Case Questions. Polycystic Ovarian Syndrome: Treatment Goals and Options. Differential Diagnosis of Hyperandrogenic Anovulation
|
|
- Reynard Thornton
- 6 years ago
- Views:
Transcription
1 Polycystic Ovarian Syndrome: Treatment Goals and Options Marc Cornier, MD Division of Endocrinology, Metabolism and Diabetes Colorado Center for Health and Wellness University of Colorado School of Medicine Denver Health Medical Center Case Questions Is this PCOS? How do we think about amenorrhea? What is the definition of PCOS? What is hirsutism? What do we consider normal levels of androgens? Differential Diagnosis of Hyperandrogenic Anovulation Polycystic Ovarian Syndrome Obesity-induced Hyperandrogenic Anovulation Congenital adrenal hyperplasia Ovarian or adrenal tumor Other: exogenous androgen administration, Cushing s syndrome, prolactinoma Idiopathic hirsuitism
2 Polycystic Ovary Syndrome Clinical and/or biochemical signs of hyperandrogenism (after exclusion of other etiologies) Chronic oligo- and/or anovulation Polycystic ovaries Not in definition: Overweight, Metabolic Syndrome, LH/FSH ratios Revised 2003 consensus on diagnostic criteria and long-term health risks related to PCOS, Hum Reprod 2004;19(1):41-47 Pathogenesis of PCOS GnRH abnormalities LH Insulin resistance insulin, IGF extraovarian androgens Ovarian steroidogenesis block Enzyme defect Hyperandrogenemia Follicular Atresia Metabolic Disorders in PCOS Obesity (central) Insulin Resistance: 31-35% of women with PCOS have IGT % of women with PCOS have T2DM vs 1.6 and 2.2% in similarly aged women Progression to T2DM is also faster. Risk of GDM is higher. Metabolic Dyslipidemia NAFLD OSA Increased CVD?
3 History Onset and pace of hirsutism Prior menstrual history** Weight history: ie timing with weight gain Stress Medications Family history of endocrine disorders, hirsuitisms Acne, balding, headaches, breast discharge Physical Exam Evidence and pattern of acne and hirsutism, male pattern balding Evidence of acanthosis nigricans Body habitus, body fat distribution Cushingoid features Thyroid Galactorrhea Pelvic exam for anatomy, clitoromegaly Visual field testing? Laboratory Evaluation ß-HCG, TSH, Prolactin, CMP Follicular Phase (progesterone withdrawal): Testosterone (total +/- freet) Dehydroepiandosterone sulfate (DHEA-S) LH, FSH, Estradiol If appropriate: 17OH-Progesterone (30min after Cosyntropin 250ug stimulation) Urinary free cortisol or LDDST
4 Laboratory/Diagnostic Evaluation Evaluate for Metabolic Disorders: Fasting Blood Glucose and/or A1c Fasting Lipid Panel Liver function tests (r/u NAFLD) Evaluate for Endometrial Hyperplasia GYN exam, etc Ovarian ultrasound not necessary Case: Case: Labs Follicular phase: LH 10 miu/ml ( ) FSH 4 miu/ml (2-10) E2 40 pg/ml (<70-12 from LH peak; from LH peak) Total T 72 ng/ml (14-76) DHEA-S 274 ( ug/ml) 17OHP 25 ng/dl (<200 in EFP) other Hormones ß-HCG neg TSH and Prolactin WNL Fasting Lipids LDL 107 Tg 89 HDL 64 TC 188 Basic metabolic panel Electrolytes, LFTs WNL Glucose 88, A1C 5.7
5 PCOS: What are the goals of therapy? Depends on stage of life what is bothering you the most? Androgen Excess (Dermatologic issues) Irregular menstrual periods (endometrial protection) Fertility Metabolic disorders Androgen Excess (Dermatologic issues): OCPs (androgenicity): Levonorgestrol (++) Norethindrone (+) Norgestimate-Desogestrel (+/-) Cyproterone actetate (0) Drospirenone (0) Spironolactone Finasteride Metformin? Direct hair removal Mechanical (laser, electrolysis, shaving) Topical Flornithine Comparison of Metformin vs OCP on Total Testosterone Costello M F et al. Hum. Reprod. 2007;22:
6 Comparison of Metformin vs OCP On Hirsutism Costello M F et al. Hum. Reprod. 2007;22: Irregular menstrual periods and endometrial protection: OCPs Intermittent progestin therapy medroxyprogesterone (10 mg) for 7 to 10 days every one to three months Continuous progesterone Fertility: Weight Loss Metformin Clomiphene Metformin + Clomiphene Others? Aromatase Inhibitors Gonadotropin Therapy Fertility Expert
