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Adverse Long-term Metabolic and Endometrial Consequences in Women with Polycystic Ovarian Syndrome: A Report of Two Cases.

Abstract

BACKGROUND

Little prospective data exist on associations between polycystic ovary syndrome (PCOS) and long-term metabolic disorders/endometrial malignancy in women. We report the cases of 2 obese, infertile women with PCOS who experienced long-term adverse metabolic and endometrial consequences.

CASE

The first woman developed type 2 diabetes and hypertension after a 10-year history of PCOS and subsequent endometrioid carcinoma after having PCOS for 16 years. The second woman was first diagnosed with endometrial atypical hyperplasia, which failed to respond to high-dose progestin treatment, and then was diagnosed with PCOS after a 10-year history of oligomenorrhea. Laboratory testing revealed dyslipidemia and impaired glucose tolerance. Both women had a family history of diabetes. The second woman was administered oral contraceptives and metformin. Her endometrial atypia regressed and insulin sensitivity improved after 6 months of treatment.

CONCLUSION

PCOS may be associated with long-term adverse metabolic and endometrial consequences. Timely diagnosis and appropriate monitoring and management should be emphasized in order to prevent these women from adverse long-term complications. Oral contraceptives in combination with metformin reversed endometrial atypical hyperplasia in the obese, progestin-resistant woman with PCOS. Further clinical studies may be needed to confirm the effectiveness of such treatment on endometrial atypia in obese, progestin-resistant women for fertility sparing.

Authors

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Source

MeSH

Adult
Carcinoma, Endometrioid
Diabetes Mellitus, Type 2
Dyslipidemias
Endometrial Hyperplasia
Endometrial Neoplasms
Fatty Liver
Female
Humans
Hypoglycemic Agents
Infertility, Female
Insulin Resistance
Metformin
Obesity
Polycystic Ovary Syndrome
Progestins
Prospective Studies

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

27424378

Citation

Mahmoud, Salma A., et al. "Adverse Long-term Metabolic and Endometrial Consequences in Women With Polycystic Ovarian Syndrome: a Report of Two Cases." The Journal of Reproductive Medicine, vol. 61, no. 5-6, 2016, pp. 302-5.
Mahmoud SA, Zhang L, Jia C, et al. Adverse Long-term Metabolic and Endometrial Consequences in Women with Polycystic Ovarian Syndrome: A Report of Two Cases. J Reprod Med. 2016;61(5-6):302-5.
Mahmoud, S. A., Zhang, L., Jia, C., & Zang, H. (2016). Adverse Long-term Metabolic and Endometrial Consequences in Women with Polycystic Ovarian Syndrome: A Report of Two Cases. The Journal of Reproductive Medicine, 61(5-6), pp. 302-5.
Mahmoud SA, et al. Adverse Long-term Metabolic and Endometrial Consequences in Women With Polycystic Ovarian Syndrome: a Report of Two Cases. J Reprod Med. 2016;61(5-6):302-5. PubMed PMID: 27424378.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Adverse Long-term Metabolic and Endometrial Consequences in Women with Polycystic Ovarian Syndrome: A Report of Two Cases. AU - Mahmoud,Salma A, AU - Zhang,Lizhi, AU - Jia,Chenyu, AU - Zang,Hong, PY - 2016/7/19/entrez PY - 2016/7/19/pubmed PY - 2016/8/3/medline SP - 302 EP - 5 JF - The Journal of reproductive medicine JO - J Reprod Med VL - 61 IS - 5-6 N2 - BACKGROUND: Little prospective data exist on associations between polycystic ovary syndrome (PCOS) and long-term metabolic disorders/endometrial malignancy in women. We report the cases of 2 obese, infertile women with PCOS who experienced long-term adverse metabolic and endometrial consequences. CASE: The first woman developed type 2 diabetes and hypertension after a 10-year history of PCOS and subsequent endometrioid carcinoma after having PCOS for 16 years. The second woman was first diagnosed with endometrial atypical hyperplasia, which failed to respond to high-dose progestin treatment, and then was diagnosed with PCOS after a 10-year history of oligomenorrhea. Laboratory testing revealed dyslipidemia and impaired glucose tolerance. Both women had a family history of diabetes. The second woman was administered oral contraceptives and metformin. Her endometrial atypia regressed and insulin sensitivity improved after 6 months of treatment. CONCLUSION: PCOS may be associated with long-term adverse metabolic and endometrial consequences. Timely diagnosis and appropriate monitoring and management should be emphasized in order to prevent these women from adverse long-term complications. Oral contraceptives in combination with metformin reversed endometrial atypical hyperplasia in the obese, progestin-resistant woman with PCOS. Further clinical studies may be needed to confirm the effectiveness of such treatment on endometrial atypia in obese, progestin-resistant women for fertility sparing. SN - 0024-7758 UR - https://www.unboundmedicine.com/medline/citation/27424378/Adverse_Long_term_Metabolic_and_Endometrial_Consequences_in_Women_with_Polycystic_Ovarian_Syndrome:_A_Report_of_Two_Cases_ L2 - http://www.diseaseinfosearch.org/result/9619 DB - PRIME DP - Unbound Medicine ER -