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Herbal Management for Polycystic Ovarian Syndrome
Published in Megh R. Goyal, Hafiz Ansar Rasul Suleria, Ademola Olabode Ayeleso, T. Jesse Joel, Sujogya Kumar Panda, The Therapeutic Properties of Medicinal Plants, 2019
Huma Bader-Ul Ain, Farhan Saeed, Muhammad Umair Arshad, Hafiz Ansar Rasul Suleria
According to Dunne and Slater [39], motivators of PCOS are many hormones such as testosterone-producing androgen, cortisol, estrogens (female hormone), FSH, insulin (carrier of blood glucose to other cells), LH, progesterone (female hormone), prolactin, and thyroid hormones disturbances. In retort to prompt by LH, the ovarian theca-cells amalgamate androgens. It is revealed from in-vitro and in-vivo studies that chances of conversion of androgenic signs into testosterone are higher in case of PCOS women with abnormal theca cells in their ovaries as compared to normal women with normal theca cells [114].
Menstrual-Cycle-Related Disorders
Published in Jane M. Ussher, Joan C. Chrisler, Janette Perz, Routledge International Handbook of Women’s Sexual and Reproductive Health, 2019
Nancy Fugate Woods, Nancy J. Kenney
In women, androgens are produced in the adrenal cortex, adipose tissue, and skin, as well as the ovaries. Androgen can be converted from precursors in peripheral tissues (e.g., androstenedione, which is produced in the ovarian theca cells and the adrenal cortex) (Pasquali & Gambineri, 2018). Androgen excess is assessed by measuring total testosterone, but recent evidence supports the importance of considering delta-4-androstenedione, free androgen index (FAI), and 5-alpha dihydrotestosterone because of their role in predicting metabolic risk. The adrenals produce androgens, and they also contribute to hyperandrogenemia: 11-oxygenated C-19 steroid metabolism products are significantly greater in women with PCOS than in other women, and these may play an important role in metabolic risk. Moreover, women with normal levels of total testosterone who have ovarian dysfunction (OD-PCOm – PCO morphology) phenotype may have elevated delta-4-androstenedione or free androgen index (Pasquali, 2018).
Adnexal masses in the neonate, child, and adolescent
Published in Joseph S. Sanfilippo, Eduardo Lara-Torre, Veronica Gomez-Lobo, Sanfilippo's Textbook of Pediatric and Adolescent GynecologySecond Edition, 2019
Lisa Allen, Nathalie Fleming, Julie Strickland, Heather C. Millar
Functional cysts may become complicated by hemorrhage. Following ovulation, both the luteinized theca cells and the granulosa cell layer of the follicle become vascularized. These vessels are fragile and may rupture easily, leading to a hemorrhagic cyst.77 The average diameter of a hemorrhagic ovarian cyst is 3.0–3.5 cm, but they may range up to 8.5 cm on ultrasound.77 A hemorrhagic ovarian cyst often presents with an abrupt onset of lower abdominal or pelvic pain midcycle or in the luteal phase without fever or leukocytosis. If the cyst wall ruptures, a hemoperitoneum may develop, and peritoneal signs or postural hypotension may be evident on examination. A hemorrhagic cyst has been termed a great imitator, as its appearance on ultrasonography may be confused with an ectopic pregnancy, ovarian neoplasm, or inflammatory process such as a tubo-ovarian abscess.78 The hallmark of a hemorrhagic ovarian cyst is its evolution over time from acute hemorrhage, through clot retraction, to resolution.77 While acute pain is often the presentation, the symptoms gradually resolve without intervention, with analgesia often required.
