Veritable evaluation and inspection of PCOS and its apropos medicaments

Polycystic Ovary Syndrome (PCOS) is a vastly familial, prevalent yet complicated endocrine disorder seen in 5 to 15% of premenopausal women. An estimated one in five ~ 20% Indian women suffer from PCOS. In India, PCOS is a tabooed disorder; If neglected, the condition can prove fatal. However, the past decade has seen the changing discourse in India. PCOS negatively affects reproduction, general health, sexual health, and quality of life. Genetic predisposition of hormonal and non-hormonal factors influence ovary functioning and are responsible for the onset of the syndrome. Hormonal imbalance, metabolic abnormality, and insulin resistance are characteristic features that significantly increase the risk of anovulatory infertility, type 2 diabetes, and cardiovascular diseases. The underlying cause of the path physiology of PCOS is still under the radar, but the derangement of the hypothalamic-pituitary-ovarian axis could be the sweeping reason for the same. PCOS management should address on healthy lifestyle with symptomatic medical therapy and psychological bearing with special emphasis on far reaching side effects and long-term metabolic consequences This review article gives a comprehensive overview of PCOS and the morbidities hooked up with it. It has a notable emphasis on the PCOS guidelines, diagnosis, non-pharmacological, and pharmacological treatments.

Effects of opium alkaloid, noscapine in RU486 induced experimental model of polycystic ovary syndrome

PCOS is a common endocrinopathy among premenopausal women, characterized by hyperandrogenism, anovulation, hirsutism. We evaluated credence of noscapine; in RU486 induced PCOS rat and compared with flutamide, a conventional drug. For 13 days, an oral dose of RU486 [20 mg/kg/day] was administered to Wistar rats exhibiting regular estrous cycle. Varying dosage of noscapine was given to PCOS rats and compared with rats administered flutamide. Cytology of estrous cycle and serum hormone levels (LH, FSH, PRL, estradiol, and testosterone) were measured. Histomorpho-metrical changes, events of apoptosis in theca and granulosa cells were observed using flow cytometry and the mode of cellular death was examined by TUNEL staining. Our findings suggested, normal folliculogenesis in PCOS rats, post noscapine administration (120 mg/kg) in 3-4 days with normal hormonal profile. Theca and granulosa cells undergo massive and marginal cellular degeneration respectively with no G2/M arrest. TUNEL staining confirms the granulosa cells in follicles are major cell type undergo apoptosis in RU486 administered rats. However, low apoptotic DNA fragmentations were found in theca cells. We conclude that the RU486 model is suitable for studies of the metabolic features of PCOS and noscapine appears to be promising therapeutic modality for amelioration of PCOS induced condition.

Assessment Of Menstrual Health And Analgesics Usage In Young Age Women

Objective: The study focuses on assessing the incidence of menstrual irregularity among young women and the factors for a disturbance with the rationale to assess the use of analgesic drugs during Premenstrual Syndrome (PMS). Methods: A cross-sectional study was used. A total of 2500 randomly selected young female between the age of 11 and 30 y completed the study questionnaire to assess lifestyle pattern, variations in menstrual pattern, perceived stress, and to capture information about their menstrual cycle and related problems. In addition, the questionnaire assessed the use of analgesics for PMS. Results: 2481 participants completed the questionnaire. The mean age of participants’ menarche was 12.85±1.432 y. The prevalence of menstrual irregularities was 25.0 % (n=621) and about 8.5% (n=211) of respondents had severe pain that was not relieved by the use of analgesics. On the other hand, 50.9 % (n=1262) reported severe pain that was relieved by analgesics. A total of 1279 (51.6 %) of participants in this study used Over The Counter (OTC) analgesics to relieve PMS. Conclusion: Dysmenorrhea is the most common complaint among young females in Saudi Arabia. Low Body Mass Index (BMI), sedentary lifestyle, stress and early age of menarche are the most important factors associated with menstrual irregularities. Proper education programs and awareness among young girls about their menstrual health, and the provision of guidance in choosing effective analgesics and treatment options for dysmenorrhea are highly recommended.

