Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology
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Gynecol. Endocrinol. · Nov 2008
Insulin response to oral glucose in healthy, lean young women and patients with polycystic ovary syndrome.
Insulin resistance and consequent hyperinsulinemia are common among patients with polycystic ovary syndrome (PCOS). Ethnicity and dietary habits affect insulin levels. There is little published information from India on insulin levels in PCOS patients. Thus the present study aimed to determine the insulin response to oral glucose in women with PCOS and healthy women. ⋯ Women with PCOS had an exaggerated insulin response to glucose. Thirty-eight percent of PCOS women had some form of abnormal glucose tolerance. Greater insulin response was seen with impairment of glucose tolerance. Obesity had no effect on fasting insulin or insulin response to oral glucose in PCOS women with NGT.
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Gynecol. Endocrinol. · Sep 2008
Case ReportsContinuous vaginal and bilateral thoracic fluid drainage for management of severe ovarian hyperstimulation syndrome.
Severe ovarian hyperstimulation syndrome (OHSS) is a serious and potentially fatal complication of ovarian stimulation. A 29-year-old nulligravid patient with anovulatory infertility was treated with in vitro fertilization. Six days after embryo transfer, the patient presented with complaint of abdominal bloating, nausea, vomiting and shortness of breath. ⋯ Posterior colpotomy was performed under general anesthesia, a Foley catheter was inserted into the posterior cul-de-sac, and bilateral chest drainage tubes were left for continuous drainage. In total, 13.2 liters of ascites and 6.1 liters of pleural fluid were drained in 8 days. Continuous drainage of ascites and pleural effusion improved the patient's comfort without need for repeated transvaginal and thoracic aspirations.
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Gynecol. Endocrinol. · Aug 2008
Body fat composition and distribution in women with polycystic ovary syndrome.
The aims of the present study were to compare the distribution and accumulation of body fat in women with polycystic ovary syndrome (PCOS) and healthy controls matched for age and body mass index (BMI), and to investigate the association between androgen levels, insulin resistance and fat distribution. ⋯ Upper-half type body fat distribution is linked with PCOS, high free testosterone levels and insulin resistance.
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Gynecol. Endocrinol. · Jul 2008
Randomized Controlled Trial Comparative StudyEffects of metformin and ethinyl estradiol-cyproterone acetate on clinical, endocrine and metabolic factors in women with polycystic ovary syndrome.
Polycystic ovary syndrome (PCOS) is a major endocrine abnormality that affects women of reproductive age. Oral contraceptive pills are usually the first choice of treatment for PCOS when fertility is not desired. Metformin, an insulin-sensitizing drug, has been shown to improve such metabolic abnormality. Aim. To compare the effects of a contraceptive pill in combination with metformin on the clinical, endocrine and metabolic parameters in obese and non-obese patients with PCOS. ⋯ Our data show that a combination of metformin and contraceptive pill may be more effective in suppressing the hyperandrogenemia of obese and non-obese PCOS patients than metformin alone and may reduce insulin levels more than contraceptive pill alone. Hence, combined treatment may become a more effective therapeutic option for PCOS.
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In a reanalysis of the Million Women Study (MWS), their authors concluded that prolonged use of hormone replacement therapy (HRT) in postmenopausal women increases the risk of ovarian cancer. Although statistically significant their results are clinically irrelevant, since the attributable risk over 5 years is only 4 per 10 000 HRT users, a figure that is not confirmed by other large studies. This risk is much lower than those associated with obesity, lack of physical exercise, smoking and nulliparity, all of which are preventable. Therefore HRT should continue to be prescribed for symptom relief and improvement of quality of life because the benefits far outweigh the very low potential risks.