Symptoms Of Polycystic Ovary Syndrome Research Articles

Polycystic ovary syndrome (PCOS) presents as a multimorbid condition by age 50-birth cohort linkage to national register data.

This population-based follow-up study investigated register-based disease diagnoses and medication use up till age of 50 years among women with polycystic ovary syndrome (PCOS) that were identified from a population-based birth cohort. Population-based longitudinal cohort study. Women reporting oligo/amenorrhea and hirsutism at age 31 and/or who were diagnosed with PCOS by a physician by age 46 (n = 244) and women without PCOS symptoms or diagnosis (n = 1 556) in the Northern Finland Birth Cohort 1966. National register data on diagnosed diseases (ICD-8-10) and medication use (ATC) until the age of 50. Women with PCOS had a 26% higher risk for any registered diagnosis (RR: 1.26 [1.09-1.46]) and a 24% higher risk for medication use (RR: 1.24 [1.05-1.46]) compared to non-PCOS women, even after adjusting for several confounders. Several main ICD categories were more prevalent among women with PCOS versus non-PCOS controls, e.g., endocrine, metabolic, nervous system, musculoskeletal and genitourinary diseases in addition with different symptoms and injuries. Surprisingly, even though the overall morbidity was only increased in women with PCOS with a BMI ≥ 25gk/m2, there were several ICD main categories that showed higher comorbidity risk especially in women with PCOS with a BMI <25 kg/m2. Several medications were prescribed more often to women with PCOS versus non-PCOS controls, e.g., medications related to the alimentary tract and metabolism, the cardiovascular system, genito-urinary system drugs and sex hormones, dermatologic and hormonal preparations, and medications to treat the musculoskeletal, nervous, and respiratory systems. Women with PCOS are burdened with multimorbidity and higher medication use, independent of BMI and other confounders. Accordingly, preventive strategies are needed to alleviate the disease burden and improve the health outcomes of women with PCOS.

Luteolin and its analog luteolin-7-methylether from Leonurus japonicus Houtt suppress aromatase-mediated estrogen biosynthesis to alleviate polycystic ovary syndrome by the inhibition of tumor progression locus 2

Ethnopharmacological relevanceLeonurus japonicus Houtt (L. japonicus, Chinese motherwort), known as Yi Mu Cao which means “good for women”, has long been widely used in China and other Asian countries to alleviate gynecological disorders, often characterized by estrogen dysregulation. It has been used for the treatment of polycystic ovary syndrome (PCOS), a common endocrine disorder in women but the underlying mechanism remains unknown. Aim of the studyThe present study was designed to investigate the effect and mechanism of flavonoid luteolin and its analog luteolin-7-methylether contained in L. japonicus on aromatase, a rate-limiting enzyme that catalyzes the conversion of androgens to estrogens and a drug target to induce ovulation in PCOS patients. Materials and methodsEstrogen biosynthesis in human ovarian granulosa cells was examined using ELISA. Western blots were used to explore the signaling pathways in the regulation of aromatase expression. Transcriptomic analysis was conducted to elucidate the potential mechanisms of action of compounds. Finally, animal models were used to assess the therapeutic potential of these compounds in PCOS. ResultsLuteolin potently inhibited estrogen biosynthesis in human ovarian granulosa cells stimulated by follicle-stimulating hormone. This effect was achieved by decreasing cAMP response element-binding protein (CREB)-mediated expression of aromatase. Mechanistically, luteolin and luteolin-7-methylether targeted tumor progression locus 2 (TPL2) to suppress mitogen-activated protein kinase 3/6 (MKK3/6)-p38 MAPK-CREB pathway signaling. Transcriptional analysis showed that these compounds regulated the expression of different genes, with the MAPK signaling pathway being the most significantly affected. Furthermore, luteolin and luteolin-7-methylether effectively alleviated the symptoms of PCOS in mice. ConclusionsThis study demonstrates a previously unrecognized role of TPL2 in estrogen biosynthesis and suggests that luteolin and luteolin-7-methylether have potential as novel therapeutic agents for the treatment of PCOS. The results provide a foundation for further development of these compounds as effective and safe therapies for women with PCOS.

