复旦大学上海医学院妇产科学系2009级六年制妇产科学课件 Polycystic Ovary Syndrome.ppt

2006-12-6 PCOS Polycystic Ovary Syndrome Introduction Definition: polycystic ovary syndrome (PCOS) is a generic description for a broad spectrum of clinical and morphological findings in women with an endocrine dysfunction, specifically abnormal androgen production and metabolism. PCOS was first identified by Stein and Leventhal in 1935 so that it can also be known as Stein – Leventhal Syndrome. Pathology Ovaries:bilateral enlarged and/or polycystic ovaries endometrium: Lack of ovulation for an extended period of time may cause excessive thickening of the endometrium (the lining of the uterus). What Are the Symptoms of PCOS? Oligomenorrhea: Reduction in frequency of menses Between 35 days and 6 months. Symptoms Hirsutism : Excessive body hair. In women with PCOS dark, coarse hair will appear on the face, neck, chest, intergluteal, axillary and pubic area. Symptoms Obesity Symptoms Acne : Because women with PCOS are producing more androgen, that produces more sebum ( skin oils and old tissue) and causes blocked pores and more acne around the jawline, arms and chest. Other Symptoms “Dirty Skin” or Acanthosis Nigricans : This condition causes light brown to black rough patches around the neck and under arms. Diagnosis BBT (basal body temperature) Ultrasound: multiple small ovarian follicles enlarged ovaries Endometrium biopsy(Curettage ) before menses reveal to proliferative glands Elevated free testosterone LH:FSH≧3:1 10-30% hyperprolactinmia hyperinsulinmia Laparoscopy PCOS: Metabolic Disorder Insulin Resistance High association with PCOS 10% have Type 2 Diabetes 30%-35% have Impaired Glucose Tolerance (IGT) Obesity 50% of PCOS patients are obese Amplifies biochemical and clinical abnormalities of PCOS PCOS: Long-term Risks Cancer Chronic anovulatory, persistently elevated estrogen levels, uninterrupted by progesterone, PCOS women found an increased risk of endometrial cancer The risk