The Role Of Polycystic Ovary Syndrome ( Pcos ) - 2046 Words

EPIDEMIOLOGY Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that affects 4% to 12% of women of childbearing age.1 The proportion of individuals in a population with PCOS depends on the diagnostic criteria.2 According to the criteria implemented by the European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine, PCOS is as great as 15% to 20%.2 As stated in The National Institute of Health Office of Disease Prevention Report, PCOS impacts about 5 million females of reproductive age in United States.3 The identification and management of the disease is estimated to cost $4 billion annually to the US health care system.3 As such, PCOS presents a major economic burden. This heterogeneous†¦show more content†¦COS may suffer include anxiety, depression, body dissatisfaction and a lower quality of life.6,7 ETIOLOGY AND PATHOPHYSIOLOGY PCOS is an oligogenic disorder that has a heritable factor of approximately 70%.3 Both genetic and environmental factors contribute to the phenotype of the disease.4 The pathophysiology of PCOS consists of defects in the hypothalamic-pituitary axis, secretion of insulin and the function of the ovary.3 Although, the cause of PCOS is an on going topic of research, it has been linked to insulin resistance and elevated androgen levels that contribute to hormonal imbalance.4 It is estimated that 60%-80% of women with PCOS, show insulin resistance and this percentage increases to 95% of women who are obese.8 Insulin resistance is a cause as well as an exacerbating factor for the development of PCOS.3 Insulin resistance contributes to metabolic disturbances, obesity and type 2 diabetes, as well as increased androgens, cardiovascular risks and anovulation.1 Insulin aids in regulation of ovarian function and overproduction of insulin causes the ovaries to produce high amounts of androgens.9 High levels of gonadotropin releasing hormone (GnRH) stimulate the ovarian thecal cells to produce a greater amount of androgens such as 17-hydroprogesterone, testosterone and progesterone.9 Furthermore, thecal cells contain a higher level of cytochrome P450 11A, CYP17 and 3-HSD2 genes.9 Increased androgens stimulate visceral adipose tissue to produce free fatty