High Fructose Diet (HFrD) Induced Hepatic Insulin Resistance Is Not Present in Liver Androgen Receptor Knockout (LivARKO) Male Mice

Background: Hyperandrogenism (HA), a common symptom of polycystic ovary syndrome (PCOS), involves action of the androgen receptor (AR) and can induce insulin resistance among 35-80% of PCOS women (PMID 35432749: Amisi 2022). The liver plays an essential role in the metabolism of insulin and androgen signaling. HA has been shown to increase insulin resistance in women and female mice. Previous studies have suggested that knocking out liver AR can lead to improvements in metabolic and reproductive functions of PCOS (PMID 34547140: Andrisse 2021). Hypothesis: We hypothesized that liver androgen receptor knockout (LivARKO) mice on a high fructose diet would exhibit increased insulin resistance compared to controls, as measured by expression of phospho-Akt (p-Akt) and phospho-FoxO1 (p-foxo1), proteins involved in insulin signaling. Methods: LivARKO mice were divided into groups based on an assigned diet (Control or High Fructose; Con, Research Diets Inc, RDI D12450J, Protein (20%), Carbs (70%, corn starch-50%, sucrose-maldextrin-20%, fructose-0%), Fat 10% (lard)) and High Fructose (HFrD, RDI D02022704, Protein (20%), Carbs (70%, corn starch-9%, sucrose-maldextrin-1%, fructose-60%), Fat 10% (lard)). The mice were sacrificed and liver tissue samples were extracted for western blotting analysis examining p-Akt S473 and p-foxo1 S256 levels. Results: LivARKO male mice fed the control diet for one month displayed a significant increase in p-AKT expression when stimulated with insulin compared to basal controls. Similarly, LivARKO male mice fed the high fructose diet for one month displayed a significant increase in p-AKT expression when stimulated with insulin compared to basal mice on the same diet. After one month, LivARKO male mice on a control diet stimulated with insulin displayed significantly decreased p-Foxo1 expression compared to non-stimulated basal control. A similar trend was seen between basal and insulin-stimulated groups in the LivARKO-HFrD male mice, though this trend was not significant. Discussion: These findings suggested that the HFrD did not induce hepatic insulin resistance in LivARKO male mice. Here, we observed a similar pattern of increased insulin stimulated p-AKT to what is seen in WT mice on a chow diet (PMCID PMC3296881: Lu 2012); and this suggested that LivARKO did not disrupt insulin signaling in the liver of male mice when fed a control diet, which was similar to what was seen previously (DOI: 10.1002/hep.22252, Lin 2008, insulin increased PI3K activity in chow diet LivARKO male mice). Our data suggested that the HFrD induced hepatic insulin resistance seen in some WT models (such as PMCID PMC3131094: Nagai 2009) is not present in LivARKO male mice.This also suggested that unlike HFD, HFrD did not cause insulin resistance in LivARKO male mice. These results illuminate LivARKO as a potential therapeutic target for insulin resistance. This project was supported by the following grants to Dr. Stanley Andrisse. (1) NIH 1R01DK126892; (2) NIH 1T34GM142610; and (3) NSF 1931045. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Therapeutic effects of Artocarpus communis J.R.Forst. & G.Forst. Seeds on Letrozole-induced Polycystic Ovary Syndrome Wistar rats

BackgroundHerbal extracts are an effective treatment for polycystic ovarian syndrome (PCOS) and have been shown to improve insulin resistance, hyperandrogenism, sex hormones, ovulation, and PCOS symptoms. Artocarpus communis seed's potential effects on polycystic ovary syndrome (PCOS) have not been studied. PurposeThis research aims to investigate the beneficial effects of Artocarpus communis seeds on PCOS induced by letrozole in Wistar rats. MethodsTo induce PCOS, female Wistar rats weighing between 160g to 250g were administered letrozole (1 mg/kg) for 21 days. Subsequently, for 12 days, the rats were given the Artocarpus communis seed methanol extract, and its hexane, DCM, ethyl acetate and aqueous fractions (100 mg/kg body weight) and Clomiphene citrate (1 mg/kg body weight), a standard medication. Luteinizing hormone (LH), follicle-stimulating hormone (FSH), and estradiol levels were assessed using ELISA, and the expression of P53, insulin receptor substrate (IRS), type 2 17-HSD (17-HSD), fat mass and obesity-associated (FTO), and 11a-hydroxylase/17,20-desmolase (CYP11a) genes were investigated. The data were analyzed using one-way ANOVA, and a significance threshold of p<0.05 was set for Dunnett's Multiple Comparison Test. ResultsAdministration of the methanol extract of Artocarpus communis seed and its Hexane fraction led to a decrease in LH level and an increase in FSH and estradiol levels in the PCOS-induced animals. Furthermore, methanol extract, DCM, and ethyl acetate fraction normalize the expression of P53, insulin receptor substrate (IRS), type 2 17-HSD (17-HSD), fat mass and obesity-associated (FTO), and 11a-hydroxylase/17,20-desmolase (CYP11a) genes in PCOS rats cervix. ConclusionArtocarpus communis seed exhibited ameliorative effects on polycystic ovary conditions in Wistar rats, suggesting its potential use in the management of PCOS.

