PREVALENCE &RISK FACTORS OF POLYCYSTIC OVARY SYNDROME Research article Fatima Qamar, Safila Naveed, Saba M. Ishtiaq, Shaheen Kausar 1 Faculty of Pharmacy, Jinnah University For Women Corresponding Author: fatimamudassar2009@hotmail.com safila117@yahoo.com ABSTRACT Health of women is regarding the precaution, protecting, finding, as well as treatment of diseases that are interesting to women. Polycystic ovary disorder (PCOS) is significantly predominant and likely constitutes the most often experienced diseases of endocrine in women of conceptive age. PCOS is a typical issue among high-schooled young girls and young women. Actually, about 1 out of 10 woman has PCOS. Our objective is to assess prevalence and the risk factors of polycystic ovary disorder (PCOS) in women of Karachi, Pakistan. This is a cross-sectional questionnaire-based study with a stratified sampling technique. A questionnaire was designed and distributed in a sample size of 100 in order to assess prevalence and factors of polycystic ovary disorder (PCOS). After the collection of data the result was evaluated. The outcome results indicated that PCOS is more prevalent in single and young women. There is significantly increased number of women with the positive family history of diabetes. PCOS is the most well known problem, which influences the conceptive period of numerous women. Since 1 out of 10 and 1 out of 20 women of childbearing age has PCOS, it is basic that women are very much educated. Doctor can deal it with. Be that as it may, keeping up a sound and dynamic way of life may diminish the possibility of building up this condition. KEYWORDS: PCOS, obsessions, young girls, young Women, prevalence, risk factors. INTRODUCTION Polycystic ovary disorder (PCOS) is a heterogeneous endocrine disorder that affects women s reproductive age. It is associated with hper-androgenism (hirutism, acne and androgen dependent alopecia) and chronic an ovulation (amenorrhea, infertility, irregular dysfunctional uterine bleeding) (Franks 1995). Polycystic ovaries are described on ultrasound by the closeness of at least eight sub-capsular follicular bruises 10 mm and extended ovarian stroma. These movements, regardless, can be accessible in ladies who are totally endocrinologically ordinary. The reason for Polycystic ovary issue (PCOS) remain unknown (Polson, Wadsworth et al., 1988; Franks 1995) but studies shows that it occur due to genetic and environmental factors (Diamanti- Kandarakis, Kandarakis et al., 2006). PCOS seems to continue running in families, so likelihood of having it is higher have unusual periods or diabetes or if other women in family have it. PCOS can be delivered from either mother's or father's side (Clayton, Ogden et al., 1992). Women with PCO have irregularities in the metabolic system of androgens and estrogen as well as in the control of creation of androgen. High concentrations of androgenic hormones in serum, for instance, testosterone, androstenedione, and dehydro-epi-androsterone sulfate (DHEA-S), may be knowledgeable about these patients. Regardless, singular variety is broad, and a particular patient has typical androgen levels. PCOS is moreover associated with fringe insulin resistance and increase insulin in blood, as well as obesity builds the level of both varieties from the standard. Insulin resistance in PCOS can be assistant to a post-binding defect in signaling
pathways of insulin receptor, and raised levels of insulin may have gonadotropin-growing outcomes for ovarian limit. Increase insulin in blood may likewise bring about concealment of hepatic era of sex hormone binding globulin (SHBG), which thus lyandrogenicity may extend androgenicity (Ramlau-Hansen 2007). Polycystic ovaries are extended equally and have a smooth, thickened container that is a vascular. On cut portions, sub capsular follicles in various periods of atresia are found in the peripheral part of the ovary. The most striking ovarian component of PCOS is hyperplasia of the theca stromal cells including caught follicles. On moment examination, luteinized theca cells are seen (Toulis, Goulis et al., 2009). Women with PCOS might be at expanded hazard for cerebro-vascular and cardiovascular infection. Hoisted serum lipoprotein levels like those of men are in women with hyper androgenism (Conway, Agrawal et al., 1992; Christian, Dumesic et