Systemic Hyperinsulinemia

Polycystic Ovary Syndrome is a common endocrine disorder that can affect many women. It is also “an incurable disorder that affects 1 in 10 women and over 50% do not know they have it” (PCOS Awareness Association, 2014). An ultrasound exam can reveal that women with PCOS have a collection of follicles on enlarged ovaries. The particular cause of polycystic ovary syndrome is unknown. It could be connected to long-term complications; therefore, doctors recommend weight loss to reduce this risk. Also, early diagnosis and treatment can have an impact on deciphering if a woman will have long-term complications. Such complications include type 2

The motive of this paper is to present a analysis of current research on polycystic ovary syndrome more commonly known as PCOS. Pcos is one the most common endocrine disorders in women of reproductive age, affecting 5-10% of the population. Despite it's prevalence, pcos remains largely unknown. The main focus of this paper will be explaining what PCOS is, the causes, the diagnosis and the treatment of polycystic ovary syndrome.

Bullock & Hales, (2013) state that the main pathophysiological mechanisms underlying PCOS are alterations in the functions of the hypothalamic-pituitary-ovary and the hypothalamic-pituitary-adrenal axes as well as the onset of insulin resistance.

According to PubMed Health, Polycystic Ovary Syndrome (PCOS) is a condition in which women possess abnormally high level of male hormones. The high hormone levels lead to risks of irregular or absent menstrual cycles, insulin resistance, ovarian cysts, issues related to the circulatory system, obesity, heart disease, diabetes and etc. Symptoms differ between each woman therefore, despite research data collected showing that PCOS affects 5-10% of women between the age of 18-44, there are many women who live their lives unaware that they have PCOS. The most common symptoms include: absences of ovulation, high levels of androgen present, and abnormal hair growth. The cause of PCOS is still unknown as more research is much-needed to better understand the disorder.

The two most common are Cushing Syndrome and Amenorrhea. “Cushing syndrome occurs when your body is expose to high levels of the hormone cortisol for a long time.” (Mayo Staff Clinic, 2016, p.1) There are several symptoms that Cushing Syndrome shares with Polycystic Ovarian Syndrome. Some of the symptoms are: weight gain, acne, hirsutism and/or irregular or absent menstrual periods. Evidently, the two diseases share similar symptoms. Another disease that shares similarities with PCOS is Amenorrhea. It is when one or more menstrual cycles are missed or the absence of menstruations. Some of the symptoms are: hair loss, excess facial hair and acne. Amenorrhea, also,

One study done on one hundred patients with PCOS showed that administration of metformin and pioglitazone shows 50 percent effectiveness in helping menstrual cycle irregularities by the end of six-months of treatment. Both medications also showed a decrease in LDL and an increase in HDL overall, but this was seen more in the pioglitazone group. This study showed that 64% of women with PCOS also had hyperinsulinism. HOMA-IR, used to assess insulin resistance, was shown to have a 15% decrease with metformin and a 50% decrease in patients who used pioglitazone. Thus, for protection from diabetes pioglitazone may be the better treatment. Ovulation was shown to be restored in up to 56% of patients on metformin and pioglitazone. This study showed that pioglitazone may be a new and better option for treatment of PCOS since it can delay onset of type II diabetes, help with signs of hyperandrogenism, and regulate menstrual cycles (sangeeta,

If the pancreas can manage with your body’s high demand for insulin your blood sugar levels will remain normal and you would not become a diabetic. Because diabetes and PCOS is closely related it is monitored closely. It is shown that women with PCOS is in much greater risk in developing diabetes. Research has shown that once the pancreatic islet cells have become exhausted and depleted in the over production of insulin to satisfy the body requirements, your pancreas stop making insulin and your blood sugar becomes elevated. When that happens the patient becomes diabetic. Besides diabetes a woman with PCOS is more likely to develop uterine cancer and heart disease. Patients are also advised not to smoke while diagnosed with PCOS because it increases the risk for heart disease.