Patient Experiences With Dismissal, Delay, and Uncertainty in Diagnosis of Polycystic Ovary Syndrome [ID 2683465

INTRODUCTION: Polycystic ovary syndrome (PCOS) affects approximately 10% of females and is underdiagnosed, undertreated, and underresearched. A majority of people with PCOS report dissatisfaction with their care experiences. We conducted focus groups to identify factors contributing to suboptimal PCOS care. METHODS: We conducted 60- to 90-minute virtual focus groups. Patients receiving PCOS care at a university hospital obstetrics and gynecology clinic were recruited. Participants were asked about PCOS symptoms and experiences of care. Rapid qualitative analysis was performed to identify major themes. RESULTS: Twenty-four participants completed focus groups. Three identified as any non-White race and eight as Hispanic or Latino; median age was 29 years. Participants' most bothersome symptoms were menstrual irregularity, unwanted hair, cystic acne, and pelvic pain. Time from symptom onset to diagnosis ranged from 2 months to 13 years. Providers’ dismissal of symptoms and failure to perform diagnostic testing contributed to diagnostic delays. Once diagnosed, participants reported feeling confused, overwhelmed, and fearful, and received little education from providers. Participants desired more information about treatment options and implications of PCOS on fertility and long-term health. Regarding initial treatment, recommendations for weight loss and prescriptions for oral contraceptives, metformin, and spironolactone were common. Referrals to nutrition and behavioral health services were rare and non-existent, respectively. Treatments focused on individual manifestations of PCOS more often than comprehensive well-being. CONCLUSION: Dismissal of symptoms, delays in diagnosis, and uncertainty about future health are common patient experiences in PCOS care. Our findings identify a need for improved patient resources and provider education about PCOS manifestations, diagnosis, and treatments.

Benefits of yoga on women with Polycystic Ovarian Syndrome (PCOS)

Polycystic ovary syndrome (PCOS) is a hormonal imbalance that occurs when the ovaries produce and release eggs creating excess hormones. Affected women range in age from 6% to 20%, depending on the diagnostic criteria. Hyperandrogenism and persistent anovulation are two characteristics of the complex condition known as polycystic ovarian syndrome (PCOS). Treatment for PCOS involves lifestyle modifications, education, and symptom-specific therapies for both individuals at risk and those with a confirmed diagnosis. Exercise and dietary changes have long been seen as the cornerstones of managing lifestyle diseases. Yoga is an age-old discipline that aims to balance a person's mental, emotional, physical, and spiritual aspects. Yoga can improve one's physical and mental well-being, making them feel better overall. Several research studies have demonstrated the beneficial effects of yoga in PCOS control. Regular yoga practice has been demonstrated to ease the symptoms of PCOS and decrease testosterone levels, also promoting relaxation. The present paper is intended to bring a thematic insight into the problem related to PCOD and the impact of yoga among the patients of PCOD.

Association between mild depressive states in polycystic ovary syndrome and an unhealthy lifestyle.

Polycystic Ovary Syndrome (PCOS) is a prevalent and frequently encountered gynecological disorder. Its high variability and the complexities associated with its management often lead to psychological stress in affected women, manifesting in symptoms of depression. Embracing a healthy lifestyle is fundamental in PCOS treatment. Consistent adherence to a healthy lifestyle not only aids in improving PCOS symptoms but also plays a role in enhancing mental well-being. However, there is currently limited research examining the extent of depression, its prevalence, and its correlation with lifestyle among individuals with PCOS. Therefore, this study aims to explore the impact of lifestyle factors on the depressive state of individuals with PCOS. This cross-sectional study gathered data from 411 individuals with PCOS at a comprehensive hospital in Henan, China. Depression status was assessed using the Hamilton Depression Scale, and demographic information as well as lifestyle habits were simultaneously collected. Univariate and multivariate analyses using logistic regression were conducted to identify risk factors associated with the depressive state in PCOS. Among the surveyed 411 individuals with PCOS, approximately 49.4% exhibited symptoms of depression, with 83.7% experiencing mild depressive symptoms. A disease duration of 1-3 years, the presence of acne, and unhealthy lifestyle factors such as high-fat diet, staying up late, lack of exercise, and mental stress emerged as significant risk factors for the onset of depressive symptoms. Depressive symptoms in individuals with PCOS are predominantly mild. The risk of comorbid depression in PCOS is associated with the presence of acne, frequent high-fat diet, regular staying up late, lack of exercise, and mental stress.

