Case of PCOS Treatment-Life style modification 1.Daily 2 hr Exercise 2-Avoid junk Food ,Oily Food 3-Take excess fibre,Vegetables and Water 4-Wt reduction Second line- 1-Metformin 2-Myoinositol 3-Calcium 4-Vit D 5-Wt reducing agent
) PCO refers to the ovaries having a higher number of follicles than normal while PCOS is a metabolic disorder related to heavily unbalanced hormone levels released by a patients ovaries. Unlike PCOS, PCO is not necessarily a disease, as it can just be a deviation from the normal amount of follicles that the average female has (1). You have PCO if you have more than 15 follicles per ovary, while PCOS sufferers generally have 50 or more. PCO is not so much a disease as it is a symptom of an underlying problem. 2) PCO is a more common condition than PCOS While one in ten women have PCOS, having polycystic ovaries is far more common, with anywhere from 20% to 30% of the population having more than the normal amount of follicles in their ovaries (2). Most of those in the latter group will never realize it though, as merely having polycystic ovaries tends to be asymptomatic in many cases (more on this later). 3) PCO develops later in life than PCOS While both PCO and PCOS tending to be genetic, those that merely have polycystic ovaries instead of full-blown polycystic ovarian syndrome usually develop their abnormal amount of follicles late in their 20s (3). Those that have PCOS usually begin showing its symptoms (hirutism, excessive acne, weight problems) during their teen years (4), as the metabolic underpinnings that define it express themselves much earlier than the mere emergence of cysts that are the only signs of PCO. 4) PCO can be caused by a variety of other conditions aside from the machinations behind PCOS Technically, the wacky metabolic problems that cause PCOS are a cause of polycystic ovaries (duh), but it is far from the only reason that women develop PCO. There is a lot of disagreement as to what causes PCO, but alternative explanations outside of the mechanisms behind PCOS point to underactive thyroid glands (hypothyroidism) (5), as well as it being a nascent condition that evolves into PCOS dependent on your eating and exercise habits. 5) Women with PCO can still get pregnant, while those with PCOS have great difficulty with this Women that have been found to have polycystic ovaries can still get pregnant without much difficulty, yet those with PCOS have had problems conceiving (and when they do, the rate of miscarriages is shockingly high). The reason for this is that in the latter case, hormonal balance that many with PCO is possess is completely gone, with insulin stimulating the production of androgens that interferes with proper ovulation (6). Eggs often fail to be released, and when they do make it out of the follicles, they are often at an immature stage of development (7). This results in frequent miscarriages, while women that only have polycystic ovaries dont have compromised hormonal levels, giving them a much better chance of getting pregnant and carrying their fetus through to childbirth.
pcod..ask pt to lose 10 percentage of body . avoid food with food with high gllycemic index give her hormones either ocps for 6 months give her ovulation induction with clomophene citrate starting 50mg on day 2 of menstraul cyxle for 5 day with luteal phase support from day 16 with micronised progesterone 200mg for conception
what is active married life?krimson- 35 for regular period and for lower androgen. can start metformin.weigh reduction most needed.lipid profile and all hormones to be done.if wants early results go for pcod drilling by laparoscopy.
ov stroma more, more than nine follicles definitely looks pco type... weight reduction , metformin, and ov induction for few cycles.. if not conceived then interventions needed.. also r/o other causes of infertility
PCO pattern.... obese...so advice weight loss..life style improvement.... see for FSH:LH ratio...whether anovulation...add CC...
down regulation with ocps then ovulation induction
polycystic ovaries.... need lap puncture
She is a obese lady with PCOD. Do a semen analysis for husband. If it is normal, requires work up of the female. GTT, Ser. Prolactin, FSH, LH &TSH. Put her on strict diet restrictions. After weight reduction, she may go for ovulation. If not induce ovulation. If she is not responding go for diagnostic laparoscopy. Do hydrotubation and ovarian puncture on noth sides. If all parameters are normal, she has high index of conception.