7 Fertility: Metformin vs Clomiphene vs Both in Women with PCOS Legro RS et al. N Engl J Med 2007;356: Metabolic disorders: Lifestyle Modification and Weight Loss Insulin Sensitizers Metformin TZDs? Incretin based therapies? Other Cardiac Risk Factors Antihypertensives Lipid-lowering therapy PCOS: What are the goals of therapy? Androgen Excess (Dermatologic issues): OCPs ± Spironolactone direct hair removal Irregular menstrual periods (endometrial protection): OCPs Fertility: not an issue at this time but may be in the future Metabolic disorders: Not an issue currently but will screen on a regular basis Promote lifestyle modification
Polycystic Ovary Syndrome HEATHER BURKS, MD OU PHYSICIANS REPRODUCTIVE MEDICINE SEPTEMBER 21, 2018
Polycystic Ovary Syndrome HEATHER BURKS, MD OU PHYSICIANS REPRODUCTIVE MEDICINE SEPTEMBER 21, 2018 Learning Objectives At the conclusion of this lecture, learners should: 1) Know the various diagnostic
More informationPolycystic Ovary Syndrome
Polycystic Ovary Syndrome Kathleen Colleran, MD Professor of Medicine University of New Mexico HSC Presented for COMM-TC May 4, 2012 Objectives Understand the pathophysiology of PCOS Understand how to
More informationPolycystic Ovarian Syndrome. Heidi Hallonquist, MD Concord Hospital Concord Obstetrics and Gynecology
Polycystic Ovarian Syndrome Heidi Hallonquist, MD Concord Hospital Concord Obstetrics and Gynecology Outline Definition Symptoms Causal factors Diagnosis Complications Treatment Why are we talking about
More information12/13/2017. Important references for PCOS. Polycystic Ovarian Syndrome (PCOS) for the Family Physician. 35 year old obese woman
Polycystic Ovarian Syndrome (PCOS) for the Family Physician Barbara S. Apgar MD, MS Professor or Family Medicine University of Michigan Ann Arbor, Michigan Important references for PCOS Endocrine Society
More informationPOLYCYSTIC OVARIAN SYNDROME Laura Tatpati, MD Reproductive Endocrinology and Infertility. Based on: ACOG No. 108 Oct 2009; reaffirmed 2015
POLYCYSTIC OVARIAN SYNDROME Laura Tatpati, MD Reproductive Endocrinology and Infertility Based on: ACOG No. 108 Oct 2009; reaffirmed 2015 NO DISCLOSURES PATIENT 26 years old presents with complaint of
More informationPolycystic Ovary Syndrome
Polycystic Ovary Syndrome Definition: the diagnostic criteria Evidence of hyperandrogenism, biochemical &/or clinical (hirsutism, acne & male pattern baldness). Ovulatory dysfunction; amenorrhoea; oligomenorrhoea
More informationOverview of Reproductive Endocrinology
Overview of Reproductive Endocrinology I have no conflicts of interest to report. Maria Yialamas, MD Female Hypothalamic--Gonadal Axis 15 4 Hormone Secretion in the Normal Menstrual Cycle LH FSH E2, Progesterone,
More informationPolycystic Ovarian Syndrome (PCOS) LOGO
Polycystic Ovarian Syndrome (PCOS) Ma qianhong Ob/Gyn Department LOGO Contents Epidemiology and Definition Pathophysiology, Endocrinological Features Diagnostic Criteria Treatment Prognosis Introduction
More informationROLE OF HORMONAL ASSAY IN DIAGNOSING PCOD DR GAANA SREENIVAS (JSS,MYSURU)
ROLE OF HORMONAL ASSAY IN DIAGNOSING PCOD DR GAANA SREENIVAS (JSS,MYSURU) In 1935, Stein and Leventhal described 7 women with bilateral enlarged PCO, amenorrhea or irregular menses, infertility and masculinizing
More information12/27/2013. Kristen Cain, MD FACOG Reproductive Medicine Institute Sanford Health, Fargo ND
Kristen Cain, MD FACOG Reproductive Medicine Institute Sanford Health, Fargo ND 7% of all women 18-45 Obesity 1/3 of all US women Incidence of PCOS is increasing with increase obesity Obesity Irregular
More informationCase. 24 year old female presented to your office complaining of excess hair growth on her face and abdomen. Questions?
