Polycystic Ovarian Syndrome Conference November 16-18, 2015 Seattle, USA

Endometriosis is a disease in which tissue that normally grows inside the uterus grows outside the uterus. Its main symptoms are pelvic pain and infertility. Nearly half have chronic pelvic pain, while in 70% pain occurs during menstruation. Pain with sex is also common. Infertility occurs in up to half of people. Less common symptoms include urinary or bowel symptoms. About 25% of women have no symptoms. Endometriosis can have both social and psychological effects.

Hormonal contraceptives Birth control pills, patches and vaginal rings help control the hormones responsible for the buildup of endometrial tissue each month .

Gonadotropin-releasing hormone (Gn-RH) agonists and antagonists These drugs block the production of ovarian-stimulating hormones, lowering estrogen levels and preventing menstruation.

Medroxyprogesterone (Depo-Provera) This injectable drug is effective in halting menstruation and the growth of endometrial implants, thereby relieving the signs and symptoms of endometriosis.

An ovarian cyst is any collection of fluid, surrounded by a very thin wall, within an ovary. Any ovarian follicle that is larger than about two centimeters is termed an ovarian cyst. Such cysts range in size from as small as a pea to larger than an orange. Ovarian cysts occur in women of all ages including neonatal period and infancy. They are most prevalent during infancy, adolescence and during the childbearing years. With ultrasonography ovarian cysts can be demonstrated in nearly all premenopausal and approximately 18% postmenopausal women

Polycystic ovarian cancer is a heterogeneous disorder of uncertain Cause. There is strong evidence that it is a genetic disease. Such evidence includes the familial clustering of cases, greater concordance in monozygotic compared with dizygotic twins and heritability of endocrine and metabolic features of PCOS.

Ovarian cancer warning signs include ongoing pain or cramps in the belly or back, abnormal vaginal bleeding, nausea, and bloating. Depending on the cancer stage, ovarian cancer treatment includes surgery and chemotherapy

There are two types of Ovarian Cyst Surgery

Laparoscopy

Most cysts can be removed using laparoscopy. This is a type of keyhole surgery where small cuts are made in your tummy and gas is blown into the pelvis to allow the surgeon to access your ovaries.

Laparotomy

During a laparotomy, a single, larger cut is made in your tummy to give the surgeon better access to the cyst.

The whole cyst and ovary may be removed and sent to a laboratory to check whether it's cancerous. Stitches or staples will be used to close the incision.

Clomiphene therapy is typically used for 5 consecutive days early in the menstrual cycle, for 3 to 6 monthly cycles. It may take several cycles to find the right dose to stimulate ovulation. After that dose is determined, a woman will take the drug for at least 3 more cycles.

Drugs used in the treatment of polycystic ovarian syndrome (PCOS) include metformin (off-label use), spironolactone, eflornithine, and oral contraceptives. Oral contraceptives containing a combination of estrogen and progestin increase sex hormone–binding globulin (SHBG) levels and thereby reduce the free testosterone level. Luteinizing hormone (LH) and follicle-stimulating hormone (FSH) levels are also suppressed. This restores cyclic exposure of the endometrium to estrogen-progestin, with the resumption of menstrual periods and decreased hirsutism. However, the use of oral contraceptives may be associated with an increased risk of thrombosis and metabolic abnormalities.

Polycystic ovarian disease (PCOD) is a common hormonal disorder among women of reproductive age. It is a condition where hormonal imbalance affects the follicular growth during the ovarian cycle, causing the affected follicles to remain in the ovary.

Ayurveda classifies PCOD as a kapha disorder. Kapha having first affected the digestive fire – jatharaagni starts to affect the metabolic aspect of the seven tissues called dhatu agni. Each dhatu agni is responsible for the nourishment and formation of that particular tissue that it resides in.

Ayurvedic for Polycystic ovarian syndrome diets focus on developing healthy Aartava (Female reproductive tissue-one of the dhatu).  A diet for patients with PCOS include fresh food and Vegetable. Also recommend fresh fruits such as peaches, pears, plums as well as dried fruits such as dates, figs and raisins

Poly cystic ovarian syndrome can result in infertility issues. It can also be treated naturally through diet and herbal remedies.

“Infertility" is a term used to describe the inability of a woman or man to conceive a child or the inability of a woman to carry a pregnancy to term.

Ovulation is the result of a maturation process that occurs in the hypothalamic-pituitary-ovarian (HPO) axis and is orchestrated by a neuroendocrine cascade terminating in the ovaries. Any alteration results in a failure to release a mature ovum, leading to anovulatory cycles. Anovulation may manifest in a variety of clinical presentations, from luteal insufficiency to oligomenorrhea.

Anovulation is a not a disease but a sign, in much the same way that polycystic ovaries are the manifestation of a much larger disease process.

Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, often the kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in a woman whose blood pressure had been normal. Even a slight rise in blood pressure may be a sign of preeclampsia.

