Symptoms Of Polycystic Ovary Syndrome Research Articles

Exploring phytoconstituent for confronting the symptoms of polycystic ovarian syndrome: molecular dynamics simulation, quantum studies, free energy calculations and network analysis approaches

Women of the current citizenry are majorly afflicted with gonadal hormonal fluctuations and stress, which play a predominant role in the occurrence and prevalence of PCOS. Synthetic medications under use influence in varietal adverse reactions, hence incorporation of herbs remains a critical part of the therapy. The present study includes selection of phytoconstituents from herbs related to uterine activity and subjection to in silico approach. The constituents were incorporated into a flow of molecular docking, ADMET analysis, toxicity, biological activity prediction, DFT studies, Molecular dynamics, free energy calculations, and network analysis. Three proteins namely Human androgen receptor (2AM9), Human progesterone (1E3K), and Estrogen receptor (1X7R) were selected and used throughout the study. From docking studies, Sarsasapogenin (SAR), β-sitosterol (BES), and Stigmasterol (STI) showed good binding energy interactions with all three proteins, and they also possess ideal drug-likeliness properties with acceptable toxicity profiles. Further analysis by Density functional theory proves they possess considerable intermolecular charge transfer. The insights from Molecular dynamics studies and free energy calculation explain, that Sarsasapogenin (SAR) among the three has strong stability and intermolecular interactions with the findings through network analysis justifying the selection of three proteins. Hence, on the compilation of results, Sarsasapogenin from Asparagus racemosus is determined to be potent and active with all three receptors together that majorly influence in the pathophysiology of the disorder. Further experimental evaluation of SAR in pre-clinical and clinical models would help emphasize the biological activity of the constituent in the management of PCOS.

Examining symptom and quality of life in polycystic ovarian syndrome: a web-based cross-sectional study.

Polycystic Ovarian Syndrome (PCOS) is a reproductive disorder that significantly impacts women's quality of life (QOL). Its unclear etiology, whether genetic or environmental, and the treatments associated with it have been widely studied globally. This study assessed the QOL of 108 women with PCOS, examining both physical and mental symptoms. Participants completed the Short Form-12 (SF-12) questionnaire through a web-based survey to evaluate their QOL scores. Common symptoms included menstrual irregularity (73.14%), hirsutism (65.7%), acne (62.03%), and obesity (22.22%). Complications such as diabetes mellitus (12.9%), hypertension (2.78%), infertility (1.85%), miscarriages (31.4%), hyperandrogenism (68.51%), and insulin resistance (28.7%) were reported. Patients with infertility had the lowest physical scores (PCS), while those working night shifts had the lowest mental scores (MCS). PCOS significantly affects QOL, with infertility contributing to the lowest physical scores and night shift work correlating with the lowest mental scores. These findings emphasize the need for integrated psychological and physical care, particularly for young working women with PCOS.

Effect of Clinical Nutrition and Healthy Lifestyle in Treating Symptoms of Polycystic Ovary Syndrome

Background: Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women and is associated with both reproductive and metabolic disorders, affecting about one in every 15 women worldwide. This study was done in two parts, the descriptive part and the experimental part, during the period (November 2020- February 2021). Objective: the objective of this study was to know the spread of PCOS in the University of Sciences and Technology, Aden, Yemen and to assess the effect of clinical nutrition and healthy lifestyle in women with PCOS. Method: The blood was withdrawn from the sample of the study and transferred to the Almadeinah Medical center to measurement the hormones (FSH - LH) and also sample of blood transferred to the laboratory of the Faculty of Medicine and Health Sciences at the University of Science and Technology, Aden, Yemen to measurement CBC. Results: In this study, we selected 60 girl and recorded 16 cases of have been suffered of polycystic ovaries , this number form about 26.7% of the total cases. At the end of the study, results showed a statistically significant progress at (P=> 0.05) in alleviating some symptoms associated with PCOS such as hair dropping (P= 0.024), acne (P= 0.002), and menstrual days (P= 0.002), with a marked improvement in the level of hormones (FSH - LH) and the level of CBC (HB – WBC – Platelet) in the groups that underwent clinical nutrition, but with no significant differences. Conclusion: Healthy life style can be a good alternative for medications in women with PCOS..

Bridging gap in treatment of polycystic ovarian syndrome through drug repurposing: what we achieved and where we are?

