MATERNAL

• PCOS

  Polycystic Ovary Syndrome
• PCOS


  • Long-term recognized, complex heterogeneous familial disorder that affects a woman's hormone levels
  • Hormonal problem that affects women during their childbearing years (ages 15 to 44)
  • Between 2.2 and 26.7 percent of women in this age group have PCOS
• Polycystic Ovary Syndrome


  • Affects a woman's ovaries, the reproductive organs that produce estrogen and progesterone - hormones that regulate the menstrual cycle
  • Ovaries also produce a small amount of male hormones called androgens
  • Ovaries release eggs to be fertilized by a man's sperm, the release of an egg each month is called ovulation
• Polycystic

  Many cysts, 12 or more follicles in an enlarged ovary
• The lack of ovulation alters levels of estrogen, progesterone, FSH, and LH. Estrogen and progesterone levels are lower than usual, while androgen levels are higher than usual.
• Follicle-stimulating hormone (FSH)


  Stimulates the ovary to produce a follicle - a sac that contains an egg
• Luteinizing hormone (LH)


  Triggers the ovary to release a mature egg
• PCOS diagnosis

  • Requires two of the following three criteria: 1. Polycystic ovaries on ultrasound, 2. Oligo ovulation or anovulation, 3. Hyperandrogenism
• PCOS symptoms

  • Irregular periods
  • Heavy bleeding
  • Hair growth
  • Acne
  • Weight gain
  • Male-pattern baldness (androgenic alopecia)
  • Darkening of the skin (acanthosis nigricans)
  • Headaches
• Hirsutism


  Excess hair growth
• Androgenic alopecia


  Hair on the scalp gets thinner and fall out
• Acanthosis nigricans


  Dark patches of skin can form in body creases
• The pathophysiology behind PCOS is not completely understood, but there is certainly a genetic component and it is attributed to two main problems: 1. Very high levels of luteinizing hormone, 2. Insulin resistance
• Factors that might play a role in PCOS

  • Excess insulin
  • Low-grade inflammation
  • Heredity
  • Excess androgen
• PCOS complications


  • Infertility
  • Metabolic syndrome
  • Sleep apnea
  • Endometrial cancer
  • Depression
  • Nonalcoholic steatohepatitis
  • Type 2 Diabetes
• PCOS effects


  • Imbalance of reproductive hormones
  • LH and FSH effects
  • Pancreatic effects
  • Inflammatory effects
  • Obesity/overweight
• PCOS signs and symptoms

  • Infrequent/prolonged/irregular menstrual periods
  • Excess facial and body hair, severe acne, male pattern baldness, darkening of the skin
  • Weight gain (obesity)
  • Headache and Pelvic Pain
• Estrogen and Progesterone decreases, Androgen increases in PCOS
• High amounts of Insulin in PCOS
• PCOS treatment options


  • Birth Control Pills
  • Fertility Medications
  • Anti androgens (Spironolactone, Finasteride)
  • Hair Removal Medicine (Optional)
  • In Vitro Fertilization
  • Surgery (Laparoscopic Ovarian Drilling)
  • Losing Weight (e.g. exercise)
  • Balanced Diet
  • Change in Lifestyle
  • Diabetic Medications (Metformin)
  • Bariatric Surgery (for morbidly obese)
• If PCOS is not treated, it can lead to heavy bleeding, endometrial cancer, high risk for cardiovascular diseases caused by metabolic syndrome, and non-alcoholic steatohepatitis (liver inflammation)
• If PCOS is treated, it lowers the risk of complications, increases the possibility of ovulation and pregnancy, decreases the physical changes caused by hormonal imbalance, and lowers the risk of development of cancer, cardiovascular diseases and diabetes
• PCOS diagnostic tests


  • Physical Examination
  • Pelvic Examination
  • Blood Tests
  • Transvaginal Ultrasound
• In Vitro Fertilization (IVF)

  A course of IVF can boost the chances of becoming pregnant for women struggling to conceive
• Ovarian Drilling


  A surgery done by laparoscopy that reduces the size of the ovaries and limits the amount of testosterone the ovaries are able to produce
• Combination Oral Contraceptives (COC)

  Changes the ratio of estrogen and testosterone produced leading to better menstrual cycle
• Continuous-dosing or extended-cycle birth control pills allow you to reduce the number of periods you have each year
• Metformin (Glucophage)


  Prevents Type 2 Diabetes by improving insulin sensitivity, which is commonly associated with PCOS
• Metformin may cause side effects like diarrhea, cramping, bloating, and a 10-15 lb weight loss
• Clomiphene (Clomid)


  Stimulates ovulation by increasing FSH and LH levels to help women with PCOS become pregnant
• Spironolactone (Aldactone) and Finasteride (Propecia)


  Antiandrogens used to decrease hair growth and reduce acne symptoms
• Nursing interventions for PCOS

  • Encourage patients to monitor their symptoms to aid diagnosis
  • Provide written information to clarify issues discussed on initial diagnosis
  • Refer patients to a dietitian for diet regimen
  • Discuss a suitable exercise regimen
  • Provide psychological support, counseling and follow-up
• Polycystic Ovary Syndrome (PCOS)


  A long-term recognized, complex heterogeneous familial disorder that affects a woman's hormone levels
• PCOS affects 2.2 to 26.7 percent of women aged 15 to 44
• PCOS

  • Affects a woman's ovaries, the reproductive organs that produce estrogen and progesterone
  • The ovaries also produce a small amount of male hormones called androgens
• Ovulation

  1. The ovaries release eggs to be fertilized by a man's sperm

  2. The release of an egg each month
• Polycystic

  Many cysts, 12 or more follicles in an enlarged ovary
• PCOS

  • Many small, fluid-filled sacs grow inside the ovaries
  • The eggs never mature enough to trigger ovulation
• Lack of ovulation

  Alters levels of estrogen, progesterone, FSH, and LH
• Follicle-stimulating hormone (FSH)

  Stimulates the ovary to produce a follicle - a sac that contains an egg