Volume : 9, Issue : 1, JAN 2023

A REVIEW ON POLYCYSTIC OVARIAN SYNDROME: IT’S ASSOCIATION WITH REPRODUCTIVE AND METABOLIC MANIFESTATIONS

CHUMI DAS, JUMI DAS

Abstract

Polycystic ovarian syndrome (PCOS) is an endocrine disorder affecting many women of childbearing age. PCOS is a multifaceted lifestyle disorder characterized by various clinical manifestations like menstrual irregularity, reproductive infertility, hyperandrogenism, hirsutism, metabolic insulin resistance, diabetes mellitus and also various psychological features. But yet, the exact etiology of the disorder is not known till date. Literature was searched from Google scholar and PubMed. It affects 8% to 13% of reproductive women and is associated with reproductive and metabolic dysfunction. And the prevalence range mainly depends the methods applied and the studies based on Rotterdam criteria shows higher prevalence rate than any other methods. Genetic and environment contributes to the pathophysiology of the disease. Obesity worsens the presentation of PCOS and weight management and is proposed to be an initial strategy along with lifestyle modifications, dietary intake habit and physical exercises. Lifestyle modifications aimed at normalizing insulin resistance, improving androgen status and aiding weight management is recognized as a crucial initial treatment strategy. Monitoring and management of long term metabolic complications is also an important part of routine clinical care. Further research is required in this complex condition, emphasizing on lifestyle management as more and more cases has been rising in India till date.

Keywords

POLYCYSTIC OVARIAN SYNDROME, INSULIN RESISTANCE, INFERTILITY, MENSTRUAL IRREGULARITY, LIFESTYLE, DEPRESSION, ANXIETY.

