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Combined oral contraceptives: Why, when, where?

Introduction Polycystic ovary syndrome (PCOS), a multifactorial disorder, involves mainly reproductive but also other endocrine systems. Based on the current Rotterdam criteria, the prevalence of PCOS varies between 5% and 10% in women of reproductive age . Metabolic issues such as inflammation, increased coagulability, visceral obesity, insulin resistance, and excess androgen are considered as key features in PCOS . Combined oral contraceptives are hormonal medications that…

Targeting metabolism in the management of PCOS: Metformin and beyond

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder among reproductive-aged women characterized by clinical or biochemical hyperandrogenism, oligo-anovulation, and polycystic ovarian morphology. Women with PCOS have increased risk for obesity, insulin resistance (IR), impaired glucose tolerance, type 2 diabetes mellitus (T2D), dyslipidemia, hypertension and metabolic syndrome. Metabolic dysfunction is not only a complication of PCOS but also is involved in the pathogenesis of the…

Diet and exercise in the management of PCOS: Starting from the basics

Obesity, insulin resistance and metabolic syndrome in PCOS Overweight and obesity constitute a modern global pandemic, with rapidly growing rates both in developed and in developing areas of the world. Over the last half-century, the worldwide prevalence of obesity has nearly tripled; in 2016, 39% of the world's adult population was overweight and 13% obese. Children and adolescents are equally affected, with over 340 million being…

Intrinsic abnormalities of adipose tissue and adipose tissue dysfunction in PCOS

Funding sources This work was supported by the Brazilian National Institute of Hormones and Women's Health/Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq INCT grant number 465482/2014-7) and Fundação de Amparo à Pesquisa do Rio Grande do Sul (FAPERGS INCT grant number 17/2551-0000519-8). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. Declarations of interest…

The pathogenic role of androgen excess in PCOS

Introduction Polycystic ovary syndrome (PCOS) is a very common and rather complex endocrine disorder with significant reproductive and metabolic impact . The overproduction of androgens seems to have a role in its development, hence not just being related to the well-known clinical manifestations of the syndrome and its long-term consequences. There have been many attempts to explain the development of PCOS. In its origin, a suspected…

Developmental origins of polycystic ovary syndrome: Everything starts in utero

Acknowledgments Financial Support: D.H.A. and J.E.L.: NIH DK121559, HD102172, OD011106. Introduction Polycystic ovary syndrome (PCOS) is a prevalent, complex, highly heritable, subfertility health disorder of premenopausal women with numerous comorbidities . PCOS is commonly diagnosed from either revised Rotterdam or NIH criteria. Rotterdam criteria require at least two out of three: oligo/anovulation, hyperandrogenism, and polycystic ovaries. NIH criteria, in contrast, require only the first two (NIH,…

Secondary PCOS: Well-defined causes, leading to the PCOS phenotype

Acknowledgments This chapter is dedicated to Prof. Renato Pasquali, for his constant commitment to the study of PCOS. Introduction PCOS has had a complex history punctuated by a constant improvement in its understanding and evolution of diagnostic criteria . These include an awareness of forms of PCOS that are secondary to other endocrinopathies, and therefore the need for them to be recognized in the diagnostic approach…

Defining PCOS: A syndrome with an intrinsic heterogeneous nature

Acknowledgments This work was supported by Grants PI1501686, PIE1600050, and PI1801122 from Instituto de Salud Carlos III, Spanish Ministry of Economy and Competitiveness, and co-financed by the European Development Regional Fund “A way to achieve Europe” (EDRF). CIBERDEM and IRYCIS are also initiatives of from Instituto de Salud Carlos III. Competing interests statement The author declares no competing interests. Introduction Polycystic ovary syndrome (PCOS) is nothing…

Reporting templates

ASC normal exam assessment Sonologist(s): Findings: A 2D transperineal exam, with the patient in the dorsal lithotomy position, was performed using a ___ 
5–9 MHz or ___ 6–12 or ___ MHz EV transducer to assess the ASC and reveals a normal ASC, with measurements at three levels as follows: Proximal level The IAS measures ___ mm, ___ mm, ___ mm, and 
___ mm at 12, 3,…

Case reviews 166–184

Outline Topic 10, Figure 359 Case 166, Figure 360 Case 167, Figure 361 Case 168, Figure 362 Case 169, Figures 363–365 Case 170, Figure 366 Case 171, Figures 367–370 Case 172, Figures 371–375 Case 173, Figures 376–378 Case 174, Figure 379 Case 175, Figure 380 Case 176, Figure 381 Case 177, Figure 382 Case 178, Figure 383 Case 179, Figure 384 Case 180, Figures 385–389 Case…

Case reviews 151–165

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Case reviews 129–150

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Case reviews 112–128

Outline Topic 7, Figure 239 Case 112, Figure 240 Case 113, Figures 241–243 Case 114, Figures 244–246 Case 115, Figure 247 Case 116, Figure 248 Case 117, Figure 249 Case 118, Figure 250 Case 119, Figures 251 and 252 Case 120, Figures 253–260 Case 121, Figure 261 Case 122, Figures 262–267 Case 123, Figures 268–272 Case 124, Figure 273 Case 125, Figure 274 Case 126, Figure…

Case reviews 95–111

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Case reviews 75–94

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Case reviews 56–74

Outline Topic 4, Figure 120 Case 56, Figure 121 Case 57, Figure 122 Case 58, Figure 123 Case 59, Figure 124 Case 60, Figure 125 Case 61, Figures 126–128 Case 62, Figures 129–131 Case 63, Figures 132–134 Case 64, Figures 135–138 Case 65, Figures 139–141 Case 66, Figure 142 Case 67, Figure 143 Case 68, Figure 144 Case 69, Figure 145 Case 70, Figures 146–148 Case…

Case reviews 36–55

Outline Topic 3, Figure 80 Case 36, Figures 81–83 Case 37, Figures 84 and 85 Case 38, Figure 86 Case 39, Figures 87 and 88 Case 40, Figure 89 Case 41, Figures 90–93 Case 42, Figures 94 and 95 Case 43, Figure 96 Case 44, Figure 97 Case 45, Figure 98 Case 46, Figure 99 Case 47, Figure 100 Case 48, Figure 101 Case 49, Figure…

Case reviews 19–35

Outline Topic 2, Figure 41 Case 19, Figure 42 Case 20, Figures 43 and 44 Case 21, Figures 45–48 Case 22, Figures 49 and 50 Case 23, Figures 51 and 52 Case 24, Figures 53 and 54 Case 25, Figure 55 Case 26, Figures 56–61 Case 27, Figures 62–65 Case 28, Figures 66–68 Case 29, Figures 69–71 Case 30, Figures 72 Case 31, Figure 73 Case…