Polycystic ovarian syndrome (PCOS) is one of the chief causes of infertility in women of reproductive age. Several drugs belonging to the oral contraceptive class have been approved for the treatment of PCOS. Nonetheless, the capability to target only a few symptoms of PCOS and fatal side effects are key hurdles to their use. Therefore, repurposing existing drugs can be promising in managing PCOS efficiently. Drugs from different pharmacological classes like antidiabetics (metformin, rosiglitazone, pioglitazone, and semaglutide), statins (simvastatin and atorvastatin), antiandrogen drugs (finasteride and flutamide), etc. demonstrated significant potential in managing PCOS. The present review offers a comprehensive overview of all the medications examined as potential repurposed options for the efficient treatment of PCOS. The pathogenesis of PCOS, existing therapies for PCOS and their challenges, drug repurposing and its significance is also explained. The small-molecular drugs from various pharmacological classes and different phytoceuticals repurposed against PCOS are discussed along with their anti-PCOS activity mechanisms. Moreover, novel drug targets responsible for PCOS and opportunities for drug repurposing are briefed. The repurposed drugs in clinical trials for PCOS and drug repurposing challenges are discussed. Thus, drug repurposing can serve as a potential way to effectively treat PCOS, reducing the extent of infertility and improving the quality of life of women.

Leonurine restrains granulosa cell ferroptosis through SLC7A11/GPX4 axis to promote the treatment of polycystic ovary syndrome.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder marked by ovarian dysfunction and metabolic abnormality. This study explores the therapeutic potential of leonurine (SCM-198) in PCOS. Our results show that SCM-198 treatment significantly improved ovarian function, hormone disorders and insulin resistance while reducing granulosa cell ferroptosis. This study provides the first evidence that SCM-198 modulates the gut microbiota composition, increases the abundance of Christensenella minuta, and boosts butyrate levels. Transcriptomic and metabolomic analyses revealed that PCOS patients exhibit granulosa cell ferroptosis and decreased butyrate levels in follicular fluid. Butyrate was shown to alleviate ferroptosis in granulosa cells via the SLC7A11/TXNRD1/GPX4 pathway, as confirmed in vitro with KGN cells. The therapeutic mechanism of SCM-198 in the management of PCOS via the gut-ovary axis involves the enhancement of intestinal microbiota and its metabolites. This intervention improves ovarian function and alleviates PCOS symptoms by targeting ferroptosis in granulosa cells.

Progress in TLR4/NF-κB Pathway Regulation by Traditional Chinese Medicine for the Treatment of Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is a common reproductive endocrine disease in women, affecting women's fertility and cardiovascular system. Due to the complexity of its pathogenesis, there are many adverse reactions commonly used in clinical treatment, and the therapeutic effect is short-lived and temporary. TLR4/NF-κB pathway is a classical signaling pathway related to inflammation, and the effective components of TCM compounds and TCM monomers have been proven to reduce the levels of various inflammatory factors in patients by regulating the TLR4/NF-κB pathway, so as to achieve the effect of PCOS. The potential value of TCM in prevention and treatment of PCOS based on TLR4/NF-κB pathway was revealed. This article aims to summarize the recent studies on the improvement of PCOS symptoms by regulating the expression of TLR4/NF-κB pathway by Chinese medicine, so as to further study the mechanism of PCOS prevention and treatment by this pathway under the regulation of Chinese medicine, so as to open up new ideas for the development of new drugs targeting this pathway and clinical research.

Assessment of Artemisia Campestris L. Leaf Extract Effects on Polycystic Ovarian Syndrome in Rats, Antioxidant and α-Amylase Inhibition Activities.

Polycystic Ovarian Syndrome (PCOS) is characterized by metabolic and reproductive dysfunction, often associated with elevated oxidative stress markers in the bloodstream. This study examines the potential antioxidant properties and α-amylase inhibitory activity of Artemisia campestris leaves extract (Artemisia campestris L) and its effects on rats with induced PCOS. Estradiol valerate was administered to ten mature Wistar rats to induce PCOS, while a control group consisted of five mature Wistar rats. Following a 16-day induction period, the rats were categorized into three groups: a control group, a PCOS group, and an experimental group receiving 200 mg/kg body weight of A. campestris L. extract orally for 15 days. Serum levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) were measured using the ELISA technique. The group treated with A. campestris L. extract exhibited significantly reduced LH levels compared to the PCOS group. Histomorphometric analysis indicated notable changes in follicle counts and the thickness of the theca layer. These findings suggest a significant alleviation of PCOS symptoms, potentially linked to the effects of A. campestris L. on oxidative stress pathways. Furthermore, aqueous extracts of A. campestris L. displayed potent in vitro inhibition of α-amylase, with an IC50 value of 2.418 μg/mL.