A cross-sectional study on relationship between body mass index and menstrual irregularity among rural women in Tamil Nadu

Background: Menstruation is a normal physiological process and irregular menstrual pattern is a problem affecting the quality of life among women in the reproductive age group. Although many factors contribute to the irregularity in menstrual cycles this study was conducted to find out the relationship between the body mass index (BMI) and irregular menstrual pattern.Methods: A cross-sectional study was conducted in the rural health and training centre of SRM hospital between August and October 2018 by using a convenience sampling method and data was collected from 163 women in the reproductive age group and analysed to find out the relationship between the BMI and menstrual irregularity.Results: The mean age of the study participants was 31.29 (±8.32) years and their mean age at menarche was 12.59 (±1.86) years. Majority of the study participants belongs to lower middle class (25%), Hindus (85%) by religion, married (82%), homemakers (53%) belongs to nuclear family (45%) having education up to high school level (61%). Only 44% of the participants have their BMI within normal range and 8% are obese. Irregular menstrual pattern was present in 13% of the study participants. The association between the BMI and the irregular menstrual pattern was found to be significant with a p<0.05.Conclusions: A significant association between the BMI and the irregular menstrual pattern highlights the importance of adapting simple and effective lifestyle and behavioural modifications in the reduction of excess weight thereby leading to healthy reproductive life among women.

A Randomized Prospective Study Of Menstrual Irregularities In Relation To Obesity In Terms Of Body Mass Index

Introduction: Obesity in women is worldwide problem. Obesity may lead to hyper androgenism resulting in increased extra glandular aromatization by adipocytes leading to anovulation and menstrual irregularities. Aims and Objectives: To establish relation between obesity and menstrual irregularities in women and also to study the effect of weight reduction on menstrual pattern. Materials and Methods – It is a randomized prospective study of one year duration in the Dept. of Obstetrics and Gynecology, Calcutta National Medical College, Kolkata. Out of 198 obese females, 62 were presented with menstrual irregularities. Body mass index was calculated to detect obesity. Following investigations were done – serum FSH, LH, Prolactin, T , T , TSH, testosterone and USG of uterus and adnexa, diagnostic 3 4 laparoscopy and endometrial biopsy. Result and Analysis: 31.3% of obese women had menstrual irregularities in our study. After reduction of 7-8 kgs, 80% of the women who had reduced weight also had menstrual improvement. Conclusion: One third of the obese female patients presented with menstrual irregularities. Weight reduction by exercise and balanced diet 6 reduced hyperandogenemia leading to ovulation which ultimately improved menstruation .

Association between Body Weight Changes and Menstrual Irregularity: The Korea National Health and Nutrition Examination Survey 2010 to 2012

BACKGROUND: Menstrual irregularity is an indicator of endocrine disorders and reproductive health status. It is associated with various diseases and medical conditions, including obesity and underweight. We aimed to assess the association between body weight changes and menstrual irregularity in Korean women. METHODS: A total of 4,621 women 19 to 54 years of age who participated in the 2010 to 2012 Korea National Health and Nutrition Examination Survey were included in this study. Self-reported questionnaires were used to collect medical information assessing menstrual health status and body weight changes. Odds ratios (ORs) and 95% confidence interval (CI) were calculated to evaluate the association between body weight changes and menstrual irregularity. RESULTS: Significantly higher ORs (95% CI) were observed in the association between menstrual irregularity and both weight loss (OR, 1.74; 95% CI, 1.22 to 2.48) and weight gain (OR, 1.45; 95% CI, 1.13 to 1.86) after adjusting for age, body mass index, current smoking, heavy alcohol drinking, regular exercise, calorie intake, education, income, metabolic syndrome, age of menarche, parity, and stress perception. Of note, significant associations were only observed in subjects with obesity and abdominal obesity, but not in non-obese or non-abdominally obese subjects. U-shaped patterns were demonstrated in both obese and abdominally obese subjects, indicating that greater changes in body weight are associated with higher odds of menstrual irregularity. CONCLUSION: We found a U-shaped pattern of association between body weight changes and menstrual irregularity among obese women in the general Korean population. This result indicates that not only proper weight management but also changes in body weight may influence the regulation of the menstrual cycle.

Evaluation of safety profile of centchroman for contraceptive purpose.