it's polycystic ovarian disease (PCOD) a common problem seen in overweight females the main cause of it is insuline resistance that leads to fat accumulation and further hampers the gonadotropin hormones and leads to polycystic ovary and hampers fertility
Cases that would interest you
- Login to View the image
A 34-year-old nulligravid woman comes to clinic complaining of difficulty getting pregnant for the past 15 months. The woman reports that her menses have always been irregular. The woman has a BMI of 31 and hirsutism on physical exam. What is the most likely cause of infertility in this patient?Prachi Saluja6 Likes27 Answers
- Login to View the image
29 year female....married with h/o irregular menses....diagonesed with p.c.o.d since 4 year difficulty in conceive ..kindly suggest best treatment.Dr. Anshu Sharma Sharma7 Likes59 Answers
- Login to View the image
POLYCYSTIC OVARIAN SYNDROME /PCOD is a chronic anovulatory endocrine disorder. * it is the commonest cause of anovulatory infertility. ROTHERDAM CRITERIA : for diagnosing pcod. requires two out of three criteria for diagnosing pcod. -oligo/anovulation = oligomenorrhoea /amenorrhoea. -clinical (acne, hirsutism, alopecia ) or biochemical signs of hyperandrogenism. -Polycystic ovaries. classic triad of pcod are -oligomenorrhoea. -hirsutism. -obesity. INVESTIGATIONS : * fsh, lh, prl, testosterone, tft, fbs, ppbs. * for hyperandrogenism dheas, androstenedione ,SHBG. * ultrasound. CLINICAL EXAMINATION : * BMI. see for acne, hirsutism, alopecia, acanthosis nigricans. MNEMONIC FOR PCOD. CHICAGO C Cystic ovaries. H Hirsutism , Hyperandrogenism. I Infertility, Insulin resistance. C Cortical stromal fibrosis. A Amenorrhoea, Acne. G Genetic predisposition, Gestational diabetes. O Obesity, oligomenorrhoea. ROLE OF METFORMIN IN PCOD. Metformin is a insulin sensitising drug. -improves insulin resistance. -restores normal cycle and ovulation. -promotes ovulation. -protects against first trimester miscarriage. -reduces GDM and fetal macrosomia. ROLE OF MYO INOSITOL IN PCOD. -insulin sensitiser. -improves the binding of insulin to the receptors on the cell wall. -improves the ovarian response to gonadotrophins. MANAGEMENT : *life style modifications. *diet and exercise effective in restoring ovulatory cycles and achieving pregnancy. * COCP ,METFORMIN. * myo inositol. *ovulation induction. * laparoscopic ovarian diathermy. * IVF if all measures fail.Dr. Suvarchala Pratap29 Likes36 Answers
- Login to View the image
Friends today I am discussion about Hormanal imbalance. Hormonal imbalances occur when there is too much or too little of a hormone in the bloodstream. Because of their essential role in the body, even small hormonal imbalances can cause side effects throughout the body. Hormones are chemicals that are produced by glands in the endocrine system. Hormones travel through the bloodstream to the tissues and organs, delivering messages that tell the organs what to do and when to do it. Hormones are important for regulating most major bodily processes, so a hormonal imbalance can affect a wide range of bodily functions. Hormones help to regulate: metabolism and appetite heart rate sleep cycles reproductive cycles and sexual function general growth and development mood and stress levels body temperature Men and women alike can be affected by imbalances in insulin, steroids, growth hormones, and adrenaline. Women may also experience imbalances in estrogen and progesterone levels, while men are more likely to experience imbalances in testosterone levels. Symptoms Hormonal imbalance in men and women Everyone experiences periods of hormonal imbalance at certain points in their life, but these can also occur when the endocrine glands are not functioning properly. The symptoms of a hormonal imbalance depend on which glands and hormones are affected. Symptoms associated with the more common causes of hormonal imbalances include: unexplained weight gain or weight loss unexplained or excessive sweating difficulty sleeping changes in sensitivity to cold and heat very dry skin or skin rashes changes in blood pressure changes in heart rate brittle or weak bones changes in blood sugar concentration irritability and anxiety unexplained and long-term fatigue increased thirst depression headaches needing to go to the bathroom more or less than usual bloating changes in appetite reduced sex drive thinning, brittle hair infertility puffy face blurred vision a bulge in the neck