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Polycystic Ovary Syndrome (PCOS) is one of the most common endocrinopathy affecting women. It has an unknown etiology and is recognized as a heterogeneous disorder that results in overproduction of androgens, primarily from the ovary, and is associated with insulin resistance (IR). Polycystic Ovary Syndrome (PCOS) has become commonplace in today's world. PCOS must be considered a serious issue because of its implication on long term health regardless of a woman's age. It needs to be seen as a lifelong condition, not one tied only to pregnancy. Polycystic ovary syndrome (PCOS) is a highly prevalent endocrine-metabolic disorder that implies various severe consequences to female health, including alarming rates of infertility. Although its exact etiology remains elusive, it is known to feature several hormonal disturbances, including hyperandrogenemia, insulin resistance (IR), and hyperinsulinemia. Insulin appears to disrupt all components of the hypothalamus-hypophysis-ovary axis, and ovarian tissue insulin resistance results in impaired metabolic signaling but intact mitogenic and steroidogenic activity, favoring hyperandrogenemia, which appears to be the main culprit of the clinical picture in PCOS. This Article analyzes the Related Literature on PCOS in obesity in Indian Scenario in detail.

Background: Endometriosis is considered as the chronic benign gynecologic disease which can cause chronic pelvic pain (CPP) and infertility. Endometriosis has affected almost 10% of the women of reproductive age. Methods: Thirty women diagnosed with endometriosis were studied. Pain intensity was assessed by visual analogue scale (VAS) and categorized as mild, moderate or severe accordingly. This was followed by laparoscopy/ laparotomy and staging of endometriosis which was done as per the American Society for Reproductive Medicine (ASRM) classification system. Corrective procedures were done simultaneously. Results: Mean age of women with endometriosis was 30±5.75 years. Majority had superficial implants (30%), 6.66% had deep implants and 6.66% had combination of superficial and deep implants. There was no significant difference between implants and severity of pain (p=0.069). There was a significant association between severity of pain with obliteration of POD. Significant association was seen between deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration and severity of pain. Conclusions: Severity of pain was significantly associated with deeply infiltrating endometriosis (DIE) represented by the pouch of Douglas (POD) obliteration. However, no association was obtained between severities of pain with superficial implants.

Introduction: Intra-abdominal adhesions are common features of endometriosis. Adhesions lead to several chronic symptoms including abdominal distension, pain, nausea, and abnormal bowel movement pattern. Adhesive disease may be life-altering in many patients. Aims and Objectives: To study types of pain and compare it with type and degree of adhesion. Materials and Methods: Thirty women diagnosed with endometriosis were studied. Pain intensity was assessed by visual analogue scale (VAS) and categorized as mild, moderate or severe accordingly. This was followed by laparoscopy/ laparotomy and staging of endometriosis which was done as per the American Society for Reproductive Medicine (ASRM) classification system. Corrective procedures were done simultaneously. Women were followed-up after 6 weeks to reassess the pain intensity by using the same visual analogue scale (VAS). Results: Mean age of study cohort was 30 ±5.75 years. As per VAS, half of the patients had moderate pain (50%). Forniceal thickening was present in 73.33% and cyst was felt in 66.66% women.76.66% had unilateral cysts. Unilateral tubal adhesions were present in 76.66% women and bilateral adhesions were present in 23.33% women. Among the types of adhesions, flimsy adhesions were most common, being present in 76.66% women and deep adhesions were present in 20% women. Majority had 1/3 rd-2/3 rd tubal adhesions (46.7%). All the ovarian adhesions were flimsy. Obliteration was present in 30% women. Forniceal thickening was reported in majority of the women with moderate pain (93.3%) (p=0.001). Cyst was felt on per-vaginum examination in 80% women with severe pain. The correlation of degree of ovarian adhesions (p=0.003) and type and degree of tubal adhesions (p=0.004) with degree of pain by VAS in endometriosis was significant. Conclusion: We found significant association between severity of pain and type of adhesions and between degree of tubal and ovarian adhesions and severity of pain. Operative procedures decrease the severity of pain.