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PMOS / PCOS Pathophysiology

Chapter 43: Polycystic Ovarian Disease

Hilgers TW

The Medical and Surgical Practice of NaProTECHNOLOGY, 573-590, 2004

RRM Academy Synopsis

PCOS is linked to irregular ovulation and long-term health risks

PCOS is linked to irregular ovulation and higher long-term health risks, a textbook chapter reports. The chapter calls it polycystic ovarian disease. It is now renamed polyendocrine metabolic ovarian syndrome (PMOS). The chapter covers causes and infertility.

Key Findings

  • A study cited in the chapter found polycystic ovaries on ultrasound in 14.2 percent of otherwise healthy women.
  • In that study, women with polycystic ovaries had irregular cycles more often (44% vs. 19%) and conceiving problems more often (25.9% vs. 9.2%) than women with normal ovaries.
  • Another cited study found polycystic ovaries in 87 percent of women with infrequent periods and 92 percent of women with excess hair growth and regular cycles.
  • The chapter lists reasons for infertility in the condition: irregular ovulation, frequent ovulation defects, endometriosis, limited mucus cycles, and abnormal follicle and corpus luteum function.
  • The chapter reports raised risks of type 2 diabetes, heart disease and endometrial cancer, citing other studies.

RRM Context

Restorative reproductive medicine treats PCOS as a condition with causes to find. The chapter reflects that principle. It describes a workup that includes cycle charting, hormone tests and ultrasound, built on the Creighton Model System. A seminal fluid analysis is included, so both partners are evaluated.

Our editorial summary of this paper, not the article's abstract.

Abstract

This chapter describes polycystic ovarian disease (PCOD), including its clinical features, diagnosis, etiology, long-term health risks, hirsutism and insulin resistance. Pope Paul VI Institute data in the chapter show defective ovulation in 11 of 18 cycles studied by ultrasound and endometriosis at laparoscopy in 50.9 percent of 55 patients with PCOD. In matched pairs before and after ovarian wedge resection, testosterone, free testosterone, androstenedione, DHEAs and LH fell significantly while FSH did not change. For infertility, the chapter names ovulation induction with clomiphene as the first line of treatment and ovarian wedge resection as the treatment of choice in clomiphene resistance.

Read the guide

  • PMOS / PCOS: Causes, Diagnosis, and Treatment

    PMOS / PCOS has four diagnostic phenotypes and distinct metabolic, reproductive, and mental health implications. How RRM-trained clinicians approach diagnosis and treatment differently.

    20 min read

Topics

By this author

Related research

PMOS / PCOS › Pathophysiology › Hyperandrogenism · Reproductive Endocrinology › Ovarian Hormones › Androgens · Menstrual Cycle › Cycle Disorders › Ovulatory Disturbances
Thomas W Hilgers
Tom Hilgers, T Hilgers
Hilgers et al. 2004, Hilgers 2004

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