al., 2003). Not everyone with PCOS has polycystic ovaries (PCO), nor does everyone with ovarian developments have PCOS; in spite of the way that a pelvic ultrasound is a significant analytic tool (Oliveira, Sampaio et al., 2010). Other reasons for irregular or absent period and hirsutism, for example, inborn adrenal hyperplasia (21-hydroxylase lack), hyper prolactinemia, hypothyroidism, androgen emitting neoplasms, Cushing's disorder, and other pituitary or adrenal issue, ought to be researched (Teede, Deeks et al., 2010). The essential treatment for PCOS include: way of life changes, medicines aa well as surgery. Treatment objectives might be considered under four classifications: Rebuilding of fertility, bringing down of insulin resistance levels, rebuilding of regular menstruation, treatment of hirsutism or skin break out, and aversion of hyperplasia of endometrium and disease of endometrium (Lim and Wong 2010). The pharmacological treatment of PCOS is oral contraceptives as well as metformin. The mechanism of oral contraceptives is to increment sex hormone restricting globulin generation, which expands binding of testosterone. This decreases side effects of hirsutism brought about by increase level of testosterone and manages come back to normal menstrual cycle. Metformin, a medication generally utilized as a part of sort 2 diabetes to diminish insulin resistance. In certain cases, metformin also provide ovarian function as well as bring back to normal ovulation (Lord, Flight et al., 2003). METHODOLOGY Study Design. The retrospective study was performed to assess prevalence and the risk factors of polycystic ovary disorder (PCOS) in women of Karachi, Pakistan which incorporate 18 questions. It occurred over 3-months of August, September and October 2016. The study was conducted over a population of Karachi for the collection of data on PCOS. Participants 100 study subjects were selected from a random population of Karachi who are suffering from PCOS. Only females were included so as to exclude variations due to sex. Data Analysis The data collected through questionnaire which was coded, entered and analyzed using Excel in to order assess PCOS. RESULTS Socio-demographic characteristics of respondents The study includes total number of 100 individuals including female of all age groups 15-25 years (20%), 26-35 years (30%), 36-45 years (25%), 46-55 years (14%), above 55 years (11%) having weight >50kg (25%) and <50kg (75%) in which (60%) were single and (40%) were married. (Table 1). Symptoms &Risk factors of PCOS The retrospective study analysis was performed using Excel which represented statistically significant results that 5% of individuals desire carbohydrates & sugar, 80% Continuous weight gain, 90% had Irregular periods, 60% had excess facial hair, 18% Felt extremely hungry, Irritable, sleepy, or fatigued after eating sweets, 22% had Skin color changes or pigmentation, 13% had unusual amount of hair on breasts, 9% had Unusual hair growth on upper thighs, 23% had hypothyroidism, 66% had worst acne (Table 2.). While 75% individuals had family history of diabetes, 50% had Family history of irregular periods, 20% had family history of CVS, 10% had family history of thyroid disease (Figure 1).
Table 1: Socio-demographic characteristics of respondents Age 15-25 years 20% 26-35 years 30% 36-45 years 25% 46-55 years 14% > 55 years 11% Weight <50kg 25% >50kg 75% Marital Status Single 60% Married 40% Table 2: Symptoms of PCOS Questions Crave/desire carbohydrates & sugar 5% Continuous weight gain 80% Irregular periods 90% excess facial hair 60% Feel extremely hungry, Irritable, sleepy, or fatigued after eating sweets 18% Skin color changes or pigmentation 6% unusual amount of hair on breasts 13% Unusal hair growth on upper thighs 9% Hypothyroidism 23% Worst acne 66% Figure 1: Risk Factors of PCOS
