Our aim was to evaluate the optimal treatment strategy addressing cardiovascular risk in obese and nonobese patients with polycystic ovary syndrome (PCOS). We planned a prospectıve randomized clinical study. Normoandrogenemic and oligoamenorrheic women with PCOS and impaired glucose tolerance (n = 96) were enrolled in the study. Six months of treatment with metformin HCL or oral contraceptive pills (OCPs) were given to the patients. Group 1 were obese and receiving metformin. Group 2 were obese and receiving OCPs. Group 3 were nonobese and receiving metformin, and Group 4 were nonobese receiving OCPs. ADMA, homocysteine, high sensitive C-reactive protein (hs-CRP) and homeostasis model assessment estimate of insulin resistance (HOMA-IR) were investigated. ADMA, homocysteine, hs-CRP and HOMA-IR were similar in obese and nonobese groups before the treatment. After 6 months of treatment, a significant decrease was observed in ADMA, homocysteine and HOMA-IR levels in Groups 1 and 3. An increase in ADMA and hs-CRP levels was observed in Groups 2 and 4. In this study, metformin treatment leads to improvement in hormonal and metabolic parameters and decreases ADMA and homocysteine levels possibly independent of BMI. However, the use of oral contraceptives in obese and nonobese patients with PCOS with impaired glucose tolerance increases ADMA and hs-CRP levels and creates an increase in the metabolic risk.
Transdermal estrogen treatment has a protective effect against the risk factors of metabolic syndrome (homocysteine, ADMA, HDL cholesterol) in surgically menopausal patients who have undergone surgery in the early premenopausal period.
The number of vaginal rejuvenation procedures for improvement of sexual function is dramatically increasing worldwide. The objective of this study was to present our experience with women who presented to our clinic with the complaint of sexual dysfunction or desire to enhance sexual function or orgasm.
MethodsDemographic and descriptive data of the patients were evaluated. In addition, sexual dysfunction of the patients who underwent vaginoplasty in our center were evaluated before and after vaginoplasty procedure using Golombok Rust Inventory of Sexual Satisfaction (GRISS) scale and the scores were compared before and after the procedure, which is used in the evaluation of sexual dysfunction by relationship counsellors and clinics.
ResultsA total of 250 women who described a sensation of a wide or floppy vagina with lost or decreased ability to achieve orgasm were included in the study. The mean age of the patients was 38.51±9.126 years. Of all women, 85.2% were college graduates. A history of normal vaginal delivery was found in 77.8% of the participants. The mean GRISS scores of "Infrequency", "Non-communication", "Dissatisfaction", "Nonsensuality", "Avoidance", "Anorgasmia" and "overall GRISS" scores were statistically significantly decreased, while the mean vaginismus score was significantly increased (p<0.01).
ConclusionHighly satisfying outcomes regarding patient satisfaction were obtained from vaginoplasty procedures that we have performed.
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