Decreased Insulin and Interleukin-6 Levels in Rattus Norvegicus Model of Polycystic Ovary Syndrome-Insulin Resistance Treated with a High Protein Diet

Hypercaloric in women of childbearing age is one of the causes of polycystic ovary syndrome (PCOS) with insulin resistance. Increased inflammation (tumor factor necrosis-α (TNF-α) and interleukin-6 (IL-6)) is the impact of endocrine and metabolic disorders involved due to metabolic syndrome, obesity, and diabetes mellitus. This study aims to evaluate whether a high-protein diet can reduce insulin and interleukin-6 levels, which are key indicators of polycystic ovary syndrome, and whether these changes can help in the treatment of the syndrome. This study used a prepost test only control design, true experimental, with a total sample of 6 female Rattus norvegicus rats aged 2–3 years (150–200 g). It consists of 4 groups, namely the negative control group (K-), the positive control group (K+), the treatment group (P), and the group without treatment (P-). The study examined the rat blood serum ELISA measurement of insulin and IL-6 levels. Anova test results of IL-6 levels (p = 0.002). Post-hoc test results of group K- and group P (p = 0.002), group K + and group P (p = 0.037), group K- and group K + (p = 0.437). The Anova test results of insulin levels between groups found a significant difference (p = 0.001). Post-hoc test of insulin levels of group K- and group P (p = 0.002), group K- and group K+ (p = 0.000), and group K+ with group P (p = 0.356). In group K and group P, the results of the ANOVA and post hoc tests on IL-6 levels and insulin levels with the provision of a high-protein diet show significant differences. This study suggests that a high-protein diet may be an effective therapeutic alternative in reducing the symptoms of polycystic ovary syndrome, especially in controlling high insulin and interleukin-6 levels.

Retinol intake and PCOS management: a plasma metabolite and protein analysis via Mendelian randomization and NHANES 2011-2016.

Polycystic Ovary Syndrome (PCOS) represents a complex endocrine disorder characterized by a significant interplay with metabolic dysfunction and obesity. This research endeavors to elucidate the causal dynamics among plasma metabolites, proteins, and PCOS, alongside Body Mass Index (BMI), to pinpoint prospective therapeutic interventions. This investigation employed Mendelian randomization (MR) analyses combined with data derived from the National Health and Nutrition Examination Survey (NHANES) to explore the relationships between 1,400 plasma metabolites and PCOS, factoring in BMI adjustments. Additionally, the study examined the influence of plasma proteins and performed a retrospective cross-sectional analysis focusing on retinol consumption and testosterone levels. MR analyses showed metabolite Glycosyl-N-(2-hydroxynervonoyl)-sphingosine (GNS) and protein Keratin 19 (KRT19) were identified as significant markers in the context of PCOS and BMI adjustments. A Phenome-Wide Association Study (PheWAS) underscored the linkage between KRT19 and BMI, while gene-drug interaction findings demonstrated a connection between KRT19 and retinol. Analysis for NHANES data disclosed a negative correlation between retinol intake and testosterone levels, particularly within normal weight and obese cohorts, suggesting the feasibility of dietary interventions for PCOS management. The study sheds light on the intricate interactions between plasma metabolites, proteins, and PCOS, considering BMI variations, and highlights KRT19 protein as a promising therapeutic target. The outcomes support the integration of retinol consumption into dietary strategies to regulate testosterone levels and potentially alleviate PCOS symptoms, underscoring the necessity for personalized nutritional and therapeutic approaches in the effective management of PCOS.

12424 A Feasibility Trial Of A Co-created Digital Self-management Programme For Adults With Polycystic Ovary Syndrome (Hope PCOS)

Abstract Disclosure: C.A. Percy: None. A. Turner: None. L. Aphramor: None. D. Broom: None. C. Clark: None. F. Martin: None. P. Wark: None. Introduction: Polycystic ovary syndrome (PCOS) has significant impact on depression, anxiety, psychological wellbeing and health-related quality of life. We co-created a theory-led, evidence-based, 6-week, digital self-management and positive wellbeing intervention (Hope PCOS), delivered to UK adults. We tested the intervention’s potential to improve mental health and wellbeing outcomes and its acceptability and usability for adults living with PCOS. Methods: This was a mixed methods feasibility randomised controlled trial conducted online, with a pre-post, waitlist-controlled design. Primary outcomes were recruitment, completion (≥ 3 intervention sessions) and follow-up rates. At baseline, participants reported demographic information, PCOS symptoms, depression (Patient Health Questionnaire (PHQ-9)), anxiety ((Generalised Anxiety Disorder Assessment (GAD-7)), polycystic ovary syndrome health-related quality of life (PCOSQ-50), psychological wellbeing (Warwick-Edinburgh Mental Wellbeing Scale, WEMWBS) and self-efficacy (Self-Efficacy to Manage Chronic Disease Scale (SEMCD6)) before randomisation to an intervention group (IG) receiving the intervention immediately or a waitlist control group (CG) receiving the intervention 12 weeks later. PHQ-9, GAD-7, PCOSQ-50, WEMWBS and SEMDC6 were reassessed at 6 and 12 weeks. IG participants reported the usability of the digital intervention (system usability scale (SUS)) and acceptability via qualitative exit interviews. Results: Of 131 eligible, consented participants, 83% (N=109, age M=37.1, SD=8.6 years) completed baseline measures and were randomised to the IG (n=54) or the CG (n=55). Baseline clinical caseness was high for depression (n=77, 70.6%) and anxiety (n=78, 71.6 %). Twenty-one participants (39%) in the IG completed ≥3 intervention sessions. At 6-week follow-up, completion of secondary outcomes was n=32 (59%) for IG and n= 38 (69%) for CG; at 12 weeks, n=31 (57%) for IG and n= 38 (69%) for CG. Twelve IG participants took part in the exit interviews. Exploratory descriptive statistics suggest there were greater improvements in depression, anxiety, psychological wellbeing, self-efficacy and quality of life for the intervention group completers compared to the waitlist control group. SUS data and thematic analysis suggest the intervention was usable, acceptable, relevant and interesting. Participants reported experiences including feeling seen and valued, having the difficulties of lifestyle change acknowledged, and learning valuable lessons, particularly how to monitor and manage emotions, prioritise self-care and complete personal goals. Conclusions: This novel intervention was rated as usable and acceptable, with potential for improving mental health and wellbeing outcomes. More research is needed to identify for whom the intervention is beneficial and on implementation in practice. Presentation: 6/1/2024

