多囊卵巢综合症（学习资料）课件.ppt

2006-12-6 PCOS Polycystic Ovary Syndrome Introduction PCOS is the abbreviation polycystic ovary syndrome PCOS is a multifactorial pathogenisis and clinical manifestation in women PCOS is an endocrine dysfunction, specifically abnormal androgen and metabolism. Etiology & Pathopysiology 1.Abnormal gonadotropin secretion 2.Hypersecretion of androgens Disrupts follicle maturation 3.Insulin resistance, Elevated insulin levels Pathology Ovaries: enlarged and/or polycystic ovaries endometrium: Lack of ovulation for an extended period of time may cause excessive thickening of the endometrium Pathology Symptoms Irregular or Lack of Menses Symptoms Hirsutism Excessive body hair. Coarse hair appear on the face, neck, chest, arms, and in between the legs. Symptoms morbid obesity. Symptoms Acne More androgen caused skin oils and blocked pores and more acne around the jawline, arms and chest. Symptoms Alopecia Thinning or loss of hair is usually contained to top of the scalp, but others loss of hair in front or on the hairline has been documented. Other Symptoms Acanthosis Nigricans This condition causes light brown to black rough patches around the neck and under arms. Other Symptoms Migraines Severe headaches that cause light sensitivity, nausea and dizziness. Diagnosis BBT (basal body temperature) B ultrasound: multiple small ovarian cysts enlarged ovary Endometrium biopsy before menses reveal to proliferative glands Determination of LH,FSH,E2,P,T,PRL，Ins，(LH:FSH≧3:1) Laparoscopy Treatment If pregnancy is desired ---- cause ovulation anti-estrogens(CC) Gonadotropins(Gn) insulin-lowering agents(?MET) anti-androgens gonadotropin releasing hormone agonists (GnRHa) Treatment If pregnancy is not desired To reduce the risk of endometrial cancer cyclical progesterone (MPA) insulin-lowering agents (MET) anti-androg