Evaluating the therapeutic potential of moxibustion on polycystic ovary syndrome: a rat model study on gut microbiota and metabolite interaction.

Polycystic ovary syndrome (PCOS) is a common systemic disorder related to endocrine disorders, affecting the fertility of women of childbearing age. It is associated with glucose and lipid metabolism disorders, altered gut microbiota, and insulin resistance. Modern treatments like pioglitazone, metformin, and spironolactone target specific symptoms of PCOS, while in Chinese medicine, moxibustion is a common treatment. This study explores moxibustion's impact on PCOS by establishing a dehydroepiandrosterone (DHEA)-induced PCOS rat model. Thirty-six specific pathogen-free female Sprague-Dawley rats were divided into four groups: a normal control group (CTRL), a PCOS model group (PCOS), a moxibustion treatment group (MBT), and a metformin treatment group (MET). The MBT rats received moxibustion, and the MET rats underwent metformin gavage for two weeks. We evaluated ovarian tissue changes, serum testosterone, fasting blood glucose (FBG), and fasting insulin levels. Additionally, we calculated the insulin sensitivity index (ISI) and the homeostasis model assessment of insulin resistance index (HOMA-IR). We used 16S rDNA sequencing for assessing the gut microbiota, 1H NMR spectroscopy for evaluating metabolic changes, and Spearman correlation analysis for investigating the associations between metabolites and gut microbiota composition. The results indicate that moxibustion therapy significantly ameliorated ovarian dysfunction and insulin resistance in DHEA-induced PCOS rats. We observed marked differences in the composition of gut microbiota and the spectrum of fecal metabolic products between CTRL and PCOS rats. Intriguingly, following moxibustion intervention, these differences were largely diminished, demonstrating the regulatory effect of moxibustion on gut microbiota. Specifically, moxibustion altered the gut microbiota by increasing the abundance of UCG-005 and Turicibacter, as well as decreasing the abundance of Desulfovibrio. Concurrently, we also noted that moxibustion promoted an increase in levels of short-chain fatty acids (including acetate, propionate, and butyrate) associated with the gut microbiota of PCOS rats, further emphasizing its positive impact on gut microbes. Additionally, moxibustion also exhibited effects in lowering FBG, testosterone, and fasting insulin levels, which are key biochemical indicators associated with PCOS and insulin resistance. Therefore, these findings suggest that moxibustion could alleviate DHEA-induced PCOS by regulating metabolic levels, restoring balance in gut microbiota, and modulating interactions between gut microbiota and host metabolites.

The use of an Internet resource in young people to identify female students at risk for polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a polygenic endocrine disorder caused by both genetic and epigenetic factors. Depending on the period of a woman’s life, the clinical picture, diagnosis, and treatment tactics of the disease are different. The syndrome has a set of reproductive, metabolic, and psychological features. Objective. To study the prevalence of PCOS among female students and to evaluate the effectiveness of using Internet platforms in identifying the manifestations that characterize reproductive health disorders. Subjects and methods. A total of 330 respondents studying in the higher educational establishments of Khabarovsk were interviewed using the Google Forms platform in October to December 2021 in order to identify whether they had irregular menstruation, hyperandrogenism, which was followed by an examination and verification of the diagnosis of PCOS in an outpatient setting. Results. According to the survey results, 87.58% of the respondents did not plan pregnancy in the next 2 years, so infertility as one of the PCOS symptoms did not cause anxiety in them. According to the survey among the female students with an irregular menstrual cycle, the incidence rate of PCOS was 24.7%. Conclusion. In our opinion, the active detection of PCOS in patients with an irregular menstrual cycle among young people using Internet resources allows them to focus their attention on reproductive health disorders and on the need to consult a gynecologist.

Exploring the Antioxidative Effects of Ginger and Cinnamon: A Comprehensive Review of Evidence and Molecular Mechanisms Involved in Polycystic Ovary Syndrome (PCOS) and Other Oxidative Stress-Related Disorders.