Hirsutism Case 24 year old female presented to your office complaining of excess hair growth on her face and abdomen Questions? Started around puberty with gradual progression Irregular menstrual cycle
More informationCREATING A PCOS TREATMENT PLAN. Ricardo Azziz, M.D., M.P.H., M.B.A. Georgia Regents University
CREATING A PCOS TREATMENT PLAN Ricardo Azziz, M.D., M.P.H., M.B.A. Georgia Regents University PCOS: CREATING A TREATMENT PLAN Good treatment plans are based on sound and complete evaluations History of
More informationObjectives 1. Be able to describe the classic presentation and diagnostic criteria 2. Be able to explain long-term health concerns associated with the diagnosis 3. Understand what basic treatment options
More informationPCOS and Obesity DUB is better treated by OCPs
PCOS and Obesity DUB is better treated by OCPs Dr. Ritu Joshi Senior consultant Fortis escorts Hospital, Jaipur Chairperson Family welfare com. FOGSI (20092012) Vice President FOGSI 2014 Introduction One
More information16 YEAR-OLD OBESE FEMALE WITH OLIGOMENORRHEA
16 YEAR-OLD OBESE FEMALE WITH OLIGOMENORRHEA Katie O Sullivan, MD Adult/Pediatric Endocrinology Fellow University of Chicago ENDORAMA Thursday, September 4th, 2014 Disclosures No financial interests. Will
More informationPCOS Awareness Symposium Atlanta September 24 th, Preventing Diabetes & Cardiovascular Disease in PCOS
PCOS Awareness Symposium Atlanta September 24 th, 2016 Preventing Diabetes & Cardiovascular Disease in PCOS Katherine Sherif, MD Professor & Vice Chair, Department of Medicine Director, Jefferson Women
More information13 th Annual Women s Health Day PCOS. Saturday 02/09/2017 Dr Mathias Epee-Bekima O&G Consultant KEMH
13 th Annual Women s Health Day PCOS Saturday 02/09/2017 Dr Mathias Epee-Bekima O&G Consultant KEMH Learning objectives Perform the appropriate investigations in women where there is a clinical suspicion
More informationPCOS. Kirtly Parker Jones MD
PCOS Kirtly Parker Jones MD OBJECTIVES The participant will be able to use knowledge about ovarian physiology to council perimenarchal women about irregular periods The participant will be able to evaluate
More informationPOLYCYSTIC OVARIAN SYNDROME WHERE WE ARE AT IN 2018
POLYCYSTIC OVARIAN SYNDROME WHERE WE ARE AT IN 2018 PCOS: WHERE WE ARE AT IN 2018 Nancy Arquette, MD Premier Women s Health 6135 Trust Drive #114 Holland, OH 43528 February 3, 2018 Kalahari Resorts ME
More informationHyperandrogenism. Dr Jack Biko. MB. BCh (Wits), MMED O & G (Pret), FCOG (SA), Dip Advanced Endoscopic Surgery(Kiel, Germany)
Hyperandrogenism Dr Jack Biko MB. BCh (Wits), MMED O & G (Pret), FCOG (SA), Dip Advanced Endoscopic Surgery(Kiel, Germany) 2012 Hyperandrogenism Excessive production of androgens Adrenal glands main source
More informationPolycystic Ovary Syndrome
Polycystic Ovary Syndrome An Individualized Approach Alice Y. Chang, MD, MSc Assistant Professor Mayo Clinic Division of Endocrinology, Diabetes, Nutrition and Metabolism Learning Objectives: To Individualize
More informationPolycystic Ovary Syndrome (PCOS):
Polycystic Ovary Syndrome (PCOS): Current diagnosis and treatment Anatte E. Karmon, MD Disclosures- Anatte Karmon, MD No financial relationships to disclose 2 Objectives At the end of this presentation,
More informationAbnormal Uterine Bleeding Case Studies
Case Study 1 Abnormal Uterine Bleeding Case Studies Abigail, a 24 year old female, presents to your office complaining that her menstrual cycles have become a problem. They are now lasting 6 7 days instead
More informationProf.Dr. Nabil Lymon Head of Internal Medicine Department
By Prof.Dr. Nabil Lymon Head of Internal Medicine Department Definitions: Hirsutism: Is the presence of terminal hair in androgendependent sites where hair does not normally grow in women. This hair growth
More information2-Hypertrichosis:- Hypertrichosis is the
Hirsutism And Virilization Hirsutism:- Is the development of androgen-dependent dependent terminal body hair in a woman in places in which terminal hair is normally not found, terminal body hairs are the
More informationREI CASE(S) Laura L. Tatpati, MD Division of REI, Dept of OB/GYN KUSM - W
REI CASE(S) Laura L. Tatpati, MD Division of REI, Dept of OB/GYN KUSM - W CASE #1 46 year old female presents with complaint of increased facial and abdominal hair growth for 6-8 months. She has had increased
More informationAmenorrhoea: polycystic ovary syndrome
There is so much we don't know in medicine that could make a difference, and often we focus on the big things, and the little things get forgotten. To highlight some smaller but important issues, we've