8673 Exploring A Case Study On Navigating Complexities In Endocrine Health And Reproductive Challenges

Abstract Disclosure: S.Y. Rizvi: None. E. Villanueva: None. Introduction: Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting many reproductive-age women, characterized by irregular menstrual cycles, hirsutism, and challenges with fertility. In this case study, we delve into the medical history of a 24-year-old female presenting with PCOS-related symptoms, hirsutism, and infertility, unraveling the multifaceted aspects of her healthcare journey. Case Description: This patient's diagnostic path began when she received an initial diagnosis of PCOS in her home country due to irregular menstrual periods and clinical signs of hirsutism. Her treatment included metformin, but it was interrupted when she relocated to the United States. Upon her arrival in the U.S., her medical course took an unexpected turn as further evaluations revealed elevated salivary cortisol (++), and a 24-hour urine free cortisol recorded 94.2 mcg (normal 4-50 mcg), indicating hypercortisolism. DHEAS: 730 mcg/dl (normal 18-390 mcg/dl), 17-hydroxyprogesterone: 508 (pre-midluteal: 431), free testosterone: 13 pg/ml (normal 0.1-6.4 pg/ml), with normal CBC, TSH, prolactin, and TPO. CT scan showed large 4.8 cm left adrenal mass. These findings indicated adrenal Cushing's syndrome, leading to referral to a tertiary care hospital's endocrine surgeon. Two months post-adrenalectomy, successful removal of the adrenal mass left the patient with relative adrenal insufficiency. Hydrocortisone replacement therapy was initiated, addressing Cushing's syndrome and revealing a potential factor contributing to infertility. Postoperatively, the patient entered the first trimester unexpectedly, complicating her case. Ensuring proper hydrocortisone levels became crucial for her well-being and the fetus, prompting a collaborative approach with obstetricians and maternal-fetal medicine specialists for optimal pregnancy care. Despite ongoing PCOS effects, including hirsutism, treatment options were limited by pregnancy constraints, deferring Aldactone due to its contraindication during pregnancy. Continuous monitoring included hormonal assessments, metabolic panels, and thyroid tests, aiming to balance adrenal insufficiency, PCOS symptoms, and a healthy pregnancy. Conclusion: This case emphasizes challenges in differentiating PCOS from adrenal Cushing's due to overlapping symptoms. Despite classic symptoms, the initial PCOS misdiagnosis highlights the need for vigilance and comprehensive diagnostics. Complex cases underscore the importance of individualized management and interdisciplinary collaboration. Positive outcomes in complex endocrine disorders and pregnancy are attainable through accurate diagnoses and tailored treatments. The case underscores the critical importance of meticulous evaluation for successful outcomes in challenging medical scenarios. Presentation: 6/3/2024

