Pcos

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  • Topic: Obesity, Insulin resistance, Insulin
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  • Published : May 1, 2013
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A Holistic Approach to Managing Patients with Polycystic Ovary Syndrome

Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. This disorder is characterized by ovulatory and menstrual dysfunction, hyperandrogenemia, metabolic abnormalities, and polycystic ovaries. Resulting from complex metabolic and endocrine dysfunctions, women with PCOS often suffer from menstrual irregularities, infertility, insulin resistance, lipid abnormalities, obesity, hirsutism, and acne. The long-term health risks of PCOS are significant as women with this disorder constitute the largest group of women at risk for the development of type 2 diabetes and cardiovascular disease. The social and emotional well-being of women with PCOS is also at stake as many women suffer from depression and social isolation due to burdening symptoms of their disorder. A holistic treatment approach to the management of PCOS is necessary to encompass the complexity of the disorder. Health care workers, specifically working in women’s health areas, have an excellent opportunity to screen for this disorder as well as counsel their patients and provide an individualized and holistic treatment plan.

Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality in young women today (Watkins-Smith & Taylor, 2011). Multiple studies have shown the prevalence of this disorder affecting anywhere from 4%-20% of women of reproductive age (Bargiota & Diamant-Kandarakis, 2012; Garad, 2011; Teede, Deeks, & Moran, 2010; Watkins-Smith & Taylor, 2011). Women with PCOS present to their healthcare provider with complaints of irregular menses, inability to become pregnant, as well as with physical complaints of acne and facial hair (Ahonen, 2010). While these clinical symptoms are unpleasant and psychologically disturbing, women are unaware of the multitude of additional health concerns they are at risk for. Women with PCOS symptoms present to obstetrics and gynecologic clinics as their concerns appear to be related to women’s health (Ahonen, 2010). Obstetrician-gynecologists and advanced practice nurses working in women’s health care have traditionally provided preventative care to women (The American College of Obstetricians and Gynecologists [ACOG], 2012). Providers working in women’s health care settings can wear a variety of healthcare hats when they counsel women at their annual visits. They often play the role of a female’s primary care provider as many young women do not seek regular care outside of their women’s healthcare team (Ahonen, 2010). For this reason, it is imperative that practitioners, specifically working in women’s health settings, have a heightened awareness of the common presenting signs and symptoms of PCOS, and not regard these women as merely having cosmetic complaints, or primarily coping with infertility (American Association of Clinical Endocrinologists [AACE], 2005). Providers should recognize that these symptoms warrant a further investigation of PCOS and to search for additional health risks associated with PCOS that may not traditionally be within the realm of women’s healthcare (Ahonen, 2010). An annual visit provides an excellent opportunity to counsel patients on their health condition, as well as provide counseling about healthy lifestyle choices to reduce health risks (ACOG, 2012). Identification of the Topic

In 1935, Stein and Leventhal first described an association between amenorrhea and polycystic ovaries in a population of infertile women (Hill, 2003). At that time, researchers found a link between certain characteristics found in infertile women such as obesity, hirsutism, amenorrhea, and enlarged cystic ovaries (Hill, 2003). Further research has given insight on the hormonal and metabolic aspects of PCOS. Originally, PCOS was only described in obese women but is now known to affect women of all body types (Hill, 2003;...
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