More informationlactotrophs 120 min- FSH 60 min- LH Hypothalamus GnRH pituitary Estradiol +/- Progesterone _ FSH L H Ovary Uterus Ovulation Antral follicle >2mm
lactotrophs Hypothalamus GnRH 120 min- 60 min- LH Progesterone _ pituitary L H + Ovary + Estradiol +/- Uterus Antral follicle >2mm Ovulation Preovulatory follicles atresia Follicular phase Luteal phase
More informationPolycystic ovary syndrome
Polycystic ovary syndrome Overview Polycystic ovary syndrome (PCOS) is a condition most often characterized by irregular menstrual periods, excess hair growth and obesity, but it can affect women in a
More informationPolycystic Ovary Disease: A Common Endocrine Disorder in Women
Polycystic Ovary Disease: A Common Endocrine Disorder in Women Paul Kaplan, M.D. Clinical Professor of Reproductive Endocrinology - OHSU Courtesy Senior Research Associate, Human Physiology University
More informationNew PCOS guidelines: What s relevant to general practice
New PCOS guidelines: What s relevant to general practice Dr Michael Costello Fertility Specialist IVF Australia UNSW Royal Hospital for Women Sydney How do we know if something is new? Louvre Museum, Paris
More informationPCOS. Reproductive Gynaecology and Infertility. Dr.Renda Bouzayen MD.FRCSC GREI,OBGYN Dalhousie University
Reproductive Gynaecology and Infertility PCOS Dr.Renda Bouzayen MD.FRCSC GREI,OBGYN Dalhousie University Dr.Hussein Sabban MD. FRCSC PGY6 GREI Dalhousie University Disclosure No conflict of interest Pilot
More informationDisclosure. Outline. Obesity: Endocrine Issues as the Cause and as the Effect 4/5/2016
Obesity: Endocrine Issues as the Cause and as the Effect Angela Lennon MD Assistant Professor, Pediatrics University of Kansas Medical Center April 22, 2016 Disclosure I have no relevant financial relationships
More informationPolycystic Ovarian Syndrome: Diagnosis, Preconceptional Management and Health Risks
Polycystic Ovarian Syndrome: Diagnosis, Preconceptional Management and Health Risks Kate D. Schoyer, M.D. May 6, 2016 Objectives To review how to make the diagnosis of Polycystic Ovarian Syndrome (PCOS)
More informationWhat every dermatologist should know about Polycystic Ovary Syndrome (PCOS)
What every dermatologist should know about Polycystic Ovary Syndrome (PCOS) Kanade Shinkai, MD PhD University of California, San Francisco Associate Professor of Dermatology I have no conflicts of interest
More informationDr Stella Milsom. Endocrinologist Fertility Associates Auckland. 12:30-12:40 When Puberty is PCO
Dr Stella Milsom Endocrinologist Fertility Associates Auckland 12:30-12:40 When Puberty is PCO Puberty or Polycystic Ovary Syndrome? Stella Milsom Endocrinologist Auckland DHB, University of Auckland,
More informationPCOS guidelines: What s relevant to general practice
PCOS guidelines: What s relevant to general Dr David Molloy Medical Director, Queensland Fertility Group International evidence based PCOS guidelines 1st ever internationally endorsed & evidence based
More informationPrevalence of Polycystic Ovarian Syndrome among urban adolescent girls and young women in Mumbai
Prevalence of Polycystic Ovarian Syndrome among urban adolescent girls and young women in Mumbai Principal Investigator Co- Investigators Consultant Collaborating Hospital Dr. Beena Joshi Dr. Srabani Mukherji
More informationNitasha Garg 1 Harkiran Kaur Khaira. About the Author
https://doi.org/10.1007/s13224-017-1082-4 ORIGINAL ARTICLE A Comparative Study on Quantitative Assessment of Blood Flow and Vascularization in Polycystic Ovary Syndrome Patients and Normal Women Using
More informationJMSCR Vol 05 Issue 05 Page May 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i5.14 Hyperinsulinemia in Polycystic Ovary Syndrome
More informationPolycystic Ovarian Syndrome: Diagnosis, Preconceptional Management and Health Risks. Kate D. Schoyer, M.D. May 6, 2016
Polycystic Ovarian Syndrome: Diagnosis, Preconceptional Management and Health Risks Kate D. Schoyer, M.D. May 6, 2016 Objectives To review how to make the diagnosis of Polycystic Ovarian Syndrome (PCOS)
More informationPCOS The intersection of sex hormones & metabolism. Educational Objectives. Presenter Disclosure Information. Polycystic Ovary Syndrome
7:45 8:45 am Polycystic Ovary Syndrome: Diagnosis & Management SPEAKER Katherine Sherif, MD Presenter Disclosure Information The following relationships exist related to this presentation: Katherine Sherif,
More informationWhat is PCOS? PCOS THE CONQUER PCOS E-BOOK. You'll be amazed when you read this...
