Polycystic ovary syndrome and hirsutism Polikistik over sendromu ve hirsutizm
Turk Pediatri Arsivi, cilt.46, ss.97-102, 2011 (SCI-Expanded, Scopus, TRDizin)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 46
- Basım Tarihi: 2011
- Doi Numarası: 10.4274/tpa.46.45
- Dergi Adı: Turk Pediatri Arsivi
- Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.97-102
- İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet
Özet
Polycystic ovary syndrome is a multi-factorial heterogenous disorder characterized by chronic anovulation and hyperandrogenism. Diagnosis is based on clinical or laboratory evidence of hyperandrogenism. For diagnosis at least two of the three Rotterdam criteria (oligo/anovulation, clinical or biochemical signs of hyperandrogenism, polycystic ovaries) should be ensured. Clinical symptoms usually begin around menarche. Oligomenorrhea, amenorrhea, hirsutism, acne, alopecia can be associated with central obesity. İnsulin resistance, hyperandrogenism, LH excess, and sonographic appearance of polycystic ovaries are the laboratory findings. Functional ovarian and adrenal hyperandrogenism can be demonstrated in the majority of the patients. Although pathogenesis is multifactorial, insulin resistance seems to play a central role. İrrespective of obesity there is insulin resistance in 50-70% of the patients. Adolescents presenting with hirsutism, menstrual irregularities and central obesity should be evaluated for differential diagnosis of hyperandrogenism and the etiology be determined. Treatment depends on the clinical signs and the source of hyperandrogenism. In the patients with menstrual disorders and/or functional ovarian hyperandrogenism, oral contraceptives are the first line drugs. Antiandrogens are prefered in patients with hirsutism and functional hyperandrogenism. If insulin resistance is the heading symptom insulin sensitizers can be used.Hirsutism is defined as excessive terminal hair growth at androgen dependent sites and is the most frequent symptom of hyperandrogenism. Treatment consists of androgen decreasing drugs related to the etiology of androgen excess and locally epilation of the hair. In patients presenting with polycystic ovary syndrome and hirsutism, initially the etiology of hyperandrogenism should be identified and treatment planned appropriate to the reason.