Biography
Biography: Anita Mani
Abstract
PCOS is a chronic condition, affecting 3 to 20 % population, of which 70 % remains undiagnosed. Reproductive symptoms of PCOS are anovulation, sub fertility and hyperandrogenism. Metabolic disorders include glucose intolerance, type 2 Diabetes and CVD. Depression and anxiety are found in some patients. Life style changes including diet, exercise and weight loss should precede any pharmacological intervention. Even a 5% loss of body weight will reduce insulin resistance and circulating androgens, resulting in spontaneous ovulation and relief of symptoms. Behavior change techniques should target optimal weight. Protocols should be provided to clinicians, to assess CVD risks considering obesity, physical inactivity, smoking, dyslipidemia, hypertension, glucose intolerance and type II diabetes/family history. Clinicians should also look for sleep apnea symptoms. Pharmacological indications includes, gestogens to induce periods in severe oligomenorrhea patients to reduce risk of endometrial hyperplasia /cancer. Insulin-sensitizing agents does not seem to have long-term benefits. Weight reduction drugs reduce hyperandrogenaemia in selected patients. Laparoscopic ovarian drilling will induce ovulation in 60% of the subjects for 20 years. When weight loss strategies fail, morbidly obese women can benefit from bariatric surgery. Psychological issues like depression and anxiety must be screened assessed and referred to professionals. Creating public health awareness on healthy eating and the necessity of regular exercise and including them in school curriculum is needed. A multidisciplinary approach involving a trained team of physicians, dieticians, exercise specialists and counselors is needed in long-term management of PCOS.