Oxidative stress represents the pathophysiological basis for most disorders, including reproductive issues. Polycystic ovary syndrome (PCOS) is heterogeneous endocrine disorder of women characterized primarily by irregular menstrual cycles, hyper-androgenism, and ovulatory dysfunction. In the last decades, PCOS was recognized as a systemic silent inflammation and an oxidative disturbance-related disorder, exerting multifaceted symptoms, including metabolic. PCOS treatment should involve a personalized approach tailored to individual symptoms; however, the results are often unsatisfactory. Various supplementary treatments have been proposed to assist in the management and alleviation of PCOS symptoms. Cinnamon and ginger, known for millennia as herbs used in spices or traditional medicine for the treatment of various diseases, are of interest in this study. The aim of this study is to evaluate and investigate the effects of cinnamon and ginger in PCOS patients. Using relevant keywords we searched through PubMed/MEDLINE, Science Direct, Google Scholar and Web of science to find animal studies, pre-clinical, and clinical studies which were then reviewed for usage. Out of all of the reviewed studies a total of 65 studies were included in this review article. Cinnamon and ginger can affect hormonal status, lipid profile, obesity, and insulin resistance by mitigating oxidative stress and inflammation. Generally, based on current clinical evidence, it was revealed that supplementation with cinnamon or ginger had a useful impact in patients with PCOS. This review summarizes the antioxidative effects of ginger and cinnamon in PCOS treatment, highlighting their potential benefits in other oxidative stress-related pathologies.

Activity of isoflavone in managing polycystic ovary syndrome symptoms (Review).

Polycystic ovary syndrome (PCOS), a hormonal and metabolic disorder manifested in women of reproductive age, is still being treated using drugs with side effects. As an alternative to these drugs, isoflavone, also identified as phytoestrogen, has anti-PCOS activity. Isoflavone can help relieve PCOS symptoms by lowering the level of testosterone, which causes hyperandrogenism, thereby normalizing the menstrual cycle and restoring normal ovarian morphology. Furthermore, isoflavone influences the improvement of the metabolic profile, which changes because of PCOS, as well as the reduction of inflammatory markers and oxidative stress. However, both significant and non-significant results have been generated on the activity of isoflavones in PCOS. The present review aims to discuss the existing literature on the effect of isoflavone on PCOS symptoms based on in vivo and clinical trial studies.

Dietary Habits and their Impact on Physical Symptoms Severity in Young Females Diagnosed with PCOS

Polycystic Ovary Syndrome (PCOS) is characterized as chronic anovulation or oligo-menorrhoea and clinical hyper-androgenism. It involves excessive Gonadotrophin releasing hormone (GnRH) leading to over-production of luteinizing hormone (LH). Advanced glycation end products (AGEs) are formed as a result of consuming thermally processed and highly modified foods in body. AGEs are expressed as pro- inflammatory receptors and their production is exaggerated in women with PCOS. The purpose of this to check whether unhealthy dietary habitsresult in increased severity of physical symptoms of PCOS in diagnosed females. And to determine the importance of diet in dealing with PCOS. Cross-sectional study was conducted on a sample size of 45 participants (n=45) diagnosed with PCOS. For statistical analysis, SPSS was used and the values of Pearson’s Correlation Coefficient were used to identify the correlation between severity of symptoms and poor dietary habits. The results of our study ranged from weak to moderate which demonstrates that there is a correlation between severity of physical symptoms of PCOS and poor dietary habits. The results of the findings of this study stand true to the hypothesis that there is a correlation between severity of physical symptoms andpoor dietary habits.

Psychological symptoms and brain activity alterations in women with PCOS and their relation to the reduced quality of life: a narrative review.

Polycystic ovary syndrome (PCOS) is the most common feminine endocrine disorder, characterized by androgen excess, ovulatory dysfunction, and polycystic ovarian morphology. The negative impact of symptoms on the quality of life (QoL) of patients is still not clear. The present review aimed at studying the impact of the symptoms, the psychological symptoms, and brain alterations in women with PCOS. A systematic search was undertaken for studies that assessed the impact of PCOS symptoms on QoL, psychological symptoms, and brain alterations in PCOS patients. Most of the information about QoL came from psychometric studies, which used culture-based questionnaires. Alterations of sleep quality, body image, and mood disorders can negatively affect the QoL of the patients. Sexual satisfaction and desire were affected by PCOS. Brain imaging studies showed functional alterations that are associated with impairments of visuospatial working memory, episodic and verbal memory, attention, and executive function. Several factors can negatively influence the quality of life of the patients, and they are directly related to hyperandrogenism and the risk of infertility.In particular, obesity, hirsutism, acne, and the fear of infertility can have a direct impact on self-esteem and sexual function. Metabolic and psychiatric comorbidities, such as mood, anxiety, and eating disorders, can affect the well-being of the patients. Moreover, specific cognitive alterations, such as impairments in attention and memory, can limit PCOS patients in a series of aspects of daily life.

