Prevalance: Estimates that between 5 and 10 % of females of reproductive age are affected by PCOS.
Defination of PCOS: 1.) Oligo or anovulation, clinical (e.g hirsutism, acne, alopecia) and or
2.) Biochemical signs of hyperandrogenism (eg. elavated levels of total or free testosterone)
3.) Polycystic ovaries on USG
Clinical manifestation of PCOS:
a.) Reproductive disorders – hyperandrogenism (ovarian and adrenal), ammenorrhoea (intermittent or complete), polycystic ovaries, high rates of miscarriage, hypersecretion of LH.
b.) Metabolic disorder – hyperinsulinemia, obesity, hyperlipedemia
c.) Steroidegenic disorders – hirsutism, acne vulgaris, androgenetic alopecia, acanthosis nigricans
PCOS largely affects three F’s of a women viz. face, figure and fertility..
Pathophysiology of PCOS: rollercoaster of hormones: women with PCOS have increased pulsative GnRH release, which results in increased levels of LH and decreased levels of FSH in most individuals.
higher LH (and insulin) levels seem to cause increased androgen production by follicular theca cells whereas decreased FSH levels leads to anovulation.
obesity and insulin resistance decrease levels of sex hormone binding globulin and thereby increase testosterone bioactivity.
maintain blood glucose levels, improve metabolic parameteres and improve lipid metabolism (improve lipid profile)
Common treatments:
lifestyle changes – such as weight loss and exercise
medications – such as oral contraceptives and insulin senitizers
Herbal remedy:
curcuma longa – antiandrogenic and antiobesity properties of curcumin
gymnema sylvestra – significant antidiabetic activity and a hypolipidemic activity
pterocarpus marsupium – insulinogenic because of post receptor intracellular medication by d-chiro-inositol
zinc oxide – an effective dietary adjuvant therapy to manage cardiovascular risk factors in PCOS patients
emblica officinalis – act as a hypolipidemic agent reducing the risk of cardiovascular complications in diabetics