breast tenderness deepening of the voice in females Causes Everyone will experience natural periods of hormonal imbalance or fluctuations at particular points in their life. But hormonal imbalances can also occur when the endocrine glands are not functioning properly. Endocrine glands are specialized cells that produce, store, and release hormones into the blood. There are several endocrine glands located throughout the body that control different organs, including the: adrenal glands gonads (testis and ovaries) pineal gland pituitary gland hypothalamus gland thyroid and parathyroid glands pancreatic islets Several medical conditions are known to impact some, or several, of the endocrine glands. Certain lifestyle habits and environmental factors may also play a role in hormonal imbalances. Causes of hormonal imbalances include: chronic or extreme stress type 1 and type 2 diabetes hyperglycemia (overproduction of glucagon) hypoglycemia (more insulin produced than there is glucose in the blood) underactive thyroid (hypothyroidism) overactive thyroid (hyperthyroidism) over- or underproduction of the parathyroid hormone poor diet and nutrition being overweight hormonal replacement or birth control medications abuse of anabolic steroid medications solitary thyroid nodules pituitary tumors Cushing's syndrome (high levels of the hormone cortisol) Addison's disease (low levels of cortisol and aldosterone) benign tumors and cysts (fluid-filled sacks) that affect the endocrine glands congenital adrenal hyperplasia (low levels of cortisol) endocrine gland injury severe allergic reactions or infections cancers that involve endocrine glands chemotherapy and radiation therapy iodine deficiency (goiters) hereditary pancreatitis Turner syndrome (females with only one functioning X chromosome) Prader-Willi syndrome anorexia phytoestrogens, naturally-occurring plant estrogens found in soy products exposure to toxins, pollutants, and endocrine disrupting chemicals, including pesticides and herbicides Hormonal imbalances in women Hormonal imbalance occurs during pregnancy Women experience several periods of hormonal change in their lifetime, primarily during puberty, menstruation, pregnancy and menopause. Women naturally experience several periods of hormonal imbalance throughout their lifetime, including during: puberty menstruation pregnancy, childbirth, and breast-feeding perimenopause, menopause, and postmenopause Women are also at risk of developing different types of hormonal imbalance disorders than men because they have different endocrine organs and cycles. Medical conditions causing irregular hormonal imbalances in women include: polycystic ovary syndrome (PCOS) hormone replacement or birth control medications early menopause primary ovarian insufficiency (POI) ovarian cancer Symptoms of hormonal imbalances in women include: heavy, irregular, or painful periods osteoporosis (weak, brittle bones) hot flashes and night sweats vaginal dryness breast tenderness indigestion constipation and diarrhea acne during or just before menstruation uterine bleeding not associated with menstruation increased hair growth on the face, neck, chest, or back infertility weight gain thinning hair or hair loss skin tags or abnormal growths deepening of the voice clitoral enlargement Bioidentical hormones: How are they used? Bioidentical hormones: How are they used? Hormone therapy and birth control pills both use bioidentical hormones. Learn more about them here. Hormonal imbalances in men Men also experience natural periods of hormonal imbalance during their lifetime. Natural causes of hormonal imbalances in men include: puberty aging Men are also at risk of developing different hormonal imbalances than women because they have different endocrine organs and cycles. Medical conditions causing hormonal imbalances in men include: prostate cancer hypogonadism (low testosterone) Symptoms of hormonal imbalances in men include: reduced sex drive erectile dysfunction (ED) low sperm count reduced muscle mass reduced body hair growth overdevelopment of breast tissue breast tenderness osteoporosis Treatment Treatment for hormonal imbalances may vary depending on the cause. Every person may require different types of treatment for hormonal imbalances. Treatment options for women with hormone imbalances include: Hormone control or birth control. For those who are not trying to get pregnant, medications containing forms of estrogen and progesterone can help