PCOS What is PCOS? You'll be amazed when you read this... What is PCOS?. Who is at risk? How to get tested? What are the complications. Is there a cure? What are the right ways to eat? What lifestyle changes
More informationPolycystic Ovary Syndrome Therapy Dr. Pilar Vigil MD, PhD, FACOG
Polycystic Ovary Syndrome Therapy Dr. Pilar Vigil MD, PhD, FACOG What is an ovulatory dysfunction? Mrs. Susana Godoy, Nurse-Midwife San José, Costa Rica Abril 2018 PONTIFICIA UNIVERSIDAD CATÓLICA DE CHILE
More informationBlood Pressure Measurement (children> 3 yrs)
Blood Pressure Measurement (children> 3 yrs) If initial BP elevated, repeat BP manually 2x and average, then classify Normal BP Systolic and diastolic
More informationDiagnosis and Management of Polycystic Ovary Syndrome During Adolescence: Questions and Controversies
Diagnosis and Management of Polycystic Ovary Syndrome During Adolescence: Questions and Controversies 2017 Illinois-AACE 2017 Annual Meeting October 14, 2017 Learning Objectives 1) Understand the challenges
More informationStelios Mantis, MD DuPage Medical Group Pediatric Endocrinology
Stelios Mantis, MD DuPage Medical Group Pediatric Endocrinology 4 11 13 Initial Presentation Pt initially presented to pediatrician for school physical in fall 2012. Pt was found to be overweight (BMI:
More informationAssisted Reproductive. Technologies: Present and. Future
Assisted Reproductive Technologies: Present and Future Paul Kaplan, M.D. The Assisted Reproductive Technologies (ART) In Vitro Fertilization (IVF) Intracytoplasmic Sperm Injection (IVF/ICSI) Donor Oocyte
More informationPolycystic Ovary Syndrome: Cardiovascular Disease risk
PCOS Challenge Atlanta September 16 th, 2017 Polycystic Ovary Syndrome: Cardiovascular Disease risk Katherine Sherif, MD Professor & Vice Chair, Department of Medicine Director, Jefferson Women s Primary
More informationPOTION OR POISON? MEDICAL TREATMENT ALTERNATIVES TO THE PILL. Lester Ruppersberger, D.O., FACOOG,CNFPI NFP only Gynecologist
POTION OR POISON? MEDICAL TREATMENT ALTERNATIVES TO THE PILL Lester Ruppersberger, D.O., FACOOG,CNFPI NFP only Gynecologist THE PILL Released to US market in 1960 10-15 x dose of hormones in HRT Over 10-14
More informationX/06/$15.00/0 The Journal of Clinical Endocrinology & Metabolism 91(1):2 6 Copyright 2006 by The Endocrine Society doi: /jc.
0021-972X/06/$15.00/0 The Journal of Clinical Endocrinology & Metabolism 91(1):2 6 Printed in U.S.A. Copyright 2006 by The Endocrine Society doi: 10.1210/jc.2005-1457 EXTENSIVE CLINICAL EXPERIENCE Relative
More informationReproductive Health and Pituitary Disease
Reproductive Health and Pituitary Disease Janet F. McLaren, MD Assistant Professor Division of Reproductive Endocrinology and Infertility Department of Obstetrics and Gynecology jmclaren@uabmc.edu Objectives
More informationClinical Problems in the Diagnosis and Treatment of PCOS During Adolescence
Clinical Problems in the Diagnosis and Treatment of PCOS During Adolescence R a c h a n a S h a h, M D M S T A s s i s t a n t P r o f e s s o r o f P e d i a t r i c s D i v i s i o n o f E n d o c r
More informationPolycystic Ovary Syndrome
What is the polycystic ovary syndrome? Polycystic Ovary Syndrome The polycystic ovary syndrome (PCOS) is a clinical diagnosis characterized by the presence of two or more of the following features: irregular
More informationInfertility for the Primary Care Provider
Infertility for the Primary Care Provider David A. Forstein, DO FACOOG Clinical Associate Professor Obstetrics and Gynecology University of South Carolina School of Medicine Greenville Disclosure I have
More informationPOLYCYSTIC OVARY SYNDROME INA S. IRABON,MD, FPOGS,FPSRM,FPSGE OBSTETRICS AND GYNECOLOGY REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY
POLYCYSTIC OVARY SYNDROME INA S. IRABON,MD, FPOGS,FPSRM,FPSGE OBSTETRICS AND GYNECOLOGY REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY TO DOWNLOAD LECTURE DECK MAIN REFERENCE Comprehensive Gynecology 7 th
More informationPOLYCYSTıC OVARY SYNDROME (PCOS) New Perspectives. Michel Abou Abdallah, MD. Reproductive Endocrinology
POLYCYSTıC OVARY SYNDROME (PCOS) New Perspectives Michel Abou Abdallah, MD. Reproductive Endocrinology At the conclusion of this presentation, participants should be able to: Appreciate the spectrum of
More informationBy Jennifer F. Teskey, MD; Heather J. Dean, MD, FRCPC; and Elizabeth AC Sellers, MSc, MD, FRCPC. amenorrhea. Following menarche 3. How to treat PCOS.