Liraglutide Improves PCOS Symptoms in Rats by Targeting FDX1.

Polycystic ovary syndrome (PCOS) is a gynecological endocrine disorder characterized by ovulatory disorders, hyperandrogenemia, and polycystic changes in the ovaries. FDX1 is a ferredoxin-reducing protein on human mitochondria that plays an important role in steroid anabolism. Liraglutide, a glucagon-like peptide-1 receptor agonist (GLP-1RA), has recently emerged as a potential therapeutic agent for PCOS. Recent studies have suggested that FDX1 may be associated with the development of PCOS. This study aims to explore the pivotal role of FDX1 in the amelioration of PCOS through liraglutide intervention. A PCOS rat model was induced via subcutaneous DHEA injections. Following successful model establishment, the rats were treated with liraglutide combined with metformin, or with each drug individually, over a six-week period. After 6 weeks of treatment, we assessed changes in body weight, fasting blood glucose, sex hormone levels, estrous cycle regularity, ovarian morphology, FDX1 expression in ovarian tissue, and ovarian ROS levels. PCOS rats exhibited significant increases in body weight and fasting blood glucose levels, disrupted estrous cycles, and polycystic ovarian morphology. FDX1 expression was notably reduced in the ovarian tissues of PCOS rats. Treatment with liraglutide, both alone and in combination with metformin, led to improvements in body weight, fasting blood glucose, sex hormone balance, estrous cycle regularity, ovarian morphology, and ovarian ROS levels. Notably, FDX1 expression was significantly restored in all treatment groups, with the most substantial increase observed in the liraglutide-treated group. This study suggests that FDX1 could serve as a potential biomarker for elucidating the underlying mechanisms of liraglutide's therapeutic effects in PCOS management.

Mechanisms and Target Parameters in Relation to Polycystic Ovary Syndrome and Physical Exercise: Focus on the Master Triad of Hormonal Changes, Oxidative Stress, and Inflammation.

Polycystic ovary syndrome (PCOS) is a common endocrine disorder among females of reproductive age with heterogeneous prevalence. It is well known that female reproductive competence depends on the dynamic regulation of the hypothalamic-pituitary-gonadal (HPG) axis; therefore, disruption of this highly regulated system leads to fertility problems. Among disruptors, both oxidative stress and inflammation contribute to an increased LH-FSH ratio and a consequent hyperandrogenism. Shifts in this bidirectional interplay between the neuroendocrine system and oxidative/inflammatory homeostasis result in the accumulation of reactive oxygen/nitrogen species and inflammatory markers as well as alterations in antioxidant defense mechanisms. Evidence shows that lifestyle changes, including regular physical exercise, are recognized as the most effective first-line management to reduce the severity of PCOS symptoms. The aim of our narrative review is to provide insights into the mechanisms and target factors of PCOS-related hormonal changes, oxidative/antioxidant homeostasis, and inflammation, and to discuss the effects of exercise, which takes into account various factors, in relation to PCOS. A better understanding of the PCOS-associated hormonal changes, oxidative and inflammatory circuits, as well as exercise-induced mechanisms of action on those targets may improve the quality of life of women with PCOS.

Gut Microbiota and Polycystic Ovary Syndrome (PCOS): Understanding the Pathogenesis and the Role of Probiotics as a Therapeutic Strategy.

Polycystic ovary syndrome (PCOS) is one of the most common disorders among women in modern societies. A variety of factors can contribute to the development of PCOS. These women often exhibit high insulin resistance (IR), hyperandrogenism, irregular periods, and infertility. Dysbiosis of the gut microbiota (GMB) in women with PCOS has attracted the attention of many researchers. Porphyromonas spp., B. coprophilus, and F. prausnitzii are found in higher numbers in the gut of women with PCOS. Short-chain fatty acids (SCFAs), produced by the intestinal microbiota through fermentation, play an essential role in regulating metabolic activities and are helpful in reducing insulin resistance and improving PCOS symptoms. According to studies, the bacteria producing SCFAs in the gut of these women are less abundant than in healthy women. The effectiveness of using probiotic supplements has been proven to improve the condition of women with PCOS. Daily consumption of probiotics improves dysbiosis of the intestinal microbiome and increases the production of SCFAs.