regulate irregular menstrual cycles and symptoms. People can take birth control medications as a pill, ring, patch, shot, or an intrauterine device (IUD). Vaginal estrogen. People experiencing vaginal dryness associated with changes in estrogen levels can apply creams containing estrogen directly to vaginal tissues to reduce symptoms. They can also use estrogen tablets and rings to reduce vaginal dryness. Hormone replacement medications. Medications are available to temporarily reduce severe symptoms associated with menopause, such as hot flashes or night sweats. Eflornithine (Vaniqa). This prescription cream may slow excessive facial hair growth in women. Anti-androgen medications. Medications that block the predominately male-sex hormone androgen can help limit severe acne and excessive hair growth or loss. Clomiphene (Clomid) and letrozole (Femara). These medications help stimulate ovulation in people with PCOS who are trying to become pregnant. Those with PCOS and infertility may also be given injections of gonadotropins to help increase the chances of pregnancy. Assisted reproductive technology. In vitro fertilization (IVF) may be used to help those with PCOS complications get pregnant. Treatment options for anyone with hormonal imbalances include: Metformin. A medication for type 2 diabetes, metformin can help manage or lower blood sugar levels. Levothyroxine. Medications containing levothyroxine, such as Synthroid and Levothroid, can help improve symptoms of hypothyroidism. Treatment options for men with hormonal imbalances include: Testosterone medications. Gels and patches containing testosterone can help reduce symptoms of hypogonadism and other conditions that cause low levels of testosterone, such as delayed or stunted puberty. Natural remedies Some natural supplements can help hormonal imbalance Some natural supplements can be used to reduce symptoms. People have used natural supplements to treat hormonal imbalances for thousands of years. However, there are no natural remedies that have been consistently proven in clinical studies to treat hormonal imbalances and their causes, aside from lifestyle changes. Natural supplements commonly used for the reduction of symptoms associated with hormonal imbalances include: black cohosh, dong quai, red clover, and evening primrose oil for hot flashes caused by menopause ginseng for irritability, anxiousness, and sleep disturbances caused by menopause ginseng, and maca for ED Lifestyle changes that may help reduce the likelihood and symptoms of hormonal imbalances include: maintaining a healthy body weight eating a nutritious and balanced diet exercising regularly practicing good personal hygiene, focusing on washing areas with a lot of natural oils, such as the face, neck, back, and chest using over-the-counter acne washes, rinses, and medicated creams or gels for minor to moderate acne avoiding triggers that cause hot flashes, such as warm weather and spicy, rich, or hot foods and drinks reducing and managing stress practicing yoga, meditation, or guided visualization limiting sugary foods and refined carbohydrates avoiding packaged foods replacing older non-stick pans with ceramic pans using glass containers to store and heat foods and drinks restricting the use of cleaning products that contain toxic chemicals, such as bleach buying fruits and vegetables that have not been sprayed with pesticides or ripening chemicals not microwaving foods and drinks in plastics Outlook Nearly everyone experiences at least one or two periods of hormonal imbalance during their lifetime. Hormonal imbalances are more common during puberty, menstruation, and pregnancy. But some people experience continual, irregular hormonal imbalances. Many hormonal imbalances are caused by external factors, such as stress or hormone medications. However, hormonal imbalances can also be caused by any medical condition that impacts or involves the endocrine system or glands. A person should speak to a doctor about long-term unexplained symptoms, especially those that cause pain, discomfort, or interfere with everyday activities.Dr. Rajesh Gupta7 Likes9 Answers
- Login to View the image