DISCUSSION Results of our study shows that PCOS is the most common health problem and is more prevalent in single and young women. The most well-known manifestations are irregular periods, continuous weight raise up, worst acne as well as overabundance facial hair and most common risk factor of PCOS is family history of diabetes as well as family history of irregular periods. In PCOS, compensatory mechanism of increase insulin in blood realizes pleiotropic impacts including adrenal steroidogenesis and co-gonadotrophic incitement of ovarian; in T2D, contribution of insulin resistance towards β-cell is exhaustion and in the long run to low secretion of insulin with result of dysglycemia. The association among PCOS and DM type 1 is acknowledged to include supra-physiological unions of insulin inside the circulation of system. In women with PCOS, different little follicles gather in the ovary. None of these little follicles are prepared for creating to a size that would initiate ovulation. In this way, the estrogen levels, progesterone, LH, as well as FSH get the opportunity to be imbalanced. Androgens may get the opportunity to be extended in women with PCOS in perspective of the elevated measures of LH. In the event that ovulation does not occur, the uterus covering (called the endometrium) does not reliably shed as well as regrow as in normal menstrual cycle Or maybe, the endometrium gets the chance to be thicker along with shed irregularly, which can realize substantial and additionally drawn out dying. Unpredictable or missing menstrual periods can construct a women's peril of plenitude of endometrium (called hyperplasia of endometrium) or even endometrial development. CONCLUSION PCOS is a wellbeing condition, which influences numerous women in today's general public. Our knowledge about PCOS still stays unclear. Despite everything we have not think of a definition or an indicative basis for it. Being a standout amongst the most well-known endocrine issue in women, it reveals that we have to increase our knowledge on the management of the disease and in addition on the basic pathogenesis related to the disease. Despite the fact that medications for PCOS are genuinely powerful yet our knowledge of the basic pathogenesis is for all intents and purposes absent. Be that as it may, keeping up a solid and dynamic way of life may diminish the shot of building up this condition. REFERENCES Christian, R. C., D. A. Dumesic, T. Behrenbeck, A. L. Oberg, P. F. Sheedy and L. A. Fitzpatrick (2003). "Prevalence and predictors of coronary artery calcification in women with polycystic ovary syndrome." The Journal of Clinical Endocrinology & Metabolism 88(6): 2562-2568. Clayton, R., V. Ogden, J. Hodgkinson, L. Worswick, D. Rodin, S. Dyer and T. Meade (1992). "How common are polycystic ovaries in normal women and what is their significance for the fertility of the population?" Clinical endocrinology 37(2): 127-134. Conway, G. S., R. Agrawal, D. Betteridge and H. Jacobs (1992). "Risk factors for coronary artery disease in lean and obese women with the polycystic ovary syndrome." Clinical endocrinology 37(2): 119-125. Diamanti-Kandarakis, E., H. Kandarakis and R. S. Legro (2006). "The role of genes and environment in the etiology of PCOS." Endocrine 30(1): 19-26. Franks, S. (1995). "Polycystic ovary syndrome." New England Journal of Medicine 333(13): 853-861. Lim, C. E. and W. S. Wong (2010). "Current evidence of acupuncture on polycystic ovarian syndrome." Gynecological Endocrinology 26(6): 473-478. Lord, J. M., I. H. Flight and R. J. Norman (2003). "Metformin in polycystic ovary syndrome: systematic review and meta-analysis." Bmj 327(7421): 951. Oliveira, A., B. Sampaio, A. Teixeira, C. Castro-Correia, M. Fontoura and J. L. Medina (2010). "Polycystic ovary syndrome: Challenges in adolescence." Endocrinología y nutrición 57(7): 328-336. Polson, D., J. Wadsworth, J. Adams and S. Franks (1988). "Polycystic ovaries a common finding in normal women." The Lancet 331(8590): 870-872. Ramlau-Hansen, C. H. (2007). Prenatal Tobacco Exposure and Other Life-style Related Risk Factors for Low Semen Quality and Subfecundity: Epidemiologic Studies in Denmark: PhD Thesis, Department of Occupational Medicine, Aarhus University Hospital.
Teede, H., A. Deeks and L. Moran (2010). "Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan." BMC medicine 8(1): 41. Toulis, K., D. Goulis, D. Farmakiotis, N. Georgopoulos, I. Katsikis, B. Tarlatzis, I. Papadimas and D. Panidis (2009). "Adiponectin levels in women with polycystic ovary syndrome: a systematic review and a meta-analysis." Human reproduction update 15(3): 297-307. Citation of this article: Fatima Qamar, Safila Naveed, Saba M. Ishtiaq, Shaheen Kausar. PREVALENCE &RISK FACTORS OF POLYCYSTIC OVARY SYNDROME. 4(6): 439-443. Source of Support: Nil Conflict of Interest: None Declared