Baicalein improves the symptoms of polycystic ovary syndrome by mitigating oxidative stress and ferroptosis in the ovary and gravid placenta

BackgroundPolycystic ovary syndrome is a metabolic and hormonal disorder that is closely linked to oxidative stress. Within individuals diagnosed with PCOS, changes occur in the ovaries, resulting in an excessive buildup of iron and peroxidation of lipids, both of which may be associated with the occurrence of ferroptosis. Baicalein, a flavonoid found in the roots of Scutellaria baicalensis and widely known as Chinese skullcap, is known for its anti-inflammatory and anti-ferroptotic properties, which protect against various diseases. Nevertheless, there has been no investigation into the impact of baicalein on polycystic ovary syndrome. PurposeThis study aimed to correlate ferroptosis with polycystic ovary syndrome and to assess the effects of baicalein on ovarian dysfunction and placental development in pregnant patients. Study design and methodsPolycystic ovary syndrome was induced in a rat model through the administration of dehydroepiandrosterone, and these rats were treated with baicalein. Oxidative stress and inflammation levels were assessed in serum and ovaries, and tissue samples were collected for histological and protein analyses. Furthermore, different groups of female rats were mated with male rats to observe pregnancy outcomes and tissue samples were obtained for histological, protein, and RNA sequencing. Then, RNA sequencing of the placenta was performed to determine the key genes involved in ferroptosis negative regulation (FNR) signatures. ResultsBaicalein was shown to reduce ovarian oxidative stress and pathology. Baicalein also ameliorated polycystic ovary syndrome by decreasing lipid peroxidation and chronic inflammation and modulating mitochondrial functions and ferroptosis in the ovaries. Specifically, glutathione peroxidase and ferritin heavy chain 1 were considerably downregulated in polycystic ovary syndrome gravid rats compared to their expression in the control group, and most of these differences were reversed after baicalein intervention. ConclusionsOur findings, initially, indicated that baicalein could potentially enhance the prognosis of individuals suffering from polycystic ovary syndrome by reducing oxidative stress and ferroptosis, thus potentially influencing the formulation of a therapeutic approach to address this condition.

Quality of Life of Women with Polycystic Ovary Syndrome.

Background and Objectives: Polycystic ovary syndrome (PCOS) is an endocrine disorder characterized by multiple hormonal and metabolic abnormalities, including insulin resistance, hyperandrogenism, and disturbances in lipid and carbohydrate metabolism. The objective of this study is to assess the quality of life of women diagnosed with polycystic ovary syndrome (PCOS) and to identify any factors within the study group that may impact the scores related to quality of life. Materials and Methods: This research was carried out among women diagnosed with PCOS. An original questionnaire, developed through an online Google Forms survey, was utilized as the research instrument and distributed through social networks and support groups to women facing PCOS. This study encompassed a participant pool of 200 women with PCOS, aged 24 years or older. For the analytical component, Pearson's χ2 test was employed-a nonparametric test designed to assess the relationship between two variables measured on a qualitative scale. The chosen level of statistical significance was set at p < 0.05. Results: The analysis revealed that the quality of life of the women under study was not linked to the duration of the disease or comorbidities. However, a significant association was observed with the inconvenience caused by PCOS symptoms. Women experiencing very bothersome symptoms of PCOS reported a lower quality of life compared to those with symptoms rated as not very bothersome. Despite the majority of women with PCOS rating their quality of life as good or very good, they often find the associated symptoms of PCOS bothersome. Women reporting lower quality of life tend to acknowledge the impact of PCOS on their lives, experience a sense of lack of control over the disease, struggle with depression, and do not accept their physical appearance. Conclusions: Hence, the support from specialists like endocrinologists, gynecologists, and nutritionists becomes crucial for many women dealing with PCOS. Adopting a healthy lifestyle, incorporating a balanced diet, and engaging in regular physical activity can assist in managing the troublesome symptoms of PCOS, thereby enhancing overall quality of life. In instances of emotional difficulties, seeking psychological support is equally important, and the significance of support and acceptance from loved ones should not be overlooked.

