PCOS Foods to avoid
Hyperglycaemia is treated with conventional medication. Insulin is used for overt diabetes. High doses of regular or long-acting insulin may be required when a pronounced resistance is present. Metformin has been suggested to improve insulin sensitivity and the control of hyperphagia. Liver steatosis and polycystic ovary syndrome may be additional indications for metformin treatment.
Amenorrhea can ensue for 2 to 3 months after a term delivery breast-feeding may inhibit hypothalamic function and lead to a greater duration of amenorrhea. However, in a nonlactating woman in whom menses does not resume by 12 weeks after delivery, then pathology must be suspected. Overall, the most common cause of amenorrhea in the reproductive years is pregnancy. Hence, a pregnancy test is the appropriate initial test. If the patient does not have a history of postpartum hemorrhage, pursuit of hypothalamic causes, such as hypothyroidism or hyperprolactinemia, often is fruitful. If the patient is somewhat obese or has a history of irregular cycles, then a diagnosis of polycystic ovarian syndrome (PCOS) would be entertained. Findings consistent with PCOS include a positive progestin withdrawal bleed (vaginal bleeding after ingestion of a progestin, such as medroxyprogesterone acetate or Provera). PCOS is characterized by estrogen excess without progesterone, obesity, hirsutism, and...
117.4 A 25-year-old woman presents with a 6-month history of amenorrhea. Her pregnancy test is negative. Which of the following is consistent with polycystic ovarian syndrome 17.4 C. PCOS is associated with estrogen excess, endometrial hyperplasia or cancer, glucose intolerance and diabetes mellitus, and a history of oligomenorrhea since menarche.
A risk factor specific to women is ovarian hormone status, for example oral contraceptives, pregnancy, and menopause and hormone replacement therapy. Polycystic ovarian syndrome, gestational diabetes or hypertension, pregnancy toxicosis and birth complications are also claimed to be important hormonal cardiovascular risk factors. Menopause, including premature menopause, is associated with negative changes in several cardiovascular risk factors. Meta-analyses of observational studies, mostly conducted in the
The pattern of hair growth is genetically predetermined. Differences in hair growth between ethnic groups are secondary to variations in hair follicle concentration and 5-a-reductase activity. Hair growth can be divided into three phases anagen (growing phase), catagen (involution phase), and telogen (quiescent phase). Hair length is determined by the length of the anagen phase, and the stability of hair is determined by the length of the telogen phase. Hair found on the face, axilla, chest, breast, pubic area, and anterior thighs are termed sex hair because they respond to sex hormones. Androgens (especially testosterone) initiate growth of, and increase the diameter and pigmentation of, sex hair. Androgens may be produced by the ovary or adrenal gland or by peripheral conversion. Dehydroepiandrosterone sulfate (DHEA-S) is derived almost exclusively from the adrenal gland. Dihydrotestosterone (DHT) is metabolized from testosterone by 5-a-reductase increased activity of 5-a-reductase...
Lipodystrophies (LDs) are clinically heterogeneous acquired or inherited disorders characterised by a generalised or regional loss of adipose tissue. Generalised LDs, both inherited and acquired, are associated with peripheral insulin resistance, glucose intolerance or overt diabetes, acanthosis nigricans, dyslipidaemia. Bone demineralisation and polycystic ovary syndrome are also part of these diseases. LDs can be classified as acquired or congenital, and generalised or partial (Table 1).
Infertility can result from ovulatory or uterine problems mechanical problems, including obstruction of the fallopian tubes male fertility factors or multiple factors in either sex or combined female and male factors. Ovulatory problems are the most common cause of female infertility. Polycystic ovarian syndrome (PCOS) affects up to 5 of reproductive-age women. It is the most common cause of ovulatory infertility. PCOS is a condition characterized by multiple ovarian cysts, often found in a row, resembling a string of pearls. Ovarian cysts are fluid-filled sacs arising from follicles swollen with fluid that are prevented from producing mature oocytes. Patients with PCOS also have hormonal imbalances, including decreased levels of LH, FSH, and progesterone and increased androgen production, including excess testosterone and DHEAS causing hirsutism or male facial patterns of hair growth. Insulin resistance is a common associated condition. PCOS is generally diagnosed when two of the...
About 190,000 new cases and 114,000 deaths from ovarian cancer occur annually in the world.24 The highest case loads are in Scandinavia, Eastern Europe, the United States, and Canada. Low incidence rates occur in Africa and Asia. As with most cancers, the risk increases with age. Risk factors include obesity, a history of pelvic inflammatory disease, polycystic ovary syndrome, and endometriosis. Hormone replacement therapy increases risk, whereas oral contraceptives and tubal ligation decrease risk. A family history of breast or ovarian cancer also increases risk and involves mutations in brca1 and brca2 genes. Hereditary non-polyposis colon cancer has also been associated with ovarian cancer.
The main ones of concern, particularly to women, are weight gain, teratogenicity (see p. 416), polycystic ovary syndrome, and loss of hair which grows back curly.6 Nausea may be a problem. Some patients exhibit a rise in liver enzymes which is usually transient and without sinister import, but they should be closely monitored until the biochemical tests return to normal as, rarely, liver failure occurs (risk maximal at 2-12 weeks) this is often indicated by anorexia, malaise and a recurrence of seizures. Other reactions include pancreatitis, and coagulation disorder due to inhibition of platelet aggregation (coagulation should be assessed before surgery).
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