PCOS & teens: The need for early detection By Jennifer F. Teskey, MD; Heather J. Dean, MD, FRCPC; and Elizabeth AC Sellers, MSc, MD, FRCPC A 15-year-old girl is referred In this article: to the pediatric
More informationDiagnosis and Management of PCOS
Diagnosis and Management of PCOS Anita L. Nelson, MD Professor Emeritus, Obstetrics & Gynecology, David Geffen School of Medicine at UCLA Clinical Professor Obstetrics & Gynecology, University Southern
More informationINSULIN RESISTANCE, POLYCYSTIC OVARIAN SYNDROME An Overview
INSULIN RESISTANCE, POLYCYSTIC OVARIAN SYNDROME An Overview University of PNG School of Medicine & Health Sciences Division of Basic Medical Sciences PBL MBBS III VJ Temple 1 Insulin Resistance: What is
More informationPolycystic Ovary Syndrome diagnosis & management
Polycystic Ovary Syndrome diagnosis & management Dr Roisin Worsley, FRACP Endocrinologist, Jean Hailes at Epworth https://jeanhailes.org.au/contents/docume nts/resources/tools PCOS is a chronic condition
More informationApproach to ovulation induction and superovulation in women with a history of infertility. Anatte E. Karmon, MD
Approach to ovulation induction and superovulation in women with a history of infertility Anatte E. Karmon, MD Disclosures- Anatte Karmon, MD No financial relationships to disclose 2 Objectives At the
More informationThe Pharmacology of PCOS
The Pharmacology of PCOS G. Wright Bates, Jr., M.D. Director Reproductive Endocrinology & Infertility University of Alabama at Birmingham Objectives Review the diagnosis of PCOS Highlight lifestyle modifications
More informationTitle of Guideline (must include the word Guideline (not protocol, policy, procedure etc)
Title of Guideline (must include the word Guideline (not protocol, policy, procedure etc) Guideline for the Investigation and Management of Polycystic Ovary Syndrome Author: Contact Name and Job Title
More informationHirsutism: Diagnosis and Treatment. Roger A. Lobo M.D. Columbia University
Hirsutism: Diagnosis and Treatment Roger A. Lobo M.D. Columbia University Signs of hyperandrogenism Acne, Hirsutism, Alopecia All explained by increased androgen production and/or increased sensitivity
More informationJannet Huang, MD, FRCPC, FACE, ABIHM, CCD, NCMP.
Jannet Huang, MD, FRCPC, FACE, ABIHM, CCD, NCMP. Polycystic Ovarian Syndrome Definition & Diagnosis Clinical Significance: Link to Diabetes and Cardiovascular Risk Management Lifestyle Strategies Pharmacologic
More informationEffect of troglitazone on endocrine and ovulatory performance in women with insulin resistance related polycystic ovary syndrome
FERTILITY AND STERILITY VOL. 71, NO. 2, FEBRUARY 1999 Copyright 1999 American Society for Reproductive Medicine Published by Elsevier Science Inc. Printed on acid-free paper in U.S.A. Effect of troglitazone
More informationClinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes
POLYCYSTIC OVARY SYNDROME Clinical and endocrine characteristics of the main polycystic ovary syndrome phenotypes Ettore Guastella, M.D., a Rosa Alba Longo, M.D., b and Enrico Carmina, M.D. b a Department
More informationPolycystic Ovary Syndrome
Polycystic Ovary Syndrome Polycystic ovary syndrome (PCOS) is common. It can cause period problems, reduced fertility, excess hair growth, and acne. Many women with PCOS are also overweight. Treatment
More informationManaging polycystic ovary syndrome in primary care
Singapore Med J 2018; 59(11): 567-571 https://doi.org/10.11622/smedj.2018135 CMEArticle Managing polycystic ovary syndrome in primary care Angelyn Chen Yin Lua 1, MBBS, MRCP(UK), Choon How How 2,3, MMed,
More informationS. AMH in PCOS Research Insights beyond a Diagnostic Marker
S. AMH in PCOS Research Insights beyond a Diagnostic Marker Dr. Anushree D. Patil, MD. DGO Scientist - D National Institute for Research in Reproductive Health (Indian Council of Medical Research) (Dr.
