Ovary polycystic

Signs of insulin resistance or conditions associated with insulin resistance (acanthosis nigricans, hypertension, dyslipidemia, or polycystic ovary disease)... 

Differential diagnoses include diabetes mellitus and metabolic syndrome because patients with these conditions share several similar characteristics with Cushing s syndrome patients (e.g., obesity, hypertension, hyperlipidemia, hyperglycemia, and insulin resistance). In women, the presentations of hirsutism, menstrual abnormalities, and insulin resistance are similar to those of polycystic ovary syndrome. Cushing s syndrome can be differentiated from these conditions by identifying the classic signs and symptoms of truncal obesity, "moon faces" with facial plethora, a "buffalo hump" and supraclavicular fat pads, red-purple skin striae, and proximal muscle weakness. 

The use of metformin and thiazolidinediones for anovulatory bleeding associated with polycystic ovary syndrome is beneficial for anovulatory bleeding and fertility and also improves glucose tolerance and decreases overall cardiovascular risk. 

Table 46-1 illustrates the pathophysiology of amenorrhea relative to the organ system(s) involved, as well as the specific condition that results in amenorrhea. Amenorrhea is also a normal side effect that may result from the use of low-dose oral contraceptives (OCs), extended-cycle OC pill use, or depot medroxyprogesterone acetate use.5 Many women may experience delayed return of menses after discontinuation of OCs. Postpill amenorrhea usually is a self-limited condition. Further evaluation for other unrecognized conditions, such as polycystic ovary syndrome (PCOS), should be considered if spontaneous resolution of the amenorrhea does not occur within 3 to 6 months following discontinuation of the OCs.6,7... 

BMD, bone mineral density NSAID, non-steroidal anti-inflammatory drug OCs, oral contraceptives PCOS, polycystic ovary syndrome PMDD, premenstrual dysphoric disorder. 

American College of Obstetricians and Gynecologists. Polycystic ovary syndrome. ACOG Practice Bulletin number 41. Obstet Gynecol 2002 100 1389-402. 

Guzick DS. Polycystic ovary syndrome. Obstet Gynecol 2004 103(1) 181-193. 

Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and longterm health risks related to polycystic ovary syndrome. Fertil Steril 2004 81(l) 19-25. 

Valproic add Cl upset Acute hepatic failure Polycystic ovary-like syndrome... 

Amenorrhoea, which refers to the absence of menstruation, is associated with anorexia nervosa, polycystic ovary syndrome and congenital adrenal hyperplasia. The condition requires referral. 

Polycystic ovary syndrome endocrine disorder characterised by amenorrhoea, hirsutism and infertility Porphyria inherited disorders presenting with increased production of porphyrins in the bone marrow Prostatic hyperplasia enlargement of the prostate Pseudomembranous colitis diarrhoea occurring in patients who received antibacterial agents, caused by the resulting overgrowth of anaerobic bacteria in the gastrointestinal tract... 

Women with anovulatory infertility should be offered full endocrinological evaluation, considering potential diagnoses such as hypothalamic-pituitary disease, polycystic ovary syndrome and primary gonadal disease. Hyperprolactinaemia must be sought as a potential cause, and its treatment is outlined below. The main treatments available include the anti-oestrogens clomiphene and tamoxifen, and gonadotrophin therapy. 

Women with the polycystic ovary syndrome are at increased risk for the metabolic syndrome and associated health risks and metformin, which also reduces hyperinsulinemia, might be effective in treating obese, infertile women with the polycystic ovary syndrome. 

Abdelmageed E, Fayed M, Sharaf M. Letrozole induction of ovulation in clomiphene citrate resistant polycystic ovary syndrome responders and non-responders. Middle East Fertility Soc J 2004 9 2. 

Guzick DS. Treating the polycystic ovary syndrome. N Engl J Med 2007 356(6) 622-4. 

Nugent D, Vandekerckhove P, Hughes E, Arnot M, Lilford R. Gonadotrophin therapy for ovulation induction in subfertility associated with polycystic ovary syndrome. Cochrane Database Syst Rev 2000. 

Unlabeled Uses Female acne, hirsutism, polycystic ovary disease... 

Rarely, decreased platelets, hepatic toxicity in infants, polycystic ovaries ... 

Chappell, K.A., Markowitz, J.S., and Jackson, C.W (1999) Is valproate pharmacotherapy associated with polycystic ovaries Ann Pharmacother 33 1211-1216. 

Eberle, A.J. (1998) Valproate and polycystic ovaries [letter] [see comments]. J Am Acad Child Adolesc Psychiatry 37 1009. 

Rasgon, N.L., Altshuler, L.L., Gudeman, D., Burt, V.K., Tanavoli, S., Hendrick, V., and Korenman, S. (2000) Medication status and polycystic ovary syndrome in women with bipolar disorder a preliminary report. / Clin Psychiatry 61 173-178. 

Isojarvi JIT, Laatikainen TJ, Pakarinen AJ, et al Polycystic ovaries and hy-perandrogenism in women taking valproate for epilepsy. N Engl J Med 39 579-584, 1993... 

Adverse reactions include polycystic ovary, edema, pain in lower abdomen and allergic reactions. 

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