0.72 CME

Pendekatan terhadap PCOS

Pembicara: Dr. Ankesh Sahetya

Consultant Obstetrician & Gynaecologist, Cloudnine Hospitals, Mumbai

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Keterangan

The approach to managing Polycystic Ovary Syndrome (PCOS) involves a multidisciplinary strategy focusing on symptom management, hormonal balance, and lifestyle modifications. Treatment typically includes addressing menstrual irregularities, managing insulin resistance, promoting weight loss, and offering options like oral contraceptives or ovulation-inducing medications for fertility concerns.

Ringkasan

  • PCOS, or Polycystic Ovary Syndrome, is a common condition impacting women's health, characterized by irregular periods, weight gain, facial hair, and potential fertility issues. It presents in two forms: lean PCOS and obese PCOS, both stemming from hormonal imbalances. Common symptoms include hair loss/growth, overweight, acne, and irregular periods.
  • The causes of PCOS range from poor diet and lifestyle choices to genetics and hormonal imbalances like hyperinsulinemia. In North America, it's sometimes referred to as "ovarian diabetes" in obese patients. Hormonal issues include excessive GNRH and LH, leading to hyperandrogenism and an imbalance in the hormones.
  • Hyperinsulinemia, an excess of insulin, results from excess male hormones and reduces the production of sex hormone-binding globulin, causing a higher concentration of free androgen. This leads to symptoms like neck pigmentation, acne, and excessive hair growth in unwanted areas. The lack of ovulation due to hormonal imbalances can lead to fertility problems.
  • Diagnosis involves assessing clinical and biochemical signs of male hormone excess, menstrual disorders, and polycystic ovaries. Patients often exhibit jawline acne and ovaries with multiple small cysts around the periphery. These are often multiple small arrested cysts indicating failure of regular rupture and ovulation
  • Treatment strategies start with lifestyle modifications, including a 15% body weight loss, exercise, a healthy diet, stress reduction, and adequate hydration. Management depends on the most dominant symptoms, such as menstruation problems, androgen issues, or fertility concerns. Inositol is used along with metformin to improve hormone balance.
  • Medical interventions include oral contraceptive pills to control androgen levels and regulate periods. Drosperinone is a drug used to reduce bloating and water retention. Metformin and decarobinus inositol can be combined, alongside birth control pills for regular periods and acne. PCO drilling and IVF are considered in resistant cases.
  • Long-term consequences of untreated PCOS include endometrial cancer, diabetes, and recurrent pregnancy loss. Proper diagnosis and management are crucial, with a focus on addressing the metabolic consequences. Patients are advised against self-medication and encouraged to seek professional medical advice for personalized treatment plans. Successful transformations are possible through weight loss, improved diet, and exercise, highlighting the potential for positive change with dedicated management.

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