What is Acanthosis Nigricans? Acanthosis nigricans is a condition characterized by abnormal thickening and darkening of the skin, especially in the armpit and around the groin and neck. It is most commonly associated with obesity or polycystic ovarian disease in women, though acanthosis nigricans can occasionally be found in people who have more serious underlying health problems or who are taking certain medications. Treatment of the underlying medical condition usually resolves the skin lesions. ￼ Who's at risk? Acanthosis nigricans can affect individuals of any age, including children and those of any ethnic background. However, it is more common in adults and in people with darker skin. Males and females are affected equally. Groups of people who commonly develop acanthosis nigricans: Overweight or obese persons People with endocrine (glandular) abnormalities Persons taking certain medications (for example, oral contraceptives, niacinamide, corticosteroids) Kidney transplant patients People with internal malignancy, especially stomach cancer (very rare cause of acanthosis nigricans) ￼ What causes acanthosis nigricans? Acanthosis nigricans sometimes occurs in people who are otherwise in good health, particularly dark-skinned people of African descent. However, in most cases it's a sign of an underlying problem or condition such as obesity, diabetes or abnormal hormone levels. Some of the main causes of acanthosis nigricans are outlined below. 1.Obesity Acanthosis nigricans is usually the result of obesity. This is known as obesity-associated acanthosis nigricans. It occurs because obesity can cause insulin resistance (when the body is unable to properly use the hormone insulin), which may lead to high levels of insulin in the blood, affecting the skin cells. Insulin resistance can also cause type 2 diabetes, so acanthosis nigricans can be an early sign that you have diabetes or are at risk of developing the condition 2.Syndromes and hormone problems Acanthosis nigricans is sometimes associated with an underlying syndrome or hormone problem, such as: polycystic ovary syndrome - a condition that affects how a woman's ovaries work, which can cause excessive body hair, irregular periods, infertility, acne and weight gain Cushing's syndrome -symptoms such as weight gain, bruising and stretch marks caused by very high levels of the hormone cortisol in the body acromegaly -where the body produces too much growth hormone, leading to the excess growth of body tissues over time underactive thyroid (hypothyroidism) -where your thyroid gland does not produce enough hormones, causing symptoms such as tiredness and weight gain This type of acanthosis nigricans is known as syndromic acanthosis nigricans. 3.Medication Acanthosis nigricans is sometimes triggered by medicines, including insulin, corticosteroids, and hormone treatments such as human growth hormone or the contraceptive pill. This is known as drug-induced or medication-associated acanthosis nigricans. 4.Genes In rare cases, acanthosis nigricans can be caused by a faulty gene inherited directly from your parents. This is known as familial or benign genetic acanthosis nigricans. This type is usually passed on in an autosomal dominant pattern, which means it can be passed on if only one of your parents carries the faulty gene. 5.Cancer If the dark skin patches come on suddenly and spread quickly, it may be a sign you have cancer (usually stomach cancer). This is known as malignant acanthosis nigricans. This is a rare condition that tends to affect middle-aged or elderly people, regardless of their weight or ethnic background. The patches are more severe and the mouth, tongue and lips may also be affected. The skin may also become irritated and itchy. Signs and Symptoms 1.Dark, velvety patches If you have acanthosis nigricans, you'll have thickened, brownish-grey or black patches of skin. The patches will be dry and rough, feeling similar to velvet. They may also be itchy. These patches may occur anywhere, but are usually seen around the neck, in the armpit, around the groin and sometimes in other skin folds. Occasionally, the skin over the joints of the fingers and toes may be affected, as well as the lips, palms of the hands and soles of the feet. The patches usually develop slowly over time. Patches that grow and spread quickly are more likely to be associated with cancer. In these cases, the mouth, tongue, throat, nose and windpipe may also be affected. 2.Tiny growths on the skin You may also have lots of tiny finger-like growths from the patches. This is known as papillomatosis. There may also be skin tags around the affected area. These are small flesh-coloured or pigmented growths that hang off the skin and look a bit like warts.Asiyah Shafeeqa3 Likes6 Answers