Diagnosing PCOS in adolescents requires a unique set of criteria for which no single marker currently exists. Adolescents at high risk for developing the syndrome are congenital virilization, low birth weight, premature pubarche, central precocious puberty, large for gestational age girls born to overweight mothers, obesity syndromes, insulin-resistant features, and girls born to parents with PCOS, central obesity, or diabetes in whom PCOS ought to be suspected when associated with irregular menses.

Neurologic and psychiatric disorders occur commonly in adolescents. Conditions such as epilepsy, migraines, and bipolar disorder are typically disorders that require chronic medication to treat symptoms and prevent recurrence of episodes.

Pelvic laparoscopy is called a minimally invasive procedure because only small incisions are made. Smaller incisions often allow patients to experience a shorter recovery period, less blood loss, and lower levels of post-surgical pain than in open surgery.

Ultrasound tests use high-frequency sound waves to allow doctors to see your internal organs. The sound waves bounce off your organs, creating images of their structures. A transvaginal ultrasound is a kind of pelvic ultrasound that is used to see reproductive organs like the uterus, ovaries, cervix, and vagina.

The endometrial biopsy is a medical procedure that involves taking a tissue sample of the lining of the uterus. The tissue subsequently undergoes a histologic evaluation which aids the physician in forming a diagnosis.

Polycystic ovary syndrome cannot be prevented. But early diagnosis and treatment helps prevent long-term complications, such as infertility, metabolic syndrome, obesity, diabetes, and heart disease. Polycystic ovarian syndrome is the most common manifestation of hormonal dysfunction in reproductive-age women today. PCOS is a heterogeneous condition, both clinically and biochemically. The prevalence of PCOS is reported to be anywhere from 4% to 12%, with mild racial variations.  

The menstrual irregularity of PCOS typically manifests in the peripubertal period, although some women may apparently have regular cycles at first and subsequently develop menstrual irregularity in association with weight gain. Menstrual irregularities include mild or severe oligomenorrhea or amenorrhea. Anovulation is very common in the presence of mild oligomenorrhea, but also when normal cycles are present.

Weight loss, in the context of medicine, health, or physical fitness, refers to a reduction of the total body mass, due to a mean loss of fluid, body fat or adipose tissue and/or lean mass, namely bone mineral deposits, muscle, tendon, and other connective tissue. Weight loss can either occur unintentionally due to malnourishment or an underlying disease or arise from a conscious effort to improve an actual or perceived overweight or obese state.

Polycystic Ovarian Syndrome, often shortened to PCOS is a condition that affects between 10-15% of women of reproductive age. PCOS affects the ovaries, the organ in a woman’s body which produces eggs, and typically means that there are a number of minute cysts around the edge of the ovaries, hence the term polycystic. It is also characterised by excess production of androgens (male-type hormones such as testosterone).

Potential areas of further research activity include the analysis of predisposing conditions that increase the risk of PCOS, particularly genetic background and environmental factors, such as endocrine disruptors and lifestyle. The concept that androgen excess may contribute to insulin resistance needs to be re-examined from a developmental perspective, since animal studies have supported the hypothesis that early exposure to modest androgen excess is associated with insulin resistance.

Defining alterations of steroidogenesis in PCOS should quantify ovarian, adrenal and extraglandular contribution, as well as clearly define blood reference levels by some universal standard. Intraovarian regulation of follicle development and mechanisms of follicle arrest should be further elucidated.

The PCOS diagnosis is generally made through clinical signs and symptoms. The doctor will want to exclude other illnesses that have similar features, such as low thyroid hormone blood levels or elevated levels of a milk-producing hormone .Also, tumors of the ovary or adrenal glands can produce elevated male hormone blood levels that cause acne or excess hair growth, mimicking symptoms of PCOS.

The cysts (fluid filled sacs) in the ovaries can be identified with imaging technology. Ultrasound imaging employs no injected dyes or radiation and is safe for all patients including pregnant women. It can also detect cysts in the kidneys of a fetus.

Insulin is the hormone produced in the pancreas that allows cells to use sugar. Excess insulin might also affect the ovaries by increasing androgen production, which may interfere with the ovaries' ability to ovulate.

Body's white blood cells produce substances to fight infection in a response called inflammation. Research has shown that women with PCOS have low-grade inflammation and that this type of low-grade inflammation stimulates polycystic ovaries to produce androgens.

Hormones are the chemical messengers in the body that travel the bloodstream to the organs and tissues. They work slowly via feedback mechanisms with other glands and organs, affecting many of the body's processes over time. Endocrine glands, which are special groups of cells, make hormones. The infertility rates with polycystic ovaries is very high. Women usually will have difficulty getting pregnant - and usually require treatment to improve chances for pregnancy. Diabetes mellitus, commonly referred to as diabetes, is a group of metabolic diseases in which there are high blood sugar levels over a prolonged period. For more details on OMICS group conferenceseries.