Review Article: The Polycystic Ovary Syndrome

Yen, S. S. C.

doi:10.1111/j.1365-2265.1980.tb02132.x

Cited by 681 publications

(302 citation statements)

References 119 publications

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“…Previous studies have found that irrespective of the severity of thyroid dysfunction, hypothyroidism is associated with low serum SHBG levels 531. As SHBG is one of the major proteins to which T is bound in plasma (the other is albumin), a decrease in SHBG is associated with increase in free T concentrations.…”

Section: Discussionmentioning

confidence: 99%

Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism

Müderris

Boztosun

Öner

et al. 2011

Annals of Saudi Medicine

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BACKGROUND AND OBJECTIVES:Primary hypothyroidism may be associated with ovarian enlargement and/ or cyst formation. We evaluated the effect of thyroid hormone replacement therapy on hormonal changes, ovarian volume and sonographic appearance.DESIGN AND SETTING:Open, prospective study of women admitted to university gynecology clinic.PATIENTS AND METHODS:The study included 26 patients with untreated hypothyroidism who had polycystic (n=10) or normal-appearing (n=16) ovaries and 20 euthyroidic controls. Basal serum total testosterone, free testosterone, androstenedione, dehydroepiandosterone-sulfate, prolactin, estradiol, luteinizing hormone, follicle-stimulating hormone, free T3, free T4 and thyroid-stimulating horone, together with ovarian volumes, were determined and repeated after euthyroidism was achieved.RESULTS:Ovarian volumes of patients with hypothyroidism were significantly greater compared with controls, and their magnitudes diminished significantly during thyroid hormone replacement therapy. Hypothyroidic patients with polycystic ovaries had significantly higher serum free testosterone and dehydroepiandosterone-sulfate, but lower androstenodione levels compared with those who had normal-appearing ovaries. Serum total testosterone concentrations were significantly higher in hypothyroidic patients without polycystic ovaries, and thyroid hormone replacement therapy achieved a significant reduction in total as well as free testosterone.CONCLUSION:Severe longstanding hypothyroidism leads to increased ovarian volume and/or cyst formation. A decrease in ovarian volume, resolution of ovarian cysts and reversal of the polycystic ovary syndrome-like appearance, together with improvement in serum hormone levels, occurred after euthyroidism was achieved.

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Section: Discussionmentioning

confidence: 99%

Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism

Müderris

Boztosun

Öner

et al. 2011

Annals of Saudi Medicine

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“…9 Age of onset of obesity has also been correlated with oligomenorrhoea or amenorrhoea in obese women affected by polycystic ovary syndrome. 1,2 More recently, Rich-Edwards et al 4 suggested that adolescent obesity may be causally related to polycystic ovary syndrome. There is also evidence that the age of menarche tends to be lower in obese 10,20 and higher in underweight 21 compared to normal weight girls, which may have implications for subsequent gynaecological problems.…”

Section: Introductionmentioning

confidence: 99%

Women's reproductive health: the role of body mass index in early and adult life

Lake¹,

Power²,

1997

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BACKGROUND: Higher risks of menstrual problems and infertility have been found in underweight and overweight women but evidence is inconsistent especially in relation to the effect of age of onset of obesity. OBJECTIVE: To determine whether body mass index (BMI) in adulthood or childhood affects the reproductive health of women. METHODS: Heights, weights (at 7, 11, 16, 23 and 33 y) and reproductive data were available for 5799 females in the 1958 British birth cohort study. Body mass index (BMI) was calculated as weight/height 2 . Age-speci®c cut-offs were used to de®ne overweight and obesity. Reproductive outcomes reported at age 33 included: menstrual problems (also reported at 16 y), hypertension in pregnancy and subfertility. RESULTS: Early menarcheal age was associated with higher risks of menstrual problems by 16 y but this relationship did not persist to 33 y. Obesity at 23 y and obesity at 7 y both independently increased the risk of menstrual problems by age 33 (OR 1.75, OR 1.59 respectively) after adjusting for other confounding factors. Obesity at 23 y increased the risk of hypertension in pregnancy (OR 2.37), after adjusting for confounders. Consistent with these ®ndings, obese women at 23 y were less likely to conceive within 12 months of unprotected intercourse after adjustment for confounders (RR 0.69). CONCLUSIONS: Overweight and obesity in early adulthood appears to increase the risk of menstrual problems, hypertension in pregnancy and subfertility. Other than menstrual problems, childhood body mass index had little impact on the reproductive health of women.

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“…27 There is also an increased prevalence of certain gynaecological tumours, for example endometrial or breast cancer, in obese women. 4,8,9,28 We investigated two subgroups of premenopausal, obese women to evaluate whether the site of body fat predominance does predict a speci®c metabolic and hormonal pro®le already in young women. Furthermore, the effects of weight reduction on menstrual irregularity and infertility in these subgroups were evaluated.…”

Section: Introductionmentioning

confidence: 99%

Impact of waist-hip-ratio and body-mass-index on hormonal and metabolic parameters in young, obese women

1997

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BACKGROUND: To investigate the impact of predominantly upper body fat localisation on the hormonal and metabolic pro®le in obese, infertile women. DESIGN: Prospective observational study of premenopausal women with obesity, infertility and menstrual dysfunction. SETTING: Department of Endocrinology and Reproduction of the University Hospital of Obstetrics and Gynaecology of Heidelberg. SUBJECTS: Eighteen women with android type obesity (waist-hip-ratio WHR b 0.85, group 1) and 22 women with gynoid type obesity (WHR 0.85, group 2) in a group of 58 premenopausal obese women (median age 28 y) with infertility. Twenty-nine women took part in a weight reducing program lasting 32 AE 14 (mean AE s.d.) weeks. MEASUREMENTS: BMI, WHR and blood pressure. Plasma lipids and liver enzymes. Blood glucose, insulin, C-peptide and different steroid and pituitary hormones during oral glucose loading. RESULTS: In the total group of 58 obese women, WHR was directly correlated to plasma triglycerides, AST, ALT and cholesterol/HDL-cholesterol-ratio. WHR correlated inversely with HDL-cholesterol. Insulin resistance was greater with increasing WHR. Systolic blood pressure, glucose, insulin, C-peptide, triglycerides, cholesterol/HDL-cholesterol-ratio, aspartate (AST) and alanine aminotransferase (ALT) were signi®cantly greater in group 1. Group 2 had greater HDLcholesterol levels. One subject in group 1, ®ve women in group 2 conceived spontaneously after weight reduction. CONCLUSIONS: Determination of the WHR is a simple measurement to identify obese patients who are at a greater risk of developing the metabolic syndrome. WHR is important in preventive medicine, as typical metabolic pro®les are already present in young women before clinical manifestation. Women with android obesity seem to be more prone to develop menstrual irregularity and infertility. The hyperinsulinaemia may be the pathway.

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Review Article: The Polycystic Ovary Syndrome

Cited by 681 publications

References 119 publications

Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism

Effect of thyroid hormone replacement therapy on ovarian volume and androgen hormones in patients with untreated primary hypothyroidism

Women's reproductive health: the role of body mass index in early and adult life

Impact of waist-hip-ratio and body-mass-index on hormonal and metabolic parameters in young, obese women

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