PCOS stratification for precision diagnostics and treatment.

Globally, polycystic ovarian syndrome (PCOS) affects approximately 10% of fertile women, leading to great health and economic burden. PCOS is a heterogenous illness that can cause infertility, irregular menstrual cycles, acne, and hirsutism, among other symptoms. The clinical diagnosis is primarily a diagnosis of exclusion if one or more of the three primary symptoms, namely, oligo- or anovulation, hyperandrogenism, and polycystic ovarian morphology, are present. Obesity and PCOS are often coexisting disorders that may be bidirectionally causally related. Phenotypic heterogeneity throughout the reproductive lifespan, such as the overlap of PCOS symptoms with regular fluctuations in a woman's menstrual cycle and metabolism during the menarche and menopausal transition, further complicates diagnosis. PCOS etiology is mostly unknown and complex, likely due to the fact that it is a group of disorders with overlapping metabolic and reproductive problems. Evidence-based, common, standardized guidelines for PCOS diagnosis and treatment are urgently needed. Genomics and clinical data from populations across diverse ages and ethnicities are urgently needed to build efficient machine learning models for the stratification of PCOS. PCOS subtype-specific strategies for early screening, an accurate diagnosis, and management throughout life will optimize healthcare resources and reduce unnecessary testing. This will pave the way for women to be able to take the best possible care of their own health using the latest clinical expertise combined with their unique needs and preferences.

Validation of an Anti-Müllerian Hormone Cutoff for Polycystic Ovarian Morphology in the Diagnosis of Polycystic Ovary Syndrome in the HARMONIA Study: Protocol for a Prospective, Noninterventional Study.

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women and is diagnosed using the Rotterdam criteria, including diagnosis of polycystic ovarian morphology (PCOM) by transvaginal ultrasound (TVUS). Due to high cost, availability, and the impact of the operator and ultrasound equipment on the reliability of the antral follicle count (AFC) by TVUS, an unmet need exists for a diagnostic test to determine PCOM without TVUS. A strong positive correlation between elevated anti-Müllerian hormone (AMH) levels and AFCs has been demonstrated in women with PCOS. In addition, recent updates to the international evidence-based PCOS guidelines state that serum AMH can be used as an alternative to TVUS-determined AFC, in the diagnosis of PCOM. The retrospective APHRODITE study derived and validated an AMH cutoff of 3.2 ng/mL for the Elecsys AMH Plus or Elecsys AMH assays (Roche) to diagnose PCOM in patients with PCOS. This study aims to further validate, in an independent prospective cohort, the AMH cutoff (3.2 ng/mL) for PCOM determination, which was previously derived and validated in the APHRODITE study. This large, prospective, multicenter, population-based, noninterventional study will evaluate the previously established AMH cutoff for the determination of PCOM during the diagnosis of PCOS using the Elecsys AMH Plus immunoassay in an independent population. Participants were women born between July 1985 and December 1987 in Northern Finland; the study partially links to the Northern Finland Birth Cohort 1986. We assessed the enrolled women, determined with the 2023 PCOS Guidelines, for current PCOS status and divided them by phenotype if positive. Each participant had 1 study visit to collect serum samples, record clinical data, and undergo a gynecological examination including TVUS. All data were collected by highly trained midwives or trained gynecologists. Sensitivity, specificity, and agreement measures were used to validate the previously determined cutoff in the whole population and in subpopulations based on phenotype and relevant demographic or clinical factors. The minimum target sample size was approximately 1800 women, including approximately 10% with PCOS. At the time of manuscript submission, participant recruitment had concluded, and 1803 women were enrolled into the study. Data collection is complete and biostatistical analysis is planned for 2023. To limit variability, there were few TVUS operators and only 2 TVUS machines of the same type. Additionally, all women who were taking oral contraceptives were excluded from the primary analysis population. Selection bias was limited as this was a population-based study and participants were not seeking treatment for PCOS symptoms. Validating the AMH cutoff in a large, population-based study will provide further evidence on the utility of the Elecsys AMH Plus or Elecsys AMH assays in PCOM diagnosis as an alternative to TVUS. Measuring AMH for PCOM diagnosis could reduce delayed or missed diagnoses due to operator-dependent TVUS examinations. ClinicalTrials.gov NCT05527353; http://tinyurl.com/2f3ffbdz. DERR1-10.2196/48854.