Article : Download PDF

Cite This Article

-

Article No : 6

Number of Downloads : 156

References

  1. Zehravi M, Maqbool M, Ara I. “Polycystic Ovary Syndrome and Infertility: an update”. Int J Adolesc Med Health. 2021; 34(2): 1-9
  2. Farhadi-Azar M, Behboudi-Gandevani S, Rahmati M, Mahboobifard F, Pouya EK, Tehrani FR and Azizi F. “The Prevalence of Polycystic Ovary Syndrome, Its Phenotype and Cardio-Metabolic Features in a Community Sample of Iranian Population: Tehran Lipid and Glucose Study”. Front Endocrinol. 2022; 13:825528
  3. Sadeeqa S, Mustafa T and Latif S. “Polycystic Ovarian Syndrome – Related Depression in Adolescent Girls: A Review”. Journal of Pharmacy & Bio allied Sciences. 2018; 10(2): 55-59
  4. Hussain A, Chandel RK, Ganie MA, Dar MA, Rather YH, Wani ZA et al. “Prevalence of psychiatric disorders in patients with a diagnosis of polycystic ovary syndrome in Kashmir”. Indian J Psychol Med. 2015; 37: 66-70
  5. Upadhya SK, Sharma A, Agarwal A. “Prevalence of anxiety and depression in polycystic ovarian syndrome”. Int J Med Sci Public Health. 2016; 5:681-3
  6. Mansson M, Holte J, Landin-Wilhemsen K, Dahlgren E, Johansson A, Landen M. “Women with Polycystic Ovary Syndrome are often depressed or anxious: A case control study”. Psychoneuroendocrinology. 2008; 33: 1132-1138
  7. Bazarganipour F, Ziaei S, Montazeri A et al. “Psychological investigation in patients with polycystic ovary syndrome”. Health Quality Life Outcomes. 2013; 11: 141
  8. Sunadararaman PG, Sweta, Sridhar GR. “Psychological aspects of women with polycystic ovary syndrome from South India”. J Assoc Physicians India. 2008; 56: 945-8
  9. Cooney LG, Lee I, Sammel MD, Dokras A. “High prevalence of moderate and severe depressive and anxiety symptoms in polycystic ovary syndrome: a systematic review and meta – analysis”. Hum Reprod. 2017; 32: 1075-1091
  10. Teede H, Deeks A, Moran L. “Polycystic Ovary Syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan”. BMC Med. 2010; 8:41
  11. Azziz R, Carmina E, Chen Z et al. “Polycystic ovary syndrome”. Nat Rev Dis Primers. 2016; 2:16057
  12. Gnawali A, Patel V, Cuello-Ramirez A et al. “Why Women with Polycystic Ovary Syndrome at Increased Risk of Depression? Exploring the Etiological maze”. Cureus. 2021; 13(2): e13489
  13. Mansson M, Holte J, Landin-Wilhemsen K, Dahlgren E, Johansson A, Landen M. “Women with Polycystic Ovary Syndrome are often depressed or anxious: A case control study”. Psychoneuroendocrinology. 2008; 33: 1132-1138
  14. Zahid, Rastogi A “Polycystic Ovary syndrome”. Centre of Health Informatics. 2016.
  15. Deshwal R, narwal V and Pundir CS. “The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review”. J Hum Reprod Sci. 2020; 13(4):261-271
  16. Times of India. “Modern Lifestyle increases PCOS Cases”. Times of India. 2012.
  17. Pal S. “PCOS Hitting the Young”. Daily News and Analysis. 2013.
  18. Garaari K. “All You Need to Know: Asian Age. 2014.
  19. Diamanti-Knadarakis E, Piperi C, Spina J, Argyrakopoulou G, Papanastasiou L, Bergiele A et al. “Polycystic Ovary Syndrome: the influence of environmental and genetic factors”. Hormones-Athens. 2006; 5:17
  20. Bulsara J and Acharya S. “A review: Brief insight into Polycystic Ovarian Syndrome”. Endocrine and Metabolic Science. 2021; 3:100085
  21. Futterweit W, Deligdisch L. “Histopathological effects of exogenously administered testosterone in 19 females to male transsexuals”. J Clin Endocrinol Metab. 1986; 62:16-21
  22. Franks S. “Polycystic Ovary Syndrome: a changing perspective”. Clin Endocrinol. 1989; 31;87-126
  23. Barbeiri RL, Ryan KJ. “Hyperdrogenism, insulin resistance and acanthosis nigricans syndrome: a common endocrinopathy with distinct pathophysiologic features”. Am J Obstet Gynecol. 1983; 147:90-101.
  24. Chang RJ, Nakamura RM, Judd HL, Kaplan SA. “Insulin resistance in non-obese patients with polycystic ovary disease”. J Clin Endocrinol Metab. 1983; 57:356-359
  25. Dunaif A, Segal KR, Futterweit W, Dobrjansky A. “Profound peripheral insulin resistance, independent of obesity, in polycystic ovary syndrome”. Diabetes. 1989; 38:1165-1174
  26. Pellat L, Hanna L, Brincat M, Galea R, Brain H, Whitehead S et al. “Granulosa cell production of anti-Mullerian hormone is increased in polycystic ovaries”. J Clin Endocrinol Metab. 2007; 92:240-4
  27. Chakrabarti J. “Serum leptin level in women with polycystic ovary syndrome: Correlation with adiposity, insulin, and circulating testosterone”. Ann Med Health Sci Res. 2013; 3:191-6
  28. Nasrat H, Patra SK, Goswami B, Jain A et al. “Study of association of leptin and insulin resistance markers in patients of PCOS”. Indian J Clin Biochem. 2016; 31:104-7
  29. Ganie MA, Vasudevan V, Rashid A et al. “Epidemiology, pathogenesis, genetics & management of polycystic ovary syndrome in India”. Indian J Med Res. 2019; 150(4):333-344
  30. Arora S, Sinha K, Kolte S and Mandal A. “Endocrinal and autoimmune linkage: Evidences from a controlled study of subjects with polycystic ovarian syndrome”. J Hum Reprod Sci. 2016: 9(1): 18-22
  31. Thathapudi S, Kodati V, Erukkambattu J, Katragadda A et al. “Anthropometric and biochemical characteristics of polycystic ovarian syndrome in South Indian women using AES-2006 criteria”. Int J Endocrinol Metab. 2014; 12: e12470
  32. Suri J, Suri JC, Chatterjee B, Mittal P, Adhikari T. “Obesity may be the common pathway for sleep-disordered breathing in women with polycystic ovary syndrome”. Sleep Med. 2016; 24:32-9
