MIT HST 071 - POLYCYSTIC OVARIAN SYNDROME (8 pages)

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POLYCYSTIC OVARIAN SYNDROME



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POLYCYSTIC OVARIAN SYNDROME

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Pages:
8
School:
Massachusetts Institute of Technology
Course:
Hst 071 - Human Reproductive Biology

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Harvard MIT Division of Health Sciences and Technology HST 071 Human Reproductive Biology Course Director Professor Henry Klapholz IN SUMMARY Polycystic Ovarian Syndrome HST 071 POLYCYSTIC OVARIAN SYNDROME Presence of oligo or anovulation in combination with hyperandrogenism Chronic anovulation may present as irregular menstrual periods or amenorrhea It is not essential to document anovulation by ultrasonography or progesterone measurements in the presence of a clear clinical history PCOS occurs in 85 to 90 of women with oligomenorrhea and in 30 40 of women with amenorrhea Diagnosed either by clinical hirsutism or laboratory elevated testosterone or androstenedione Should not be diagnosed if evidence of other causes of oligo ovulation and hyperandrogenism ovarian androgen secreting tumor or nonclassical adrenal hyperplasia Prevalence of PCOS is approximately 5 7 of women of reproductive age 50 of PCOS women are obese and tend to have an android pattern of obesity Elevated levels of serum LH increased LH pulse amplitude and LH pulse frequency Steady state levels of gonadotropins and ovarian steroids o o o o chronic estrous state Proliferation and hyperplasia of the endometrium Can lead to unpredictable bleeding episodes Unopposed estrogen exposure confirmed by progesterone withdrawal test Women with PCOS have higher mean concentrations of LH o Increased bioactivity of LH o Low to low normal levels of follicle stimulating hormone Obese PCOS women do not have elevated LH levels o normal LH level or normal LH FSH ratio does not rule out PCOS o LH FSH ratio is now not included in the diagnostic criteria of PCOS In research studies almost all women with PCOS have elevated LH secretion In clinical practice difficult to use a single measurement of LH to diagnose PCOS LH is secreted in a pulsatile manner Normal range of serum LH concentration decreases with increasing body mass index BMI IN SUMMARY Polycystic Ovarian Syndrome HST 071 Association between hyperinsulinemia and



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