8558 Prevalence of Polycystic Ovary Syndrome in Adolescent Girls by World Health Organization Region

Abstract Disclosure: S. Hatoum: None. M. Amiri: None. R.P. Buyalos: None. A. Sheidaei: None. R. Azziz: Consulting Fee; Self; Spruce Bioscience, May Health, Core Access Surgical Technologies, Acacia Bio, Fortress Biotech, Rani Therapeutics. Stock Owner; Self; Martin Imaging. Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among women of reproductive age. The use of several diagnostic criteria imposes a challenge for healthcare providers, especially in adolescents, whose PCOS symptoms may mimic normal pubertal changes. Objectives: This systematic review and meta-analysis aims to estimate the pooled prevalence of PCOS in adolescents using various diagnostic criteria in total and by WHO region. Methods: We systematically reviewed Pubmed and Embase through July 2023 to capture all studies performed in medically unbiased adolescent populations (age <18 years) reporting PCOS prevalence. Studies were categorized according to: a) PCOS criteria (NIH 1990 [PCOS phenotypes A&B], AE-PCOS 2006 [PCOS phenotypes A-C], Rotterdam 2003 [PCOS phenotypes A-D], and ‘other/self-reported’ criteria); b) subject assessment type (direct assessment, survey/indirect assessment, or mixed assessment); and c) study quality, assessed using the PCOS Epidemiology and Phenotype (PEP) quality assessment tool. We performed a meta-analysis using fixed-effects or random-effects models depending on the heterogeneity among the studies. We conducted subgroup analyses based on PCOS criteria, assessment type, study quality, and WHO region. Results: 6,644 studies were initially retrieved, of which 11 were eligible for inclusion including a total of 10,516 adolescents, yielding 15 study groups according to the diagnostic criteria. Considering all studies, PCOS prevalence was 4.98% according to the NIH 1990, 8.80% according to Rotterdam 2003, 4.74% according to the AE-PCOS 2006, and 1.69% according to other criteria/self-report, with an overall pooled PCOS prevalence of 4.57%. All studies using NIH 1990, Rotterdam 2003, and AE-PCOS 2006 were of high quality, and those using other criteria/self-report were of low quality, thus subgroup analysis based on quality resulted in the same prevalences as above. When including only high-quality studies that used direct or mixed assessment, PCOS prevalence was highest in the Western Pacific Region (WPR) at 20.69% and lowest in the Eastern Mediterranean Region at 3.43% under Rotterdam 2003, while it was highest in the South-East Asia Region at 6.20% and lowest in the WPR at 3.94% under NIH 1990. Only one high-quality study using direct or mixed assessment was available under AE-PCOS 2006. Conclusion: This meta-analysis revealed that PCOS prevalence varies according to the PCOS criteria, assessment type, and WHO region. This variability should be addressed, ideally through unifying the diagnostic criteria and using meticulous methods in PCOS epidemiologic studies. The effect of study quality alone on PCOS prevalence could not be detected because of insufficient data, further reinforcing the need for undertaking PCOS prevalence studies in all populations and regions. Presentation: 6/2/2024

8687 The Efficacy of GLP1 Receptor Agonists in Obese Women with PCOS in Promoting Weight Loss and Hormonal Regulation: A Systematic Review and Meta-Analysis

Abstract Disclosure: B. Austregesilo Athayde H Morais: None. V.M. Prizão: None. B. Ximenes Mendes: None. M.L. Defante: None. O.C. Martins: None. T.L. Correa: None. M.D. De Moura de Souza: None. Background: GLP1 receptor antagonists (GLP1a) are known for their efficacy in promoting weight loss among obese and diabetic patients. However, their impact on weight reduction and hormonal regulation in obese females with polycystic ovarian syndrome (PCOS) remains understudied. Therefore, we aimed to perform a meta-analysis exploring the efficacy of GLP1a against placebo for ameliorating symptoms of PCOS. Hypothesis: The use of GLP1 receptor agonists in obese women with PCOS reduces body mass index and waist circumference as well as normalizes hormone levels such as total testosterone, total cholesterol, and HOMA-IR. Methods: We conducted a comprehensive search of PubMed, Cochrane, and Scopus databases to identify trials comparing GLP1a against placebo among women diagnosed with PCOS based on the Rotterdam Criteria. Our primary outcomes of interest included body mass index (BMI), triglycerides, waist circumference, total testosterone, total cholesterol, and HOMA-IR. We performed data extraction and quality assessment for studies that met the inclusion criteria. Subsequently, we conducted a statistical analysis using Review Manager 5.1.7 (Cochrane Collaboration). We evaluated heterogeneity using I² statistics. Results: We included 176 participants from 4 studies, which all were RCTs. GLP1a was used to treat 111 (63.06%) patients. Analyzed outcomes included waist circumference (MD: −5.16 cm; 95% CI: −6.11 to −4.21; p < 0.00001), total testosterone (MD: −1.33; 95% CI: −2.55 to −0.12; p =0.03), BMI (MD: -2.42; 95% CI: -3.10 to -1.74; p < 0.00001), total cholesterol (MD: −0.04; 95% CI: −0.10 to 0.01; p =0.15), HOMA-IR (MD: −0.30; 95% CI: −0.92 to 0.32; p =0.35), Triglycerides (MD: −0.20; 95% CI: −0.30 to −0.11; p < 0.00001) were lower in patients treated with GLP1a compared with placebo. Most patients who discontinued the trials did so because of a nausea side effect. Conclusion: The utilization of GLP1a demonstrates efficacy in reducing body mass index (BMI), triglycerides, waist circumference, total testosterone, total cholesterol, and HOMA-IR. These results signify its viability as a favorable treatment option for managing PCOS in obese females. Presentation: 6/3/2024

