Polycystic ovary syndrome: clinical and pathogenetic aspects of a multidisciplinary problem

Syusyuka, V.G.; Сергієнко, М.Ю.; Makurina, H. I.; Єршова, О.А.; Chornenka, A.S.

doi:10.30841/2708-8731.2.2021.232513

Cited by 3 publications

(4 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…PCOS is a multidisciplinary problem that requires determination of the severity of clinical manifestations,source and pathogenesis of androgen hyperproduction, an impact on reproductive function, as well as assessment of metabolic and cardiovascular risks [21]. This contingent of women has a significant risk of developing cardiometabolic disorders during their lifetime [22][23][24].…”

Section: гінекологічні та дерматологічні аспекти діагностики синдрому...mentioning

confidence: 99%

Gynecological and dermatological aspects of diagnostics of polycystic ovary syndrome from puberty to menopause

Siusiuka,

Sergienko,

Мakarchuk

et al. 2023

RHW

View full text Add to dashboard Cite

The article is devoted to the review of scientific publications on gynecological and dermatological aspects of polycystic ovary syndrome (PCOS) in different age periods of women’s life. Analysis of domestic and foreign publications presents that the prevalence of PCOS depends on the age of women and the state of their reproductive function, and is accounted 17% in women 21 to 30 years old and significantly decreased with age. More than half of all cases of endocrine infertility (50-75%) and about 20-22% of the causes of infertile marriage in general are associated with PCOS. The phenotypic heterogeneity of women with PCOS affects the pregnancy outcomes in different ways, which increases the risk of its pathological course, early pregnancy loss, the development of gestational diabetes mellitus, hypertensive disorders, the birth of small and large for gestational age babies, etc.“The golden standard” for hyperandrogenism diagnosis in PCOS patients is the determination of the index of free testosterone and androstenedione. Other indicators are important for differential diagnosis and definition of syndrome phenotypes. Different PCOS phenotypes are characterized by different ratios of the contribution of sources of excess androgen synthesis. Depending on the cause, hyperandrogenism in PCOS patients is accompanied by various metabolic risks. Usually, an excess of androgens in women is clinically manifested by hirsutism, seborrheic dermatitis, acne, acanthosis nigricans, and androgenetic alopecia.The presence of dermatological manifestations of hyperandrogenism has different diagnostic value in puberty, women of reproductive age and in menopause. Acne can be the first sign of pubertal maturation. Additional examinations should be planned in extremely severe cases, which are accompanied by signs of androgen excess, or do not respond to treatment. In women of reproductive age and in perimenopause, the need to assess androgenic status is extremely important. Hair loss according to the female type is associated with manifestations of metabolic syndrome, and it is an independent risk factor for the development of diabetes, atherosclerosis and mortality from cardiovascular diseases.Therefore it is recommended to use the modified Rotterdam criteria for PCOS diagnosis. Such criteria include clinical or biochemical hyperandrogenism, signs of oligoanovulation, polycystosis (morphology of the ovaries according to ultrasound diagnostics), if other causes of relevant disorders are excluded. At the same time, any two of the specified criteria have diagnostic value, which makes possible to establish not only the diagnosis, but also clinical variant (phenotype) of PCOS, the diagnosis of which is the basis for choosing individual treatment for this contingent of women.

show abstract

Section: гінекологічні та дерматологічні аспекти діагностики синдрому...mentioning

confidence: 99%

Gynecological and dermatological aspects of diagnostics of polycystic ovary syndrome from puberty to menopause

Siusiuka,

Sergienko,

Мakarchuk

et al. 2023

RHW

View full text Add to dashboard Cite

show abstract

“…Згідно з науковими даними, проблема МС полягає не тільки в неправильному харчуванні. Важливими є фактори зниженої фізичної активності, генетична схильність, наявність афективних розладів, як-от депресивних станів, що разом з адиктивною поведінкою (алкоголь, тютюнокуріння) спричиняють метаболічний синдром [4,6].…”

Section: мета роботиunclassified

“…Однією з найбільших загроз для людства і викликом для охорони здоров'я ХХІ століття, за даними ВООЗ, є ожиріння, що набуло масштабів глобальної пандемії [1][2][3][4][5]. Проблема аліментарно-залежної патології поглиблюється стрімкими темпами.…”

unclassified

See 1 more Smart Citation

The role of metabolic syndrome in the development of polycystic ovary syndrome in adolescence

