A 27-Year-Old Woman With a Diagnosis of Polycystic Ovary Syndrome

Abstract

Background: Polycystic ovary syndrome and oligomenorrhea which is one of its complications are considered as the most common causes of menstrual disorders which increases the risk of depression and psychological effects complications. The prevalence of oligomenorrhea is predicted to be 12 to 15 percent. This syndrome occurs with symptoms such as obesity, impaired glucose metabolism, dysmenorrhea, oligomenorrhea and other symptoms. In addition, incidence of decreased libido, painful sexual intercourse and decreased libido are also observed in the patients concurrently which must be considered during the treatment. Case Presentation: The case is a 27 year old woman married 2 years ago without children, unprotected, housewife who has been referred to the clinic of traditional medicine in June 2016 with palpitation complaints, dizziness, extreme tiredness, poor sleep, fatigue, darkening of skin along with syncopal attacks. She was the candidate for standard treatment for depression with diagnosis of depression by a psychiatrist. Based on the history of the patient, she has experienced delayed period for up to three months, severe pain prior to and during menstruation, dyspareunia and fear of sexual intercourse, decreased libido and progressive lack of sexual satisfaction over the past two years. She suffered from epileptic attack every 7-10 days without falling resulting in organ and head damage. After taking history, medical tonic treatment of ovarian and treatment using sitz-bath and training for sexual intercourse were conducted simultaneously from the perceptive of modern and Iranian medicine and menstruation was regulated in the first three months and sexual intercourse gradually became possible in the next three months and patient experienced regular menstruation and complete sexual intercourse with sexual pleasure at the end of six months. Conclusion: Treatment of this patient by modification of her uterus and ovaries function, creation of menstrual regularity and possibility of sexual intercourse along with sexual pleasure based on sexual pleasure highlights the necessity of more attention to the connection between the different organs in the human body. A woman's uterus and femininity functions make her sick in the case of disorder, one of such is termed strangulation of uterus (Ekhtenagh in Persian) in Iranian medicine.

Racial differences in self-reported infertility and risk factors for infertility in a cohort of black and white women: The CARDIA Women's Study

“…In addition, we did not find that hyperandrogenemia or menstrual abnormalities were associated with infertility in late reproductive age black or white women. The lack of an association between hyperandrogenemia, menstrual irregularity, and infertility is inconsistent with the literature on PCOS (25)(26)(27)(28). It is possible that our lack of findings regarding hyperandrogenemia may be due to low prevalence of PCOS or clinically significant hyperandrogenemia in our population, low precision of the total testosterone assay, or to the relatively older average age of our sample compared to other studies of PCOS (13).…”

Polycystic ovary syndrome

“…There is also no evidence that biochemical indices of IR (other than plasma glucose values derived from a GTT) offer any therapeutic or prognostic value in women with PCOS; neither does it predict weight loss (insulin resistant subjects with PCOS do not respond differently to weight loss interventions compared to PCOS subjects who are not IR). 67 The assessment of IR is therefore a clinical one based on conventional criteria for the metabolic syndrome. The biochemical assessment of insulin levels and its derived indices currently has no merit in clinical practice and increases the cost of managing this condition unnecessarily.…”

Polycystic Ovary Syndrome

“…[4][5][6] Other potential etiologies must be excluded such as thyroid disease, hyperprolactinemia, ovarian failure, androgen secreting tumors, and congenital adrenal hyperplasia. [4][5][6] Common hyperandrogenic symptoms include acne and/or hirsutism with a modified Ferriman-Gallwey score Z6, usually owing to increased midline androgen-dependent hair growth, and less commonly androgenic alopecia, whereas laboratory testing may indicate elevated levels of total or bioavailable testosterone and dehydroepiandrosterone sulfate. [4][5][6] Follicular phase ultrasound suggests polycystic ovary morphology when either ovary has Z12 follicles each <10 mm diameter or when the volume of either ovary is Z10 cm 3 , in the absence of dominant follicles or large ovarian cysts.…”

“…[4][5][6] Common hyperandrogenic symptoms include acne and/or hirsutism with a modified Ferriman-Gallwey score Z6, usually owing to increased midline androgen-dependent hair growth, and less commonly androgenic alopecia, whereas laboratory testing may indicate elevated levels of total or bioavailable testosterone and dehydroepiandrosterone sulfate. [4][5][6] Follicular phase ultrasound suggests polycystic ovary morphology when either ovary has Z12 follicles each <10 mm diameter or when the volume of either ovary is Z10 cm 3 , in the absence of dominant follicles or large ovarian cysts. [4][5][6] An elevated luteinizing hormone to follicle stimulating hormone ratio is not required as false negative findings can occur owing to the pulsatile nature of these hormones and the attenuated ratios frequently seen with obesity.…”

“…4 The cardinal features of polycystic ovary syndrome are oligo-ovulation, hyperandrogenism, and polycystic ovary morphology. As infertility is the focus of this article, the phenotype that will most occupy us is the anovulatory one.…”