Can Polycystic Ovarian Syndrome be cured? Unfolding the Concept of Secondary Polycystic Ovarian Syndrome!

Abstract

Classic polycystic ovarian syndrome (PCOS) is one of the commonest endocrine metabolic disorders in women of reproductive years. It is very disappointing that we have still not been able to know the exact cause, and hence, we cannot completely cure this syndrome. With availability of effective drugs and lifestyle modification, it can only be controlled and symptoms can be reduced. There are some well-defined factors which lead to PCOS phenotype. A concept of secondary PCOS is being described recently. This condition, even though rare, is completely curable, as majority of these factors are treatable. Hence, it is advisable to actively look for these conditions and offer treatment in time. This editorial gives an account of various causes of secondary PCOS, gives broader view of PCOS phenotypes and aims for an insight into pathophysiological aspects of PCOS. The clinical categorization by HA-PODS nomenclature of both primary and secondary PCOS can minimize diagnostic and therapeutic pitfalls and will serve as a checklist to ensure the appropriate investigation is ordered and specific treatment is initiated as per diagnostic code. This will achieve uniformity in therapies offered and also enable better comparison of data and a smooth conduct of research which is much needed in this field.

Polycystic Ovarian Syndrome (PCOS), A Distress of Female Reproductive Health

“…The variation in each criterion might interfere with the proper diagnosis. Therefore, to overcome diagnostic pitfalls this new nomenclatureproposed which emphasises on clinical and pathological aspects calling it as HA-PODS (Hyperandrogenism and persistent ovarian dysfunction syndrome) (Khadilkar, 2019). This in facttakes into consideration the secondary causes contributing in etiology of PCOS such as insulin resistance, endometrial hyperplasia, hypertension, obesity, thyroid disorders, etc.…”

“…This in facttakes into consideration the secondary causes contributing in etiology of PCOS such as insulin resistance, endometrial hyperplasia, hypertension, obesity, thyroid disorders, etc. (Khadilkar, 2019).…”

“…The estrogen level is increased and progesterone level is decreased. Simultaneously increased Anti Mullerian hormone (AMH) and Prolactin (PRL) levels totally alters the pituitary -ovarian endocrine loop (Rao and Homburg, 2018;Khadilkar, 2019). This mainly occurs due to disturbances in steroidogenesis pathway of androgens occurring in thecal cells of ovaries.…”

“…al., 2018).Administration of statins has proved effective in reducing androgens, decreasing ovarian size and impairment in menstrual cycle (Ortega and Duleba, 2014). Statins are also effective in improving lipid profile and decreasing the risk of cardiovascular diseases (Ortega and Duleba, 2014).Cabergoline and dopamine agonists can reverse hyperprolactinemia (Khadilkar, 2019).Alternatively, Bariatric surgery has proved to be effective in improving hyperandrogenism and menstrual irregularities in PCOS patients. It also helps in weight loss and improvement in some markers of dyslipidaemia such a triglycerides, HDL-C, VLDL-C (Christ and Falcone, 2018).…”

Signing off… As Editor in Chief

“…I am extremely happy to share with you all that the accesses of my articles have crossed unprecedented "40,000" mark as of November 2020. In my first year, I wrote my editorial series on medical writing and ethical aspects of medical writing [2][3][4][5][6][7], second year, I chose the editorial series on gyn-endocrinology [8][9][10][11][12][13], a topic close to my heart, and third year, I had a few guest editorials and some miscellaneous topics of common interest [14][15][16][17][18].…”