12270 Adolescent PCOS With Unexpected, Sudden-onset GAD And MDD: A Call For Vigilance In Longitudinal PCOS Care

Abstract Disclosure: K.I. Sarkisian: None. T. Aliabadi: None. F.Z. Stanczyk: None. Background: Polycystic Ovary Syndrome (PCOS) is a multifaceted endocrine disorder often associated with psychiatric disorders, yet the integration of psychiatric monitoring and multidisciplinary care following diagnosis remains understated as a guideline of clinical management of PCOS post-diagnosis. Historically, psychiatric comorbidities in PCOS have been attributed to social and personal factors such as self-image and self-esteem. However, the present patient’s denial of thoughts of disordered eating and lack of self-esteem related to acne or hirsutism challenges these assumptions.Clinical Case: A 13-year-old girl presented with classic symptoms of PCOS, including hirsutism, irregular and painful periods, and premature adrenarche. Laboratory investigations revealed an elevated total testosterone level (58 ng/dL, normal<38 ng/dL), consistent with PCOS. Previously, the patient had not expressed any concerns about mood. However psychological symptoms emerged alongside the physical symptoms. A psychological assessment performed by a licensed therapist revealed moderate-to-severe generalized anxiety disorder (GAD), which had rapidly worsened in a matter of weeks. Both the patient and the patient’s parents denied prior symptoms of moderate-to-severe anxiety before the onset of PCOS symptoms. Over the course of follow-up spanning 47 months, the patient documented symptoms, tracking both mood and PCOS fluctuations. During the follow-up period, the patient’s mood worsened, leading to the formal diagnosis of Major Depressive Disorder (MDD), despite a low assessed risk, no family history, and no symptoms prior to her PCOS development. The diagnoses of GAD and MDD were later confirmed through neuropsychiatric testing by a licensed psychologist.Clinical Lessons: While this presentation may not be considered novel in the context of PCOS, its overwhelming prevalence underscores the need for heightened awareness and research on the topic. The patient, previously considered low-risk for psychiatric conditions, experienced an unexpected onset of GAD and MDD concurrently with the diagnosis of PCOS. It is imperative to recognize that PCOS patients defy the conventional categorization of ‘healthy’ individuals concerning psychiatric care. This notion holds significance not only in clinical practice but also in research endeavors. Merely attributing psychiatric comorbidities in PCOS patients to social factors overlooks the unforeseen presentations of psychiatric disorders, as demonstrated in this patient. These manifestations cannot be solely attributed to social aspects of identity-insecurity, emphasizing the need for a more nuanced, proactive approach to psychiatric care in PCOS. This is crucial for achieving the best long-term prognosis and quality of life in affected individuals. Presentation: 6/1/2024

Efficacy of WeChat-Based Digital Intervention Versus Metformin in Women With Polycystic Ovary Syndrome: Randomized Controlled Trial.

The first-line treatment for polycystic ovary syndrome (PCOS) is lifestyle modification. However, it is currently unknown whether digital medicine can assist patients with PCOS in maintaining a healthy lifestyle while alleviating PCOS symptoms. This study aims to evaluate the efficacy of WeChat-based digital intervention versus metformin treatment in women with PCOS and insulin resistance. A total of 80 women with PCOS and insulin resistance were recruited from an endocrinology clinic and randomly assigned to receive either a WeChat-based digital intervention (n=40, 50%) or metformin (n=40, 50%) for 12 weeks. The WeChat-based digital intervention consisted of 3 modules; a coach assisted the patients in using the intervention. The primary outcome was the change in a homeostatic model assessment for insulin resistance. At baseline and after the 12-week intervention, anthropometric parameters, menstruation frequency, sex hormone levels, metabolic factors, and body fat distribution were measured in the clinic. Furthermore, self-assessed web-based questionnaires on diet, exercise, sleep, anxiety, and depression were obtained. A total of 72 participants completed the follow-up (for a 90% follow-up rate), including 35 of 40 (88%) participants from the digital intervention group and 37 of 40 (93%) participants from the metformin group. The homeostatic model assessment for insulin resistance in the digital intervention group was significantly improved after 12 weeks of treatment with a mean change of -0.93 (95% CI -1.64 to -0.23), but no statistical difference was observed between the groups (least squares mean difference -0.20; 95% CI -0.98 to 0.58; P=.62). Both digital intervention and metformin treatment significantly improved menstruation frequency (digital intervention: P<.001; metformin: P<.001) and reduced body weight (digital intervention: P<.001; metformin: P<.001) and total fat mass (digital intervention: P<.001; metformin: P<.001). Furthermore, the digital intervention had a significant advantage over metformin in improving waist circumference (least squares mean difference -1.84; 95% CI -3.44 to -0.24; P=.03), waist-to-hip ratio (least squares mean difference -0.02; 95% CI -0.03 to 0.00; P=.03), total fat mass (least squares mean difference -1.59; 95% CI -2.88 to -0.30; P=.02), and dehydroepiandrosterone sulfate (least squares mean difference -69.73; 95% CI -129.70 to -9.75; P=.02). In terms of safety, the main adverse events were sensations of hunger in the digital intervention group (2/40, 5%) and gastrointestinal adverse events in the metformin group (12/40, 30%). Our data suggest that digital intervention is an effective treatment option for patients with PCOS, with an efficacy comparable to that of metformin, and that it can also alleviate the negative effects of medications and make it easier and more efficient to adhere to lifestyle treatments. WeChat-based digital interventions have the potential to provide a new path for the improvement and health of women with PCOS in China. ClinicalTrials.gov NCT05386706; https://clinicaltrials.gov/study/NCT05386706.