CircEpha5 regulates the synthesis and secretion of androgen in mouse preantral follicles by targeting miR-758-5p
Published in Journal of Obstetrics and Gynaecology, 2023
Xueying Zhang, Jiaxuan Liu, Hao Wu, Yan Chen, Xuesen Zhang, Boqun Xu
It has been reported that most PCOS patients with hyperandrogenism exhibit steroid secretion defects, which can lead to abnormal folliculogenesis and a failure in dominant follicle selection (Zeng et al.2020). For example, overexpression of steroidogenesis acute regulator (StAR) in PCOS exhibited a state of hyperandrogenism (Kalyani et al.2018). The elevation of luteinizing hormone receptor (LHR) promotes the conversion of cholesterol into testosterone and androsterone, thus stimulating ovarian theca cells to produce excessive androgen (Ritu et al.2019). Studies have shown that CAG repeat polymorphisms in androgen receptor (AR) gene may cause hyperandrogenemia in PCOS (Ryan et al.2018). Theca cells from polycystic ovaries of classic PCOS patients overexpress most steroidogenic enzymes. Cytochrome P450 cholesterol side chain lyase (P450c11, encoded by CYP11A1 gene), catalyses the conversion of cholesterol to progesterenolone during steroid hormone synthesis. Cytochrome P450 17 A-hydroxylase and 17 and 20 carbon chain lyase (P450c17, CYP17A1 gene code) are rate-limiting enzymes for androgen production in the ovary and adrenal cortex (Belani et al.2018). The expression of enzymes related to androgen biosynthesis increases in follicular membrane cells of PCOS mice, and the level of testosterone also rises in the culture medium of PCOS follicular membrane cells (Jakimiuk et al.2001, Madeleine et al.2018). Studying the synthesis and secretion of androgen in follicles may provide new insight into the pathogenesis of PCOS hyperandrogenemia.
Mucinous cystadenoma with fibroma: a rare combination of collision tumour
Published in Journal of Obstetrics and Gynaecology, 2022
Tanisha Singla, Chintamani Pathak, Anam Singh, Gaurav Singla, Swati Singla, Naveen Kumar R.
On gross examination we received a large grey white soft tissue mass measuring 20 × 18 × 6 cm. External surface was bosselated with intact capsule (Figure 1(B)). On cut, the tumour was predominantly solid along with few cystic areas (Figure 1(B)). Cysts were filled with sero-mucinous fluid and varied in size from 1 to 4 cm in diameter. Extensive sampling was done and multiple sections examined from the solid areas revealed a spindle cell tumour arranged in a fascicular pattern (Figure 1(C)). The spindle cells were oval to elongated with no atypia. The fascicular arrangement was intervened by thecal cells which were oval to polygonal with abundant clear cytoplasm. No atypia or atypical mitoses were identified (Figure 1(C)). Sections from the cystic areas revealed cyst wall lined by a single layer of mucin secreting tall columnar endocervical type epithelium (Figure 1(D)) with no atypia/nuclear hyperchromasia. Focal stratification was seen (<10%). No normal ovarian tissue was identified. Based on the histopathological findings a diagnosis of collision tumour-fibroma with mucinous cystadenoma with focal epithelial proliferation was rendered.
The different doses of radiation therapy-induced damage to the ovarian environment in rats
Published in International Journal of Radiation Biology, 2021
Gozde Ozge Onder, Esra Balcioglu, Munevver Baran, Ayse Ceyhan, Ozge Cengiz, Pinar Alisan Suna, Oguz Galip Yıldız, Arzu Yay
The immunohistochemical analysis of Bax, Bcl-2, and caspase 3 was conducted to assess the state of apoptosis in rat ovary. We found minimal expression of Bax in ovarian theca interstitial cells and ovarian stromal cells obtained from the control rat. In contrast, we found a significantly increased level of Bax in the samples obtained from the rat treated irradiated ovaries with 1 Gy (p < .01). 5 Gy and especially 10 Gy irradiated ovaries showed an increase in the Bax immunoreactivity which was evident by strong positive brown staining compared to control ovaries (p < .01). We also assessed the state of apoptosis by anti-apoptotic molecule Bcl-2. It was expressed mainly in the granulosa and theca cells, as well as ovarian stromal cells. Immunohistochemical staining of Bcl-2 revealed that ovarian sections of control showed a moderate of immunostaining for Bcl-2. According to our results, the immunoreactivity intensity of Bcl-2 was decreased in 10 Gy irradiated ovaries compared with control ovaries, but there was no statistically significant difference. Bcl-2 levels did not differ between radiation-exposed ovarian tissues and control ovaries. The immunohistochemical staining of Bax and Bcl-2 were quantified as mean density of the stained regions using the Image J software analysis and the results are represented in Figure 2.