More informationLaura Stewart, MD, FRCPC Clinical Associate Professor Division of Pediatric Endocrinology University of British Columbia
Precocious Puberty Laura Stewart, MD, FRCPC Clinical Associate Professor Division of Pediatric Endocrinology University of British Columbia Faculty Disclosure Faculty: Laura Stewart No relationships with
More informationThe Impact of Insulin Resistance on Long-Term Health in PCOS
Saturday, April 16 th, 2016 PCOS Challenge & Thomas Jefferson University PCOS Awareness Symposium Philadelphia The Impact of Insulin Resistance on Long-Term Health in PCOS Katherine Sherif, MD Professor
More informationVol-4 No.-2 July-September 2011
"Women's Health" is also available at www.squarepharma.com.bd Vol-4 No.-2 July-September 2011 Editorial Board Dr. Omar Akramur Rab MBBS, FCGP, FIAGP Mohammad Hanif M. Pharm, MBA A.H.M.Rashidul Bari M.
More informationPCOS IN ADOLESCENTS: EARLY DETECTION AND INTERVENTION
PCOS IN ADOLESCENTS: EARLY DETECTION AND INTERVENTION R A C H A N A S H A H, M D M S T R A S S I S TA N T P R O F E S S O R O F P E D I AT R I C S D I V I S I O N O F E N D O C R I N O L O G Y A N D D
More information14 Girl with Cushing s Disease: An Update. Kristen Dillard, MD Endorama October 17, 2013
14 Girl with Cushing s Disease: An Update Kristen Dillard, MD Endorama October 17, 2013 Initial Presentation Pt initially presented to pediatrician for school physical in fall 2012. Pt was found to be
More informationAdolescents with PCOS in a busy clinical practice: Making the most of your 15 minutes
Financial Disclosures Learning Objectives Adolescents with PCOS in a busy clinical practice: Making the most of your 15 minutes Amy Sass, MD, MPH Adolescent Medicine Patricia Huguelet, MD Pediatric and
More informationEvaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society* Clinical Practice Guideline
CLINICAL PRACTICE GUIDELINE Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society* Clinical Practice Guideline Kathryn A. Martin, 1 R. Rox Anderson, 1 R. Jeffrey Chang, 2 David
More informationAchieving Pregnancy: Obesity and Infertility. Jordan Vaughan, MSN, APN, WHNP-BC Women s Health Nurse Practitioner Nashville Fertility Center
Achieving Pregnancy: Obesity and Infertility Jordan Vaughan, MSN, APN, WHNP-BC Women s Health Nurse Practitioner Nashville Fertility Center Disclosures Speakers Bureau EMD Serono Board of Directors Nurse
More informationA practical approach to the diagnosis of polycystic ovary syndrome
American Journal of Obstetrics and Gynecology (2004) 191, 713 7 www.elsevier.com/locate/ajog CLINICAL OPINION A practical approach to the diagnosis of polycystic ovary syndrome R. Jeffrey Chang, MD Department
More informationUPDATE: Women s Health Issues
UPDATE: Women s Health Issues Renee B. Alexis, MD, MBA, MPH, FACOG Associate Professor Department of OBGYN Kiran C. Patel College of Osteopathic Medicine Disclosure of Conflicts of Interest I have no financial
More informationDifference Between PCOS and Endometriosis
Difference Between PCOS and Endometriosis www.differencebetween.com Key Difference PCOS vs Endometriosis Ovaries play an important role in the reproduction and the maintenance of the female body. They
More informationTreatment of hirsutism with a gonadotropin-releasing hormone agonist and estrogen replacement therapy*
Gynecology-endocrinology FERTILITY AND STERILITY Copyright 1994 The American Fertility Society Printed on acid-free paper in U S. A. Treatment of hirsutism with a gonadotropin-releasing hormone agonist
More informationGynecological Problems: Case Study Approach
Gynecological Problems: Case Study Approach Joyce King, CNM, Ph.D. Disclosure Statement I have no real or perceived vested interests that relate to this presentation nor do I have any relationship with
More informationHd Hydroxylase. Cholesterol. 17-OH Pregnenolne DHEA Andrstendiol. Pregnenolone. 17-OH Progestrone. Androstendione. Progestrone.
PATHOPHISIOLOGY OF SEX HORMONES R. Mohammadi Biochemist (Ph.D.) Faculty member of Medical Faculty CHOLESTEROL IS THE PRECURSOR OF STERIOD HORMONES Cholesterol Pregnenolone 17-OH 17βHSD Pregnenolne DHEA
More informationTHE PREVALENCE AND ETIOLOGY OF POLYCYSTIC OVARIAN SYNDROME (PCOS) AS A CAUSE OF FEMALE INFERTILITY IN CENTRAL TRAVANCORE
NSave Nature to Survive 9(1): 01-06, 2014 www.thebioscan.in THE PREVALENCE AND ETIOLOGY OF POLYCYSTIC OVARIAN SYNDROME (PCOS) AS A CAUSE OF FEMALE INFERTILITY IN CENTRAL TRAVANCORE K. ROY GEORGE AND N.