Optimized polycystic ovarian disease prognosis and classification using AI based computational approaches on multi-modality data

Polycystic Ovarian Disease or Polycystic Ovary Syndrome (PCOS) is becoming increasingly communal among women, owing to poor lifestyle choices. According to the research conducted by National Institutes of Health, it has been observe that PCOS, an endocrine condition common in women of childbearing age, has become a significant contributing factor to infertility. Ovarian abnormalities brought on by PCOS carry a high risk of miscarriage, infertility, cardiac problems, diabetes, uterine cancer, etc. Ovarian cysts, obesity, menstrual irregularities, elevated amounts of male hormones, acne vulgaris, hair loss, and hirsutism are some of the symptoms of PCOS. It is not easy to determine PCOS because of its different combinations of symptoms in different women and various criteria needed for diagnosis. Taking biochemical tests and ovary scanning is a time-consuming process and the financial expenses have become a hardship to the patients. Thus, early prognosis of PCOS is crucial to avoid infertility. The goal of the proposed work is to analyse PCOS symptoms based on clinical data for early diagnosis and to classify into PCOS affected or not. To achieve this objective, clinical features dataset and ultrasound imaging dataset from Kaggle is utilized. Initially 541 instances of 45 clinical features such as testosterone, hirsutism, family history, BMI, fast food, menstrual disorder, risk etc. are considered and correlation-based feature extraction method is applied to this dataset which results in 17 features. The extracted features are applied to various machine learning algorithms such as Logistic Regression, Naïve Bayes and Support Vector Machine. The performance of each method is evaluated based on accuracy, precision, recall, F1-score and the result shows that among three models, Support Vector Machine model achieved high accuracy of 94.44%. In addition to this, 3856 ultrasound images are analysed by CNN based deep learning algorithm and VGG16 transfer learning algorithm. The performance of these models is evaluated using training accuracy, loss and validation accuracy, loss and the result depicts that VGG16 outperforms than CNN model with validation accuracy of 98.29%.

Effect of Choline Inositol and Metformin Combination Versus Metformin Alone on Ovarian Activities in PCOS Iraqi Women: A Cross Sectional Study

Abstract: Polycystic ovary syndrome (PCOS) is a predominant endocrine sickness disturbing females. It is marked via unequal menstrual cycles, hyper-androgenism, and polycystic ovarian morphology. Furthermore, PCOS is linked to several health issues, including insulin resistance and metabolic syndrome. PCOS management encompasses a range of strategies and treatments. Medications acting on hormones, including insulin sensitizers such as inositol and metformin, are commonly used to treat PCOS symptoms. Also choline is other potential therapies that could improve reproductive health. It has been suggested to be beneficial in various aspects of fertility, including endocrine disorders like polycystic ovarian syndrome (PCOS). Aim of the study: The current study aims to determine the effect of choline inositol and metformin combination versus metformin alone on ovarian. Materials and methods: This study was performed at the Maternity and Paediatrics Teaching Hospital in ALdiwaniyah Province, Iraq. The study involved a total of (150) patients at (18- &lt;40) years. A gynecologist uses Rotterdam criteria and ultrasound ovarian morphology in the selection of PCOS patients. The study consisted of several groups: G1 is a thirty women had received oral Metformin 500 mg bid during meal for last three months and served as metformin group. G2 is a thirty women had received choline inositol supplement 500/500 mg per- oral twice daily for last three months and served as the choline inositol supplement group. G3 is a thirty women had received choline inositol and metformin combination, they received with the same above dose for last three months and served as the choline inositol and metformin combination group . G4 is a thirty women who have not received any treatment for PCOS and served as new diagnosis PCOS group. Finally G5 is a thirty healthy women control group (control group). Characteristics included body mass index, type of period (regular, irregular ,amenorrhea ) were evaluated for all the participants. Furthermore, follicle and ovary volume were measured for all women .Additionally, serum hormonal levels [prolactin, (FSH), (LH), (TSH)], test were done. Results: There was no important alteration in the mean age, TSH and prolactin among the five groups. The results showed that metformin had significantly lowered in BMI but the addition choline inositol to metformin showed more significantly lowering in BMI but new PCOS group had higher significant BMI than other groups followed by choline inositol group. Rate of amenorrhea and rate of cycle irregularity stayed considerably upper in metformin grouping paralleled to choline inositol and choline inositol + metformin combination groups but this rate was more significantly higher in new PCOS compared to other groups. Metformin had significantly higher LH level compared to other groups but choline inositol + metformin and choline inositol groups had significantly lower LH level and there were no significance in the mean of LH between Choline inositol + metformin and choline inositol groups. Moreover, choline inositol + metformin group showed more significant FSH normal followed by metformin and new PCOS then by choline inositol and lastly control group. Choline inositol followed by metformin showed a significance in the mean of follicle and ovary volume but when adding choline inositol to metformin it showed more significant improvement in follicle and ovary volume ,so positive pregnancy was only seen in choline inositol + metformin as compared to other groups.