Introduction: Centchroman is an effective oral contraceptive has a good patient acceptability and compliance due to its minimal side effects, low cost and simple dosage schedule. This study was undertaken to study the adverse drug reactions of centchroman used for contraceptive purpose. Material and Methods: The cases were selected from the patients attending post partum programme centre and outdoor department of Obstetrics and Gynaecology, at LLRM Medical college and associated hospital, Meerut, UP, who were taking non-hormonal oral contraceptives (centchroman) preparations for a period of twelve months. Women of reproductive age groups were included and asked not to use any other method of contraception during the study. Every Woman was asked to report immediately if she develops any problem after taking pills and asked for regular follow up at every month. Results: During the study period, a total of 25 women receiving centchroman for contraception were evaluated. The most common adverse drug reaction reported was menstrual irregularity. After 6 months of therapy, 40% women presented with this complain. 12% cases presented with other complaints in form of abdominal pain and giddiness. Conclusion: Non-hormonal oral contraceptives (centchroman) are quite safe regarding adverse effect but menstrual irregularities are the major limiting factor for its use as contraceptive.

Clinical assessment of ethinylestradiol and cyproterone acetate in menstrual irregularities of hyper-androgenic origin / Avaliação clínica do uso de duas preparações de etinilestradiol e acetato de ciproterona em menstruação irregular de origem hiperandrogênica

We report on the results of a double-blind, randomized, controlled clinical trial comparing two preparations of ethinylestradiol and cyproterone acetate in the treatment of women of reproductive age presenting menstrual irregularities of hyper-androgenic origin. After obtaining informed consent, subjects were randomized to a 4-month treatment period consisting of one daily dose of 0.035mg ethinylestradiol + 2mg cyproterone acetate. The treatment regimen cycle consisted of one pill, once daily for 21 days, followed by a 7-day pill-free period. We compared the efficacy of two presentations of the drug combination after each treatment cycle (Visits 2, 3, 4, and 5) in establishment and maintenance of menstrual regulation, intensity of menstrual flow, and dysmenorrhea, as well as a comparison of the two presentations in terms of Global Satisfaction and Drug Satisfaction assessments performed by the patients and the investigating physician. At each study visit, drug compliance and use of concomitant medications, as well as incidence, severity and duration of adverse events were recorded. A total of 86 subjects were randomized to treatment, with 43 subjects in each treatment group. At Visit 2 and each subsequent visit, all patients in both treatment groups reported an episode of withdrawal bleeding during the 7-day hormone-free period. We observed a statistically significant (p<0.0001) decrease in the incidence of dysmenorrhea at each study visit in relation to the pretreatment assessment. There was a significant reduction (p<0.0001) in the number of subjects reporting intermenstrual bleeding at each study visit in both treatment groups. Global Satisfaction scores by the patient and physician increased significantly at each successive study visit in both treatment groups. There were no clinically significant changes in vital signs, weight, and body mass index throughout the study period in either group. The number of subjects reporting adverse events at each visit did not vary between treatment groups. The combined oral contraceptive pill containing ethinylestradiol and cyproterone acetate was found to be both effective and safe in the menstrual irregularities of hyper-androgenic origin (amenorrhea, dysmenorrhea, and intermenstrual bleeding) assessed in this study.

Irregularidade do ciclo menstrual no menacme como marcador para fatores de risco cardiovasculares na pós-menopausa / Menstrual cycle irregularity as a marker of cardiovascular risk factors at postmenopausal years / Menstrual cycle irregularity as a marker of cardiovascular risk factors at postmenopausal years

