Polycystic Ovary Syndrome Essay

Polycystic Ovary Syndrome Essay

Polycystic Ovary Syndrome Essay

Women’s Health W4D

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders affecting women of reproductive age. According to Pereira & Kreider (2017), PCOS Can lead to anovulation and hyperandrogenism hence increasing the risks of several health complications such as infertility, cardiovascular disease, and diabetes mellitus. This discussion thus focuses on the evaluation and management of patients with PCOS in addition to identifying the available evidence-based guidelines for this disorder.

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Patient History

            When taking the history of patients with PCOS, clinicians are advised to focus on the menstrual history of the patient, fluctuations in patients’ weight, in addition to their impact on symptoms of PCOS, and cutaneous findings like skin tags, acanthosis nigricans, alopecia, acne, and terminal hair (Armanini et al., 2022). The patient also needs to be asked about factors relating to common PCOS comorbidities such as metabolic syndrome.

Emotional Issues

            Studies show that PCOS is associated with an increased risk of anxiety, depression, obsessive-compulsive disorder, and bipolar disorder (Chemerinski et al., 2018). It is also associated with worsening symptoms of anxiety, OCD, somatization, and depression. As such, screening for these emotional issues is crucial for early intervention.

PCOS specialists

            A patient diagnosed with PCOS should be referred to an endocrinologist given that they have advanced training in the diagnosis and management of hormone-related medical problems (Pereira & Kreider, 2017). Obstetricians/gynecologists should also be involved in the patient care process, as menstrual and fertility problems can be used to identify the early signs of PCOS. the gynecologist can continue treating the patient, while the endocrinologist goes on coordinating the patient care.

PCOS Comorbidities

            If left untreated studies report that PCOS can increase the risks of several comorbidities such as type 2 diabetes, cardiovascular disease, metabolic syndrome, obstructive sleep apnea, glucose intolerance, and dyslipidemia (Chemerinski et al., 2018). PCOS is also associated with menstrual disorders such as infertility, menorrhagia, amenorrhea, and oligomenorrhea.

Fatty Liver Disease and PCOS

            Nonalcoholic fatty liver disease is common among patients diagnosed with PCOS. This has mainly been attributed to insulin resistance and obesity (Armanini et al., 2022). Androgen excess has also been reported to be a contributing factor to the development of the fatty liver. PCOS patients, especially those who are obese are advised to screen for nonalcoholic fatty liver for early intervention.

PCOS Medication

            Current clinical practice guidelines recommend the use of clomiphene (Clomid) and metformin, alone or in combination, besides, rosiglitazone (Avandia) for the induction of ovulation and treatment of infertility among patients diagnosed with PCOS. Metformin is effective in improving insulin resistance and improving menstrual irregularities among patients with PCOS.

Evidence-based Guidelines for PCOS

            Several evidence-based clinical guidelines are available for use in the management of patients with PCOS. For this discussion, I managed to use the “international evidence-based guideline for the assessment and management of PCOS” (Fong et al., 2021). The Journal of Clinical Endocrinology & Metabolism has also published an “evidence-based clinical practice guideline on the diagnosis and management of PCOS”.

Conclusion

PCOS is a serious endocrine disorder that is associated with several comorbidities which undermine the health of the patient. However, through evidence-based practice, several treatment options have been proven to be effective in managing the symptoms and reducing the risks of comorbidities among patients with PCOS such as metformin and clomiphene.

 References

Armanini, D., Boscaro, M., Bordin, L., & Sabbadin, C. (2022). Controversies in the Pathogenesis, Diagnosis, and Treatment of PCOS: Focus on Insulin Resistance, Inflammation, and Hyperandrogenism. International Journal of Molecular Sciences, 23(8), 4110. https://doi.org/10.3390/ijms23084110

Chemerinski, A., Cooney, L. G., Gibson-Helm, M., & Dokras, A. (2018). Resident knowledge of PCOS: identifying gaps and educational opportunities. Fertility and Sterility, 110(4), e112. https://doi.org/10.1016/j.fertnstert.2018.07.340

Fong, S. L., Douma, A., & Verhaeghe, J. (2021). Implementing the international evidence-based guideline of assessment and management of polycystic ovary syndrome (PCOS): how to achieve weight loss in overweight and obese women with PCOS?. Journal of Gynecology Obstetrics and Human Reproduction, 50(6), 101894. https://doi.org/10.1016/j.jogoh.2020.101894

Pereira, K., & Kreider, K. E. (2017). Caring for women with polycystic ovary syndrome. Nurse Practitioner, 42(2), 39–47. DOI: 10.1097/01.NPR.0000480586.24537.64.

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For this assignment, read the following article:

Pereira, K., & Kreider, K. E. (2017). Caring for women with polycystic ovary syndrome. Nurse Practitioner, 42(2), 39–47.

Discuss the following issues:
What would be the most important questions to ask while taking the history of a patient with polycystic ovary syndrome (PCOS)?
What emotional issues would you have to consider with a PCOS patient?
What specialists would you possibly refer the patient to and why?
Discuss the comorbidities associated with PCOS.
Discuss the relationship between fatty liver disease and PCOS. What education would you provide for this patient in relationship to developing fatty liver disease?
What medications might you start a PCOS pt on and why?
What evidence-based guidelines did you find for PCOS?