‘I just want a normal life': the impact of obesity
Jenny Radcliffe in Cut Down to Size, 2013
Women who are severely overweight are more prone to fertility problems. Polycystic ovary syndrome5 (PCOS) is a hormonal disorder causing irregular periods, infertility, weight gain and excess hair on the face and body. It is a common condition, affecting up to 10 per cent of adult women. It has been estimated that 15 per cent of women seeking weight loss surgery have a diagnosis of PCOS and fertility problems are often a motivation for wanting surgery.18My main reason [for wanting weight loss surgery] was that my husband and I have been trying for a baby for three years. We had had every test and nothing is wrong with either of us. Our fertility consultant told me that it is because I am obese, and all the time I am so fat we will never fall naturally.K, gastric bypass
Clinical specialties
Andrew Schofield, Paul Schofield in The Complete SAQ Study Guide, 2019
Laura and Richard, both aged 30, come to see you, having spent a year trying to conceive, with no success. Neither partner has had children from previous relationships. Explain the difference between primary and secondary infertility. (1)Name three causes of female infertility. (3)What lifestyle changes could you suggest? (2)Name two blood tests to look at ovulatory function. (2)Name one test to assess tubal patency. (1)Laura’s blood tests reveal anovulation and raised testosterone.On USS, there are multiple follicular cysts arranged in a pearl necklace fashion on each ovary. Name two possible symptoms of polycystic ovary syndrome (PCOS). (2)Name two medical treatments to treat PCOS-associated infertility. (2)
Lifestyle Medicine and the Management of Prediabetes
James M. Rippe in Lifestyle Medicine, 2019
Insulin resistance is increased via two mechanisms: (i) nonphysiological deposition of fat in visceral, hepatic, and intramyocellular sites, and (ii) intracellular sequestration of GLUT-4 glucose transporters in unexercised muscle, resulting in reduced glucose uptake.18 Free fatty acids, produced more readily in visceral abdominal fat, decrease insulin sensitivity, impair vascular reactivity, and also increase endothelial dysfunction. “Toxic messages” from the adipose organ, such as free fatty acids, altered cytokines (e.g., an increase in tumor necrosis factor-alpha and a decrease in adiponectin), and oxidative stress impair insulin action to restrain glucose production in the liver and promote glucose disposal in muscle.49 Increases in intracellular diacylglycerol (DAG) have been recently identified as an important mechanism of free fatty acid-induced insulin resistance in muscle and liver,50,51 disproving the “Randle hypothesis” of action via inhibition of pyruvate dehydrogenase.52,53 Polycystic ovary syndrome (PCOS) has also been linked to insulin resistance in women of reproductive age. Between 65%–70% of women with PCOS have insulin resistance,54 and they have been found to be more insulin resistant than age- and BMI-matched women without PCOS.55 Though the exact mechanism remains unclear, one theory suggests this is related to a post-insulin receptor defect that affects signal transduction, resulting in an increase in ovarian and adrenal androgens.54
Progesterone-loaded nanosized transethosomes for vaginal permeation enhancement: formulation, statistical optimization, and clinical evaluation in anovulatory polycystic ovary syndrome
Published in Journal of Liposome Research, 2019
Heba F. Salem, Rasha M. Kharshoum, Heba A. Abou-Taleb, Hisham A. AbouTaleb, Kariman M. AbouElhassan
The polycystic ovary syndrome (PCOS) is a set of symptoms caused by elevated androgens (male hormones) in females (Cicinelli et al. 2000, Schumacher et al. 2004). It is responsible for almost 80% of women with anovulatory infertility (Montville et al. 2010, Balen 2013). Bio-identical progesterone (PRG) is an exogenous female steroidal hormone which is involved in mammary gland development, pregnancy and menstrual cycle (Maliwal et al. 2009, Tien et al. 2013). It is identical to the endogenous PRG in structure but does not induce any teratogenicity or affect lipoprotein metabolism (Jiang et al. 1992, Salem 2010). PRG has been used alone or in combination with Letrozole (ovulation-inducing agent) for a patient with PCOS (Partridge 2007). However, it has a major problem which is the low bioavailability due to hepatic metabolism and poor solubility (Salem 2010, Campaña-Seoane et al. 2014).
Isorhamnetin inhibits inflammatory response to alleviate DHEA-induced polycystic ovary syndrome in rats
Published in Gynecological Endocrinology, 2023
Fei Yu, Yanfeng Xue, Yunyan Zhao, Long Zhang, Xiao He, Zheng Liu
Polycystic ovary syndrome (PCOS) is clinically manifested by polycystic ovary, abnormal ovulation, and hyperandrogenemia; and is often accompanied by increased risk of metabolic disorders, cardiovascular disease, and diabetes [1–3]. PCOS is a common endocrine disease in women of childbearing age with an incidence of about 10% [1,4]. At present, oral contraceptive [5], letrozole [6], and clomiphene are the main treatments for PCOS to induce ovulation, regulate menstrual cycle, reduce insulin resistance and reduce serum androgen levels [7]. However, existing drug treatments may cause adverse reactions such as ovarian hyperstimulation syndrome, allergic dermatitis, abnormal glucose and lipid metabolism, and gastrointestinal side effects [8,9]. Thus, it is urgent to search new drug for PCOS treatment.
IMPROVE lifestyle in polycystic ovary syndrome: a systematic strategy
Published in Gynecological Endocrinology, 2021
Lino Del Pup, Angelo Cagnacci
Lifestyle is regarded as a first-line therapy to manage reproductive and metabolic outcomes of polycystic ovary syndrome (PCOS) [1]. Although studies investigating adherence to advice on lifestyle are of poor quality and short-lasting [2–4], adherence appears to be rather low [2–4]. Psychological disturbances, such as anxiety or depression, though under-recognized, seem to affect 28%–64% of women with PCOS [5,6], and less than 5% of these women are satisfied with the counseling they receive [6]. In this paper we propose a strategy used in our clinical practice to help PCOS patients better adhere to lifestyle recommendations. Evidence supporting this strategy, was searched in Medline using the following key words: polycystic ovary syndrome (PCOS); lifestyle; counseling; adherence; exercise; body weight; diet; fertility; infertility.
Related Knowledge Centers
- Acanthosis Nigricans
- Acne
- Cyst
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- Hyperandrogenism
- Infertility
- Menstrual Cycle
- Ovary
- Endocrine System
- Heavy Menstrual Bleeding