10 Aug P11#2
Polycystic ovarian syndrome (PCOS) affects 5–20% of women of reproductive age worldwide and is characterized by hyperandrogenism, ovulatory dysfunction and polycystic ovarian morphology (PCOM) (Azziz, et al, 2016). Excessive androgen production by the ovaries is a key feature of PCOS with the overproduction being caused by insulin resistance and resultant compensatory hyperinsulinemia (Huether & McCance, 2017). The major contributing factor to PCOS is related to a genetic predisposition and an obesity-prone lifestyle which can be linked back to insulin resistance and excess amounts of insulin and androgens (Huether & McCance, 2017).
Treatment should be tailored to the complaints and needs of the patient and involves targeting metabolic abnormalities through lifestyle changes, medication and potentially surgery for the prevention and management of excess weight, androgen suppression and/or blockade, endometrial protection, reproductive therapy and the detection and treatment of psychological features (Azziz, et al, 2016). Proper diagnosis of PCOS is important because it can be confused with benign ovarian cysts that are common during the reproductive years (Huether & McCance, 2017).
Benign Ovarian Cysts
Benign ovarian cysts are most likely to occur during female reproductive years but can occur at any stage of life (Huether & McCance, 2017). In premenopausal females, most ovarian masses are benign, as are many of the cysts seen in the postmenopausal patient (Farahani & Datta, 2016). The overall incidence of malignancy is 1 in 1000 in a premenopausal patient and 3 in 1000 at the age of 50 (Farahani & Datta, 206). Approximately 1 in 25 women will have an ovarian cyst causing symptoms at some point in their lives which includes pain or pressure (Farahani & Datta, 2016).
Risk Factors
Obviously, the female gender is dominant in both PCOS and benign ovarian cysts since both affect the female reproductive system. Age is the second biggest risk for both PCOS and benign ovarian cysts since both have the highest occurrence rate during child bearing years. However, women who undergo early menopause experience a higher burden of health problems related to metabolic syndromes such as insulin resistance that can lead to PCOS (Li, et al, 2016).
References
Azziz, R., Carmina, E., Chen, Z., Dunaif, A., Laven, J., Legro, R. S., & Yildiz, B. O. (2016).
Polycystic ovary syndrome. Nature reviews Disease primers, 2, 16057.
Farahani, L., & Datta, S. (2016). Benign ovarian cysts. Obstetrics, Gynecology & Reproductive
Medicine, 26(9), 271-275.
Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis,
MO: Mosby.
Li, J., Eriksson, M., Czene, K., Hall, P., & Rodriguez-Wallberg, K. A. (2016). Common diseases
as determinants of menopausal age. Human Reproduction, 1-9.
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