A associação entre fatores de risco cardiovascular (FRCV) na pós-menopausa e o antecedente de irregularidade menstrual no menacme foi avaliado em estudo caso-controle envolvendo 414 mulheres na pós-menopausa com idade de 60,4 ± 5,5 anos e IMC de 25,3 ± 4,7 kg/m². As variáveis consideradas foram: caracterização do ciclo menstrual entre 20 e 35 anos (independente) e relato atual sobre ocorrência de hipertensão arterial, dislipidemia, diabetes mellitus e doença arterial coronariana (dependentes). Utilizou-se o teste qui-quadrado e modelos de regressão logística, ajustados para outras variáveis implicadas no risco para doenças CV, com nível de significância 5 por cento. Observou-se que mulheres que relataram irregularidade menstrual prévia estiveram associadas com risco aumentado para ocorrência de algum FRCV [odds ratio ajustado (OR)= 2,14; IC-95 por cento= 1,02­4,48], quando comparadas àquelas com ciclos regulares. Análise estratificada demonstrou as seguintes associações significativas com o antecedente de irregularidade menstrual: hipertensão arterial (OR= 2,4; 95 por cento IC= 1,39­5,41), hipercolesterolemia (OR= 2,32; 95 por cento IC= 1,17­4,59), hipertrigliceridemia (OR= 2,09; 95 por cento IC= 1,10­4,33) e angioplastia coronariana (OR= 6,82; 95 por cento IC= 1,44­32,18). Os dados sugerem que o antecedente de irregularidade menstrual, indicativo da ocorrência da síndrome dos ovários policísticos na idade reprodutiva, pode estar relacionado com aumento do risco para doenças CV na pós-menopausa.

To evaluate the association between cardiovascular risk factors (CVRF) during postmenopausal years and previous menstrual irregularity during reproductive years, we performed a case-control study in 414 postmenopausal women (mean age 60.4 ± 5.5 years; BMI 25.3 ± 4.7 kg/m²). The variables assessed were: menstrual cycle characteristics at age 20­35y (independent) and records of arterial hypertension, dyslipidemia, diabetes mellitus, and coronary heart disease (dependent). Statistical analysis used the chi-square test and logistic regression, adjusting for potential confounders for cardiovascular risk, with significance set at 5 percent. Women reporting previous menstrual irregularity were associated with increased risk for some CVRF [adjusted odds ratio (OR) 2.14; CI-95 percent= 1.02­4.48], when compared with those reporting regular menstrual cycles. Stratified analysis demonstrated significant associations of previous menstrual irregularity with: arterial hypertension [OR= 2.74; CI-95 percent= 1.39­5.41), hypercholesterolemia (OR= 2.32; CI-95 percent= 1.17­4.59), hypertriglyceridemia (OR= 2.09; CI-95 percent=1.10­4.33), and coronary angioplasty (OR= 6.82; CI-95 percent= 1.44­32.18). These data suggest that a prior history of menstrual irregularity, as indicative of polycystic ovary syndrome, may be related to increased risk for CVD during postmenopausal years.

A Study on Plasma Levels of Testosterone, Dihydrotestosterone, Estradiol and Dehydroepiandrosterone-sulfate in Patients with Acne Vulgaris / 대한피부과학회지

BACKGROUND: Although it is evident that androgens have an important role in pathogenesis of acne, the results of current studies on the relationship between serum androgens and acne are inconsistent. Additionally there has been sparse clinical datas about hormonal derangcment with regard to acne in Korea. OBJECTIVE: This study was conducted to elucidate hormonal abnormalities by detecting the quantitative difference between the acne patients and normal persons with respect to the levels of plasma free/total Testosterone(T), Dihydrotestosterone(DHT), Dehydroepiandrosterone-sulfate(DHEA-S) and Estradiol(E2) in acne patients. METHODS: In this study, we measured serum levels of free T, total T, DHT, DHEA-S and E2 in 25 women and in 15 men with acne and in 40 healthy control subjects. RESULTS: 1. The levels of free T and E2 in the male patient group were significantly higher than those in the control groups. In the female patient group the levels of DHT were more elevated than those in the control groups. 2. The levels of free T and E2 in all the male subgroups classified by Burke & Cunliffe were significantly elevated compared to those in the male control groups. The plasma levels of DHT in all the female clinical subgroups were significantly higher than those in the female control groups. However, we could not find any correlative relationship between hormonal parameters and the clinical severity in all the patient groups. 3. There was a positive relationship between free T levels and E2 levels in the male patient gfOUp. 4. The patients with menstrual cyclic irregularity had higher mean free T and acne grading scores when compared with those who had regular periods. Also they were younger than the patients with regular menstrual cyclicity. CONCLUSION: The levels of free T and E2 in male patients were higber than in normal control subjects. In the female patients the levels of DHT were higher than in the control subjects. However, there was no correlative relationship between hormonal parameters and the clinical severity of acne. Also the patients with irregular menstrual cyclicity had a higher free T and showed severe acne clinically.