  33. Ramanand SJ, Ghongane BB, Ramanand RR, Jain SS. “Clinical characteristics of polycystic ovary syndrome in Indian women”. Indian J Endocrinol Metab. 2013; 17:138-45
  34. Shivaprakash G, Basu A, Kamath A, Adhikari P, Rathnakar UP et al. “Acanthosis nigricans in PCOS patients and its relation with type 2 diabetes mellitus and body mass at a tertiary care hospital in Southern India”. J Clin Diagn Res.2013; 7:317-9
  35. Moreira S, Soares E, Tomaz G, Maranhao T et al. “Polycystic Ovary Syndrome: a psychosocial approach”. Acta Medica Portuguesa. 2010; 23(2):237-42
  36. De Niet JE, De Koning CM, Pastoor H, Duivenvoorden HJ, Valkenburg O, Ramakers MJ et al. “Psychological well-being and sexarche in women with polycystic ovary syndrome”. Hum Reprod. 2010; 25(6): 1497-503
  37. Hahn S, Janseen OE, Tan S, Pleger K et al. “Psychological correlates of quality-of-life in polycystic ovary syndrome”. Eur J Endocrinol. 2005; 153(6):853-60
  38. Barnard L, Ferriday D, Guenther N, Strauss B et al. “Quality of life and psychological well being in polycystic ovary syndrome”. Human reproduction. 2007; 22(8):2279-86
  39. Tan S, Hahn S, Benson S, Janseen OE et al. “Psychological implications of infertility in women with polycystic ovary syndrome”. Hum reprod. 2008; 23(9):2064-71
  40. Sulaiman MA, Al-Farsi YM, Al-Khaduri MM, Waly MI et al. “Psychological burden among women with polycystic ovarian syndrome in Oman: a case-control study”. Dovepress. 2017; 9:897-904
  41. Barry JA, Qu F, Hardiman PJ. “An exploration of the hypothesis that testosterone is implicated in the psychological functioning of women with polycystic ovary syndrome (PCOS)”. Hypotheses. 2018; 110, 42-45
  42. Barry JA, Kuczmierczyk AR, Hardiman PJ. “Anxiety and depression in polycystic ovary syndrome: a systematic review and meta-analysis”. Reprod. 2011; 26. 2442-2451
  43. Annagur BB, Tazegul A, Uguz F, Kerimoglu O et al. “Biological correlates and major depression and generalized anxiety disorder in women with polycystic ovary syndrome”. Pschosomatic Res. 2013; 74, 244-247
  44. Farkas J, Rigo A, Demetrovics Z. “Psychological aspects of the polycystic ovary syndrome”. Gynecological Endocrinology. 2013; 30(2)
  45. Himelein MJ, Thatcher SS. “Polycystic ovary syndrome and mental health: a review”. Obstet Gynecol Survey. 2006; 61:723-31
  46. Hahn S, Janseen OE, Tan S, Pleger K et al. “Psychological correlates of quality-of-life in polycystic ovary syndrome”. Eur J Endocrinol. 2005; 153(6):853-60
  47. Wang R, Mol BW. “The Rotterdam criteria for polycystic ovary syndrome: evidence-based criteria”? Hum Reprod. 2017; 32:261-4
  48. Day F, Karaderi T, Jones MR et al. “Large-scale genome –wide meta-analysis of polycystic ovary syndrome suggests shared genetic architecture for different diagnosis criteria”. PLos Genet. 2018; 14:e1007813
  49. Akre S, Sharma K, Chakole S, Wanjari MB. “Recent advances in the Management of polycystic ovary syndrome: A Review Article”. Cureus. 2022; 14(8): e27689
  50. Rajagopal G, Reddy AP, Vemkata Harinarayan C, Suresh V et al. “Effect of lifestyle modification and metformin therapy on emerging cardiovascular risk factors in overweight Indian women with polycystic ovary syndrome”. Metab Syndr Relat Disord. 2012; 10:273-9
  51. Meenakumari KJ, Agarwal S, Krishna A, Pandey LK. “Effects of metformin treatment on luteal phase progesterone concentration in polycystic ovary syndrome”. Braz J Med Biol Res. 2004; 37:1637-44
  52. Teede H, Hutchinson SK, Zougas S. “The management of insulin resistance in polycystic ovary syndrome”. Trends Endocrinol Metab. 2007; 18: 273-279
  53. Moran LJ, Pasquali R, Teede HJ, Hoeger KM et al. “Treatment of obesity in polycystic ovary syndrome: a position statement of the Androgen Excess and Polycystic Ovary Syndrome”. Fertility and sterility. 2009; 92(6):1966-1982
  54. Hamilton-Fairley D, Kiddy D, Anyaoku V, Koistinen R et al. “Response of sex hormone binding globulin and insulin-like growth factor binding protein-1 to an oral glucose tolerance test in obese women with polycystic ovary syndrome before and after calorie restriction”. Clin Endocrinol (Oxf). 1993, 39:363-367.10.1111/j.1365-2265. 1993.tb02378. x.
  55. Clark AM, Thornley B, Tomilson L, Galletley C et al. “Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment”. Hum Reprod. 1998; 13:1502-1505
  56. Wahrenberg H, Ek I, Reynisdottir S, Carlstrom K et al. “Divergent effects of weight reduction and oral anticonception treatment or adrenergic lipolysis regulation in obese women with the polycystic ovary syndrome”. J Clin Endocrinol Metab. 1999; 84:2182-2187.10.1210/jc.84.6.2182.
  57. Dansinger ML, Gleason JA, Griffith JL, Selker HP et al. “Comparison of the Atkins, Ornish, Weight Watchers, and Zone diets for weight loss and heart disease risk reduction: a randomized trail”. JAMA. 2005; 293:43-53
  58. Poehlam ET, Dvorak RV, DeNino WF, Brochu M et al. “Effects of resistance training and endurance training on insulin sensitivity in non-obese, young women: a controlled randomized trail”. J Clin Endocrinol Metab. 2000; 85:2463-2468
  59. Meyer C, McGrath BP, Teede HJ. “Effects of medical therapy on insulin resistance and the cardiovascular system in polycystic ovary syndrome”. Diabetes Care. 2007; 30:471-478
  60. Tang T, Lord JM, Norman RJ, Yasmin E et al. “Insulin-resistance sensitizing drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligoamenorrhoea and subfertility”. Conchrane Database Syst Rev. 2009; 4:CD003053
  61. Alberti KG, Zimmet P, Shaw J. “International Diabetes Federation: a consensus on Type 2 Diabetes prevention”. Diabet Med. 2007; 24:451-463