Авраменко¹,

Kabachenko²,

Barkovskiy³

et al. 2023

ZMJ

View full text Add to dashboard Cite

The review article presents an analysis of the metabolic syndrome problem in children and adolescents, its role in the development of polycystic ovary syndrome (PCOS) in accordance with the latest International guidelines and modern literature. The urgency of the problem lies in the rapid spread of overweight among children in the world and, consequently, the growth of alimentary-dependent pathology. One of the major consequences of weight problems is metabolic syndrome (MS). There are still no clear MS criteria for children and adolescents. IDF suggests using IDF criteria for adults. Priority in the pathogenesis of MS is given to insulin resistance (IR), which is associated with puberty. The problem of IR assessment remains. HOMA-IR and QUICKI methods are not considered reliable tests to determine IR, so the assessment is based on clinical signs (hyperglycemia, dyslipidemia, abdominal obesity, hypertension). Obesity and IR can be predictors of PCOS, which can often be associated with puberty. Pathological signs of the syndrome typical for adults in adolescence may be a manifestation of the physiological course of puberty. Obligative criteria for the diagnosis of PCOS in adolescence are irregular menstruation/oligomenorrhea, proven biochemically and clinically hyperandrogenemia). First-line therapy for PCOS in adolescents with MS is weight loss and dosed exercise, which helps to normalize a hormonal balance. Drug treatment may include insulin-sensitizing drugs (metformin), antiandrogens (spironlactone, flutamide, cyproterone acetate), 5-alpha-reductase inhibitors (finasteride), combined oral contraceptives, inositol. Prevention of overweight, obesity in children can prevent the development of IR and, accordingly, associated MS and PCOS, reproductive health disorders. Prevention measures are aimed at avoiding maternal obesity, gestational diabetes, malnutrition and smoking during pregnancy, promoting breastfeeding and physical activity.

show abstract

A multidisciplinary approach in the management of patients with acne

Syusyuka

Makurina

Chornenka

et al. 2022

RHW

Self Cite

View full text Add to dashboard Cite

The article summarizes the data of the scientific publications about the management of patients with androgen-dependent dermatopathies, namely acne, taking into account the current view on the pathogenesis, clinical manifestations and results of the examinations of this group of women. Androgen-dependent dermatopathies are not only a medical problem but also a socio-economic one, as they lead to impaired socialization and reduced quality of life. Acne is one of the most common dermatoses. Acne is a chronic multifactorial disease of the pilosebation complex, which is clinically manifested by polymorphic rash in the form of open and closed comedones, papules, pustules, nodules. The pathogenesis of the disease is based on four main links: changes in the quantitative and qualitative composition of sebum due to hypersecretion of androgens and/or increased sensitivity of receptors to their action, impaired follicular keratinization, inflammation and changes in skin microbiome. Besides the main pathogenetic aspects, trigger factors are taken into account, such as nutrition, stress, smoking, mechanical agents. The current treatment of acne according to dermatological protocols is presented in the article, which is based on a combination of topical therapy with local retinoids and antibiotics, benzoyl peroxide, azelaic acid, in case of severe or ineffective local therapy systemic antibiotics and systemic retinoids are used. However, despite the presence of many treatment regimens for dermatosis, it is often not possible to achieve a lasting effect of treatment, and the adherence of patients to follow the doctor’s recommendations decreases. Given that the leading role in the pathogenesis of acne is due to hyperandrogenic effects on the skin, as well as the fact that the disease reduces the quality of life and self-esteem in patients, it is necessary to involve a wider range of specialists, such as dermatologists, gynecologists, endocrinologists and psychotherapists for successful treatment and prevention of persistent aesthetic skin defects.

show abstract

Polycystic ovary syndrome: clinical and pathogenetic aspects of a multidisciplinary problem

Cited by 3 publications

References 38 publications

Gynecological and dermatological aspects of diagnostics of polycystic ovary syndrome from puberty to menopause

Gynecological and dermatological aspects of diagnostics of polycystic ovary syndrome from puberty to menopause

The role of metabolic syndrome in the development of polycystic ovary syndrome in adolescence

A multidisciplinary approach in the management of patients with acne

Contact Info

Product

Resources

About