The Association Between Lifestyle and Symptoms of Polycystic Ovary Syndrome: A Study Conducted on Taif University Medical Students.

Introduction Polycystic ovary syndrome (PCOS) is a common endocrinological disorder affecting millions of women worldwide, often leading to significant physiological and psychological challenges among medical students because of unhealthy lifestyle behaviors. Methods A cross-sectional study was conducted among female medical students at Taif University in Saudi Arabia in January 2024 using an online questionnaire distributed via a Google form. Results Out of 243 participants, 23 students (9.5%) were diagnosed with PCOS. One hundred and fifty-six (64.9%) of females experienced skin symptoms, including acne and oily skin, mostly during exam periods. More than half (n=131, 54.4%) had generalized anxiety, and 42 students (17.4%) reported delays in the menstrual cycle. Significant associations were found between being diagnosed with PCOS and experiencing generalized anxiety(p=0.020), irregular menstrual cycles (p=0.004), having diabetes (p=0.006), family history of PCOS (p=0.001), and being aware of PCOS and lifestyle relation (p=0.022). Conclusion The study findings showed that Taif University medical students do not exhibit a noticeably increased prevalence of PCOS. Still, most students are at risk of developing PCOS due to thepositive family history of PCOS andexcessive generalized anxiety and females with irregularity in the menstrual cycle and those who have diabetes.

Leveraging genomic-based machine learning to discover bioactive molecules that alleviate symptoms of polycystic ovary syndrome

Leveraging genomic-based machine learning to discover bioactive molecules that alleviate symptoms of polycystic ovary syndrome

Exploring the benefits of astaxanthin as a functional food ingredient: Its effects on oxidative stress and reproductive outcomes in women with PCOS - A systematic review and single-arm meta-analysis of randomized clinical trials.

Polycystic ovary syndrome (PCOS) is a prevalent gynecological-endocrinological disorder characterized by hyperandrogenism, menstrual irregularities, and metabolic disturbances. Recent research has highlighted the role of oxidative stress and chronic inflammation in exacerbating PCOS symptoms and impeding reproductive outcomes. Astaxanthin, a potent antioxidant found in marine organisms, has been suggested as a potential therapeutic intervention due to its ability to reduce oxidative stress and inflammation. This meta-analysis systematically reviews randomized controlled trials assessing the impact of astaxanthin supplementation on oxidative stress and reproductive outcomes in women with PCOS. Data from four trials were analyzed, focusing on markers of oxidative stress and reproductive health metrics. The meta-analysis utilized fixed and random-effects models to synthesize results, with heterogeneity assessed using Chi-square and I2 statistics. The findings indicate that while astaxanthin significantly improves markers of total antioxidant capacity (TAC) in follicular fluid, it does not show a consistent effect on other oxidative stress biomarkers such as malondialdehyde (MDA), catalase (CAT), or superoxide dismutase (SOD). Reproductive outcomes, including oocyte quality and the number of high-quality embryos, showed moderate improvements, although effects on fertilization rates and pregnancy outcomes were insignificant. The analysis highlights variability in study designs and dosing, suggesting a need for further research with standardized protocols and larger sample sizes. Future studies should focus on determining optimal dosing, exploring mechanistic pathways, and investigating the combined effects of astaxanthin with other interventions. Longitudinal studies are needed to assess long-term benefits and safety, and personalized approaches could enhance treatment efficacy for individualswithPCOS.