Polycystic Ovarian Syndrome Research Paper

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Polycystic ovarian syndrome (PCOS) is a disorder of the hypothalamic-pituitary-ovarian axis, which leads temporary or constant anovulation and androgen excess (Neinstein, Gordon, Katzman, Rose, & Woods, 2009). There are troublesome body changes that can arise with PCOS due to an excess of androgens. Some of these body changes are hirsutism, acne, alopecia, and the inability to lose weight. All these symptoms are not well liked by the patient, so the provider should take all steps possible to help the patient diminish these changes. Addressing the patient's lifestyle habits is the first step to help minimize these unwanted changes. The provider should have a thorough conversation with the patient to explain PCOS and why some of these…show more content…
Some short-term complications are menstrual irregularities, hyperandrogenism, infertility, obesity, OSA, insulin resistance and hyperinsulinemia, and dyslipidemia. Menstrual irregularities can be managed with a goal of a 5% weight loss and combination oral contraceptives COCs). Metformin is also an oral drug that can have a positive effect on ovulatory dysfunction and hyperandrogenism leading to a normal return of menstruation (Burch & Paladino, 2011). Also for hyperandrogenism, the practitioner can prescribe an anti-androgen medication, such as spironolactone, flutamide, or finasteride along with COCs. For infertility, the first step is lifestyle modifications,such as weight reduction, decreasing alcohol intake, smoking cessation and limiting caffeine intake. The first line pharmacologic treatment in anovulatory females with PCOS is clomiphene citrate, and other agents used are metformin and thiazolidinediones (Burch & Paladino, 2011). Obesity and OSA can be managed with weight reduction, and insulin resistance and hyperinsulinemia respond to metformin and thiazolidinediones, as well. The standard treatment for dyslipidemia is lifestyle modifications and statin drugs (Burch & Paladino, 2011). Long-term complications are endometrial hyperplasia and carcinoma, metabolic syndrome, cardiovascular disease, and nonalcoholic steatohepatitis. The use of COCs, or the use of intermittent progestin, will…show more content…
A question that should be asked is about the patient's last menstrual period to possibly rule out an ectopic pregnancy. Some other questions to ask the patient are if the are having any symptoms, such as bloating, pain, difficulty eating, or early satiety. Also, it is important to ask the patient if they have felt the mass, and if they have, when did they first notice the mass and has it gotten bigger overtime. Another non-gynecologic concern would be constipation. The provider could be feeling a distend loop of the colon due to hard stool. If this is the case, then asking the patient about their last bowel movement and bowel habits would be of high importance. If the diagnosis leads more to constipation, then starting the patient on some laxatives to help move the constipation through would be the first step. A pregnancy test should be the first initial workup of a pelvic mass in a women of reproductive age (Lyons, Soliman & Frumovitz, 2014). If the provider thinks the mass is in the pelvis, then a transvaginal ultrasound should can be ordered to get a clearer picture of where the mass may originate. It is important to see if the provider can determine if the mass is benign or malignant. The only downfall to sonography is the lack of specificity for diagnosing cancer (Lyons,

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