Polycystic Ovary Syndrome 2nd edition by Gabor Kovacs, Robert Norman 9780521848497 0521848490

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ISBN 10: 0521848490
ISBN 13: 9780521848497 
Author: Gabor T. Kovacs, Robert Norman

Polycystic ovary syndrome (PCOS) is one of the most common reproductive health problems of women. Despite this, its effective treatment remains a significant challenge to the medical profession. This second edition (published 2007) of a highly successful and well-reviewed book is a thorough update on the syndrome, its aetiology, pathology, impact on infertility, and effective medical management. Every chapter has been extensively referenced and completely revised and updated. New chapters cover: hyperinsulinemic insulin resistance; new treatments including in-vitro maturation; paediatric origins, including the Barker Hypothesis; adrenocortal dysfunction; polycystic ovary syndrome in non-western societies; surgical treatment of obesity associated with polycystic ovaries, and treatment with vitamins and minerals. The book is a reference text for all clinicians with an interest in reproductive endocrinology, including gynaecologists, IVF specialists and obstetricians.

Polycystic Ovary Syndrome 2nd Table of contents:

1 Introduction: Polycystic ovary syndrome is an intergenerational problem
REFERENCES

2 Introduction and history of polycystic ovary syndrome
Recognition
The diagnosis of polycystic ovary syndrome
Prevalence studies
Concept of a spectrum

Clinical manifestations
Menstrual disturbances
Hirsutism, acne, and alopecia
Recurrent miscarriage
Metabolic symptomatology

Etiology
Pathophysiology
Advances in management of PCOS

Advances in management of PCOS
Hirsutism
Anovulation
Weight loss
Summary
REFERENCES

3 Phenotype and genotype in polycystic ovary syndrome
Introduction
Ethnic predisposition
Familial aggregation
Twin studies
Associated mendelian disorders

Modes of genetic analysis utilized in PCOS studies
Association studies
Family-based association studies
Linkage analysis
Pitfalls of genetic analyses in PCOS

Candidate genes involved in PCOS
Gonadotropin action and regulation
Follistatin
Steroid hormone synthesis and action
The CYP11A gene
Insulin action
Insulin gene
Insulin receptor

Summary
REFERENCES

4 The pathology of the polycystic ovary syndrome
Introduction
Macroscopic features
Microscopic features
Differential diagnosis
REFERENCES

5 Imaging polycystic ovaries
Introduction

Two-dimensional (2D) ultrasonography
Technical aspects and recommendations
The consensual definition of PCO
Increased ovarian volume
Increased follicle number
Other criteria and definitions
External morphological signs of PCO
Ovarian area
Increased stroma
Follicle distribution

Other imaging techniques
Three-dimensional ultrasound
Doppler ultrasonography
Magnetic resonance imaging

Conclusions
REFERENCES

6 Insulin sensitizers in the treatment of polycystic ovary syndrome
Introduction

Metformin
Menstrual regulation, ovulation, pregnancy, and birth rates
Androgen status
Body weight
PCOS, metabolic syndrome, and cardiovascular disease
Hypertension
Insulin resistance
Lipids
Side effects of metformin

Other drugs
Thiozolidinediones
Other drugs

Conclusions
REFERENCES

7 Long-term health consequences of polycystic ovary syndrome
Hyperinsulinemia and insulin resistance
Impaired pancreatic beta cell function and increased risk of type 2 diabetes
Obesity
Hyperlipidemia

Prevalence of other cardiovascular risk factors
Hypertension
Endothelial dysfunction, chronic inflammation, and altered vascular function
Premature atherosclerosis
Cardiovascular events
Endometrial cancer

Summary
REFERENCES

8 Skin manifestations of polycystic ovary syndrome
Introduction

Acne
Definition
Incidence
Pathogenesis
Association with PCOS
Clinical features
Treatment

Hirsutism
Definition
Incidence
Pathogenesis
Association with polycystic ovaries
Clinical features
Treatment
Psychological impact
Physical methods of hair removal
Weight loss

Pharmacological methods
Oral contraceptives
Cyproterone acetate
Spironolactone
Flutemide
Finasteride

Androgenetic alopecia (female pattern hair loss)
Definition
Incidence
Pathogenesis
Association with PCOS
Clinical features
Treatment
Non-pharmacological and pharmacological treatments
Minoxidil
Cyproterone acetate, spironolactone, and finasteride

Acanthosis nigricans
Conclusion
REFERENCES

9 Lifestyle factors in the etiology and management of polycystic ovary syndrome
Introduction

Obesity and disease
Metabolic activity of fat tissue
Obesity, PCOS, and menstruation
Obesity, PCOS, and infertility
Obesity, PCOS, and miscarriage
Obesity, PCOS, and pregnancy
Obesity, PCOS, and glucose intolerance
Obesity, PCOS, and response to infertility treatment
Fat distribution, PCOS, and reproduction

Effect of weight loss
On menstruation and infertility
Weight loss and exercise programs in lifestyle modification
Diet for PCOS
Dietary intervention and insulin sensitizing agents
Reasons for weight-related menstrual problems
Smoking
Stress reduction

Conclusions
REFERENCES

10 Ovulation induction for women with polycystic ovary syndrome
Introduction

Management of hyperinsulinism for ovulation induction
Weight loss
Metformin
Metformin alone
Metformin + clomiphene
Metformin + low-dose follicle stimulating hormone
Metformin in in vitro fertilization
Metformin during pregnancy

Stimulation of the ovaries with follicle stimulating hormone
Clomiphene citrate

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