Since PCOS is the most common endocrine disorder for women of reproductive ages, Questions to explore are: How does lifestyle factors such as obesity impacts the development of PCOS, how does PCOS affects a women quality of life and what are the best treatment options?

For this article there were no research questions, but the authors wanted to focus on the pathogenesis, diagnosis and treatment of PCOS. They found that polycystic ovary syndrome (PCOS) is common in women, with a10% prevalence in women of reproductive age. Polycystic ovary syndrome is defined as ovarian dysfunction with polycystic ovaries. It also includes androgen excess which is shown by testosterone levels being elevated. Increased levels of testosterone can be seen through excess body hair. Obesity is seen in many women with PCOS, this can lead to insulin resistance and Type II Diabetes. Genetics has an impact on polycystic ovary syndrome with 20-40% of people with PCOS having first-degree relatives with the syndrome.

Increased androgen hormone levels within the body can negatively affect the normal ovulation process and cause fluid-filled cysts to form on the ovaries. PCOS prevents ovarian egg release during the menstrual cycle, which causes infertility in women with this condition. Additional symptoms of PCOS include pelvic pain, acne, oily skin, hair loss or excessive hair growth on the body or face. Currently, there is no cure for PCOS but hormone therapy can help regulate your menstrual cycle or clear up your skin.

There is one dream that every little girl has when growing up, that is becoming a mother; to love and watch her children grow. No one ever dreams of that not happening to them or being part of that group being label as infertile. It happens to millions of women living in the United States every day. Polycystic Ovary Syndrome is the most common endocrine disease that affects women of reproductive age, which is typically puberty to menopause. Polycystic Ovary Syndrome does not only affect a woman’s ovaries and chances of conceiving, but it affects the whole endocrine system in the body. It can cause Excess Androgen Production, Insulin Resistant, Obesity, Hirsute and Cardiovascular problems.

There are many long-term consequences of PCOS. If PCOS is not properly treated there is a bigger chance of having long-term consequences. One of these consequences is type II diabetes. Women with PCOS frequently have hyperinsulinism and insulin resistance. Women who have irregular ovulation tend to have more insulin resistance. Insulin resistance is a precursor to diabetes, so PCOS patients are more at risk of developing diabetes. It is also shown that women with PCOS are more at risk of having glucose intolerance. Researchers found that women with PCOS also have an increased incidence of mortality related to diabetes complications (Nandi et al., 2014).

Polycystic ovary syndrome (PCOS) is one of the most common conditions of hyperandrogenic disorders in reproductive-age of women. It comes with mentrual irregularity, ovary disfunction and hyperandrogenism such as amenorrhea, menorrhagia, anovulation, infertility, ovarian cysts, acne, hirsutism, etc.1,2 Additionally, patients with PCOS also experience with serious cardiovascular problems, and metabolic disorders such as hypertension, dyslipidemia, obesity and type 2 diabetes mellitus (T2DM).1 Especially, patients with PCOS have higher risks to develop T2DM more than general population, because of experiencing metabolic disorders.3 Therefore, metformin is used as the first line agent for insulin-resistance and weight loss in obese and T2DM

Much information on how and where these hormones are produced in the body and the regulation of their expression, as well as how and where GH and IGF-I exert their biological action has been

Androgens act on sebaceous glands by increasing the proliferation of sebocytes and increasing lipid production through sterol response element binding proteins (SREBP’s). 5-alphareductase type 1 is one of the most important enzymes that found in sebocytes and keratinocytes of the infundibulum , this enzyme responsible for transform testosterone into DHT, its activity greater in the follicular infra infundibulum than in the epidermis and acts 5–10 times more effective than its precursor testosterone. 5-alphareductase type 1 binding to its receptor protein then DHT is translocated to the nucleus and initiates the transcription of androgen-responsive genes after that 5 DHT increases the mRNA of proteins involved in fatty acid, triglyceride and