hormone (FSH), sex hormone-binding globulin (SHBG), total testosterone, androstenedione, free androgen index and FG score … Polycystic Ovary Syndrome: Therapy
