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Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances.
Arq Bras Endocrinol Metabol. 2014 Mar; 58(2):182-7.AB

Abstract

Polycystic ovary syndrome (PCOS) is a common condition in women at reproductive age associated with reproductive and metabolic dysfunction. Proposed diagnosed criteria for PCOS include two out of three features: androgen excess, menstrual irregularity, and polycystic ovary appearance on ultrasound (PCO), after other causes of hyperandrogenism and dysovulation are excluded. Based on these diagnostic criteria, the most common phenotypes are the "classic PCOS"--hyperandrogenism and oligomenorrhea, with or without PCO; the "ovulatory phenotype"--hyperandrogenism and PCO in ovulatory women; and the "non-hyperandrogenic phenotype", in which there is oligomenorrhea and PCO, without overt hyperandrogenism. The presence of obesity may exacerbate the metabolic and reproductive disorders associated with the syndrome. In addition, PCOS women present higher risk for type 2 diabetes and higher prevalence of cardiovascular risk factors that seems to be associated with the classic phenotype. The main interventions to minimize cardiovascular and metabolic risks in PCOS are lifestyle changes, pharmacological therapy, and bariatric surgery. Treatment with metformin has been shown to improve insulin sensitivity, lowering blood glucose and androgen levels. These effects are more potent when combined with lifestyle interventions. In conclusion, besides reproductive abnormalities, PCOS has been associated to metabolic comorbidities, most of them linked to obesity. Confounders, such as the lack of standard diagnostic criteria, heterogeneity of the clinical presentation, and presence of obesity, make management of PCOS difficult. Therefore, the approach to metabolic abnormalities should be tailored to the risks and treatment goals of each individual woman.

Authors+Show Affiliations

Gynecologic Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

24830595

Citation

Spritzer, Poli Mara. "Polycystic Ovary Syndrome: Reviewing Diagnosis and Management of Metabolic Disturbances." Arquivos Brasileiros De Endocrinologia E Metabologia, vol. 58, no. 2, 2014, pp. 182-7.
Spritzer PM. Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances. Arq Bras Endocrinol Metabol. 2014;58(2):182-7.
Spritzer, P. M. (2014). Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances. Arquivos Brasileiros De Endocrinologia E Metabologia, 58(2), 182-7.
Spritzer PM. Polycystic Ovary Syndrome: Reviewing Diagnosis and Management of Metabolic Disturbances. Arq Bras Endocrinol Metabol. 2014;58(2):182-7. PubMed PMID: 24830595.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polycystic ovary syndrome: reviewing diagnosis and management of metabolic disturbances. A1 - Spritzer,Poli Mara, PY - 2013/10/09/received PY - 2013/11/26/accepted PY - 2014/5/17/entrez PY - 2014/5/17/pubmed PY - 2015/4/14/medline SP - 182 EP - 7 JF - Arquivos brasileiros de endocrinologia e metabologia JO - Arq Bras Endocrinol Metabol VL - 58 IS - 2 N2 - Polycystic ovary syndrome (PCOS) is a common condition in women at reproductive age associated with reproductive and metabolic dysfunction. Proposed diagnosed criteria for PCOS include two out of three features: androgen excess, menstrual irregularity, and polycystic ovary appearance on ultrasound (PCO), after other causes of hyperandrogenism and dysovulation are excluded. Based on these diagnostic criteria, the most common phenotypes are the "classic PCOS"--hyperandrogenism and oligomenorrhea, with or without PCO; the "ovulatory phenotype"--hyperandrogenism and PCO in ovulatory women; and the "non-hyperandrogenic phenotype", in which there is oligomenorrhea and PCO, without overt hyperandrogenism. The presence of obesity may exacerbate the metabolic and reproductive disorders associated with the syndrome. In addition, PCOS women present higher risk for type 2 diabetes and higher prevalence of cardiovascular risk factors that seems to be associated with the classic phenotype. The main interventions to minimize cardiovascular and metabolic risks in PCOS are lifestyle changes, pharmacological therapy, and bariatric surgery. Treatment with metformin has been shown to improve insulin sensitivity, lowering blood glucose and androgen levels. These effects are more potent when combined with lifestyle interventions. In conclusion, besides reproductive abnormalities, PCOS has been associated to metabolic comorbidities, most of them linked to obesity. Confounders, such as the lack of standard diagnostic criteria, heterogeneity of the clinical presentation, and presence of obesity, make management of PCOS difficult. Therefore, the approach to metabolic abnormalities should be tailored to the risks and treatment goals of each individual woman. SN - 1677-9487 UR - https://www.unboundmedicine.com/medline/citation/24830595/Polycystic_ovary_syndrome:_reviewing_diagnosis_and_management_of_metabolic_disturbances_ L2 - https://medlineplus.gov/obesity.html DB - PRIME DP - Unbound Medicine ER -