Polycystic Ovary Syndrome and Insulin Resistance

The impaired function has the insulin in the body of women who suffer from polycystic ovary syndrome, confirming Italian review published recently in the journal Current Pharmaceutical Design.

H-Insulin is a hormone secreted by the pancreas and regulates blood sugar levels. This achieves facilitating the transport of glucose from the bloodstream into cells where it will become a fuel to produce energy. This effect of insulin is so important, that in the absence of the hormone blood sugar levels in the blood rise to very high levels and diabetes develops.
In some cases (obesity, polycystic ovaries, predisposed to diabetes, hypersecretion of cortisol etc.), while not adversely affecting the production and secretion of insulin, said the disturbing action of the cells. Thus, despite the presence of insulin, glucose can not be set as the tissues “resist” on an action (insulin resistance). To address this the body, forces the pancreas to excessive insulin production so that the blood levels to rise by 2 to 10 times above normal (hyperinsulinemia). This phenomenon is so common, occurring in about 20-26% of the adult population in Europe and America.

A recent review of studies from the University of Verona confirmed that insulin resistance is a major health issue in young women with polycystic ovary syndrome. Dr. Paulo Motzetti evaluated data on the pathogenesis and treatment of impaired action of insulin often diagnosed in women with this syndrome. Ultimately, he concluded that insulin resistance is a key mechanism in the pathogenesis of polycystic ovary syndrome because basically, hyperinsulinemia has the strong interaction with excess androgens defining the gynecological condition. In addition, impaired insulin action is a central mechanism of metabolic abnormalities, also found in these women and is a major aspect of the underlying medical weight attributed to polycystic ovary syndrome.

“A key question that arises after each study for PCOS is the role of body weight and in particular of excess body fat in women with polycystic ovary syndrome. Moreover, systematic studies have shown that obese women sufferers who have resistance to the action of insulin at risk up to 20% of dying from diabetes mellitus type II (non-insulin-dependent). However, even patients who are not obese, but have increased body weight (body mass index> 27) have an increased risk of the disease. Lifestyle changes and/or certain medications can contribute positively to the management of the situation. But the therapeutic model selected each time must be individualized, “says Charis Ch. Chinas, Obstetrician-Gynecologist Surgeon specializing in IVF and Laparoscopic Surgery.

And he adds: “Given the opportunity to clarify that not the polycystic ovary syndrome should be confused with polycystic ovaries. The latter is a finding with increasing frequency due to the use of ultrasound in the routine gynecological examination. It is estimated that about 20% of women of reproductive age have polycystic ovaries, but fewer than half have biochemical and hormonal findings are polycystic ovary syndrome, which refers finally to 4-5% of women of reproductive age population. In fact, studies on the causes of the syndrome have highlighted the role of a particular gene, which means that it can be passed down from mother to daughter. ”

Therefore, according to Dr. China di, for proper diagnosis of the syndrome polycystic ovarian key is to take a detailed medical history assessing data such as obesity or a tendency to easy weight gain, physical heredity and more dominant features, such as irregular cycle (amenorrhea-oligomenorrhoea -Arai minor Oia at 20-50%), increased hair growth (65-70%), the edge (25-35%) and alopecia (3-6%).

“A significant proportion (20-75%) of these women suffering from infertility and in most of these cases PCOS diagnosed during the investigation of the causes of the couple’s infertility,” Dr. adds. China is.
The investigation continues by Transvaginal ultrasound Ovary and then to control the hormonal profile of the patient with a series of tests (LH, FSH, Prolactin, Progesterone, DHEAS, SHBG, etc.). “Simultaneously control and adrenal function to exclude some arrenopoiitikous tumors are the rare whiles, but when displayed mimic the symptoms of polycystic ovary syndrome,” he says.

Personalized treatment program for the successful therapeutic management of polycystic ovary syndrome, the caregiver must take into account all the clinical, laboratory and imaging data. “Usually first is a choice between a simple antisylliptko pill or cyproterone acetate with progestrerinoeides to achieve constant cycle and protect the endometrium. Simultaneously involves regular exercise and diet. If needed and shown by insulin/glucose control then according to the new data can be gradually administered metformin, administered and Diabetes Mellitus Type II, with satisfactory results in weight control, hair growth, but also ooer ixia. For hair growth, there are several treatment methods (laser, photolysis, etc.), but the decision should be taken after an examination by a qualified dermatologist. The same applies to the edge where the simple treatment with antibacterial antibiotics and can give way to a more specialized (spironolactone, chemical app Oli OSI-peeling, etc.), “says Dr. Harris Chiniadis.

Regarding the treatment of infertility due to polycystic ovary syndrome, Mr. Chiniadis explains that a proportion of patients reacted positively to ovulation induction with clomiphene citrate when it is closely monitored by ultrasound. If this does not succeed, then followed the route of insemination or IVF. “These should always be done by specialist gynecologists in recognized centers of assisted reproduction as an increased risk of the Ovarian Syndrome,” he says.