More informationPolycystic Ovary Disease: A Common Endocrine Disorder in Women
Polycystic Ovary Disease: A Common Endocrine Disorder in Women Paul Kaplan, M.D. Clinical Professor of Reproductive Endocrinology - OHSU Courtesy Senior Research Associate, Human Physiology University
More informationUniversity of Cape Town
P a g e 1 The Polycystic Ovary Syndrome a comparison of the presentation in adolescents compared to women aged 35 years and older attending the Gynaecological Endocrine clinic at Groote Schuur Hospital.
More informationFemale Reproductive Endocrinology
Female Reproductive Endocrinology Dr. Channa Jayasena PhD MRCP FRCPath Clinical Senior Lecturer & Consultant Endocrinologist Department of Gynaecology, Hammersmith Hospital Anovulation is a common cause
More informationMetformin and Pioglitazone in Polycystic Ovarian Syndrome: A Comparative Study
The Journal of Obstetrics and Gynecology of India (September-October 2012) 62(5):551 556 DOI 10.1007/s13224-012-0183-3 ORIGINAL ARTICLE Metformin and Pioglitazone in Polycystic Ovarian Syndrome: A Comparative
More informationSyndrome in Clinical Practice
Focus on CME at the University of British Columbia Polycystic Ovarian Syndrome in Clinical Practice Although polycystic ovarian syndrome was first recognized and described more than 60 years ago, the primary
More informationFrom the editors desk
From the editors desk Dear all, We are happy to introduce the first issue of our magazine on hormonal health. This magazine will focus on updates related to common clinical problems in diabetes, thyroid,
More informationJMSCR Vol 05 Issue 04 Page April 2017
www.jmscr.igmpublication.org Impact Factor 5.84 Index Copernicus Value: 83.27 ISSN (e)-2347-176x ISSN (p) 2455-0450 DOI: https://dx.doi.org/10.18535/jmscr/v5i4.228 Study of Cutaneous Manifestations of
More informationClinical evaluation of hirsutism in South India
International Journal of Research in Dermatology http://www.ijord.com Original Research Article DOI: http://dx.doi.org/10.18203/issn.2455-4529.intjresdermatol20184459 Clinical evaluation of hirsutism in
More informationAdolescent Gynecology: Evaluation and Management of Adnexal Mass, PCOS, and Endometriosis. Shanna M. Combs, MD
Adolescent Gynecology: Evaluation and Management of Adnexal Mass, PCOS, and Endometriosis Shanna M. Combs, MD Adolescent Visit and Exam Adolescent Reproductive Health Visit Initial visit should take place
More informationAbout PCOS. About PCOS
About PCOS About PCOS Polycystic Ovarian Syndrome (PCOS) is the most common hormonal reproductive problem in women of childbearing age. It can affect a woman s menstrual cycle, fertility, hormones, insulin
More informationRotterdam Criteria 9/30/2017. A Changing Paradigm in PCOS. Polycystic Ovary Syndrome - Is the Cardiometabolic Risk Increased After Menopause?
Disclosure Polycystic Ovary Syndrome - Is the Cardiometabolic Risk Increased After Menopause? Fractyl laboratories, Inc Anuja Dokras, MD., Ph.D. Professor of Obstetrics and Gynecology Director PENN PCOS
More informationPCOS Long Term Consequences Need For a Preventive Strategy
PCOS Long Term Consequences Need For a Preventive Strategy Dr. Piya Ballani Thakkar Hyperandrogenism Reproductive dysfunction Macrovascular complications PCOS Malignancies Central obesity Dyslipidemia
More informationEFFECT OF WEIGHT LOSS ON OVARIAN AND ADRENAL ANDROGEN SENSITIVITY. Department OB/GYN. EVMA Norfolk, Va Telephone: (804)
This study predates but predicts the use of glucophage, exercise and diet for the treatment of PCO. EFFECT OF WEIGHT LOSS ON OVARIAN AND ADRENAL ANDROGEN SENSITIVITY Principal Investigator: Hofheimer Hall
More informationReproductive Testing: Less is More G. Wright Bates, Jr., M.D. Professor and Director Reproductive Endocrinology and Infertility Objectives
Reproductive Testing: Less is More G. Wright Bates, Jr., M.D. Professor and Director Reproductive Endocrinology and Infertility Objectives 1. Review definition of infertility and impact of age 2. Stress
More information