POLYCYSTIC OVARIAN SYNDROME

POLYCYSTIC OVARIAN SYNDROME

            Polycystic ovarian syndromes affect 5-10% of all premenopausal women and young girls. Puberty, polycystic ovarian syndrome, metabolic syndrome and exposure to gestational diabetes are all linked to insulin resistant.

            PCOS is considered a sex specific form of metabolic syndrome. It consists of oligo/anovulation and signs of hyperandrogenism and hyperandrogenemia. Insulin resistance is an integral components of the syndrome and is present in overweight and normal weight women with PCOS. Obese adolescents with PCOS have 50% lower in vivo insulin sensitivity compared with equally obese control girls of similar body composition and abdominal adiposity. Further more the higher prevalence of IGT (~30%) and type II diabetes (3-5%) in adolescents with PCOS appears to be due to impaired insulin secretion in IGT compared with normal glucose tolerance. Therefore it is not unreasonable to screen these high risk obese PCOS adolescents for the presence of IGT and type II diabetes, or to screen obese girls with type II diabetes for possibility of PCOS.

            This syndrome is a clinical description of hirsute women with hyperprolactenemia, amenorrhea, galactorrhea and polycystic ovaries, acanthosis nigricans is a characteristics clinical features. There is insulin resistance and hyperinsulinemia as well as an increased risk of developing type II diabetes, hypertension and cardiovascular disease – most of the key features of metabolic syndrome. The defect in both IR and insulin secretion probably explains the increased risk diabetes in PCOS. Metformin induced weight loss could be a reflection of its insulin sparing and lipid lowering effects. Metformin has been found to be extremely useful in PCOS. It facilitates normal menstruation and successful pregnancy. It reduces hyperinsulinemia, IR systolic BP and hyperandrogenemia. Anovulatory women with PCOS have higher LH level. A patient is overweight screening of OGTT should be done.

CONCLUSION:

            More than 25% of obese women with PCOS develop impaired GTT or overt DM by the age of 30 years.

REFERENCE:

            RSSDI Text Book of Diabetes Mellitus