Bakgrund: Polycystiskt ovarialsyndrom (PCOS) är den vanligaste orsaken till endokrin obalans hos kvinnor. Den drabbar 5–10% av fertila kvinnor och påverkar äggstockarna och den hormonella balansen. Det visar sig genom oregelbunden eller utebliven menstruation, ökad kroppsbehåring, viktuppgång samt risk för infertilitet. Sjuksköterskor ska kunna tillgodose patienter med relevant information och motivera till livsstilsförändringar. Vårdrelationen har en viktig betydelse för att patienter ska känna ett stöd och bli delaktiga i sin vård. Syfte: Syftet var att skildra kvinnors upplevelser av att leva med polycystiskt ovarialsyndrom. Metod: En litteraturöversikt skapad av elva vetenskapliga artiklar hämtade från databaserna Cinahl Complete och PubMed. Resultat: Resultatet mynnade ut i tre huvudteman; Upplevelser i mötet med hälsosjukvård, Upplevelser av symtom och Upplevelser av kvinnlig identitet. Det framkom fyra tillhörande underteman. Sammanfattning: I resultatet framkom det att kvinnorna upplevt att vårdpersonalen har haft dålig kunskap om PCOS vilket påverkade vårdpersonalens bemötande. Kvinnorna upplevde svårigheter med att hantera sina symtom från PCOS och hade ett behov av stöd från närstående eller andra kvinnor med samma diagnos. Kvinnorna upplevde sig okvinnliga på grund av deras symtom och ovissheten över förmågan att bli gravid. / Backround: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women. The prevalence of PCOS is 5–10% of fertile women and the disorder affects the ovaries and hormonal balance. The symptoms are irregular or absent menstruation, increased body hair, weight gain and the risk of infertility. Nurses should be able to provide patients with relevant information and motivate lifestyle changes. The caring relationship has an important meaning for patients to feel supported and to become more involved in their own care.  Aim: The aim of this study was to depict women’s experiences of living with polycystic ovary syndrome. Method: A literature review based on eleven scientific articles retrieved from the databases Cinahl Complete and Pubmed.  Results: The analysis resulted in three main themes; Experiences in the encounter with health care, Experience of symptoms and Experience of femine identity. Four belonging subthemes emerged. Summary: The result showed that women experienced a lack of knowledge from the health care which resulted in poor treatment. The women experienced difficulties with handling their symptoms from PCOS and had a need for support from relatives or other women with the same diagnosis. The women felt unfeminine because of their symptoms and the uncertainty about their fertility.

Polycystic ovary syndrome is the single most common endocrine abnormality of women of reproductive age and is a leading cause of female infertility. Common clinical features include hirsutism, various ovarian abnormalities, obesity, and insulin resistance. Expert consensus recommendations on diagnostic criteria vary, but the most recent focus on the presence of clinical features of hyperandrogenism, hyperandrogenemia, polycystic ovaries, and ovulatory and menstrual dysfunction to the exclusion of alternative diagnoses. In adolescence, diagnosis is more difficult because of the frequent presence of individual clinical findings in otherwise "normal" individuals. Laboratory tests and pelvic ultrasound are necessary to confirm polycystic ovary syndrome and exclude other disorders that may mimic this syndrome. Treatment is centered on the clinical manifestations and should be initiated early to prevent/limit long-term complications, including the metabolic syndrome, diabetes, endometrial carcinoma, and infertility.

Bakgrund: Ofrivillig barnlöshet innebär en oförmåga att uppnå en graviditet inom ett års tid med oskyddat samlag. En av de vanligaste orsakerna till ofrivillig barnlöshet är ovulationsrubbningar där syndromet polycystiskt ovarialsyndrom är den vanligaste. De som drabbas av infertilitet hamnar oftast i en livskris som pågår under flera år och kräver därav olika insatser från sjukvården. Det finns även en koppling mellan psykisk ohälsa och stressen kring att inte uppnå en graviditet. Syfte: Syftet med denna studie är att beskriva kvinnors erfarenheter av att leva med Infertilitet orsakat av polycystiskt ovarialsyndrom. Metod: En litteraturstudie som inkluderar elva originalartiklar. Data analyserades med integrerad dataanalys. Resultat: Två kategorier presenteras ”Infertilitetens påverkan på livet” och ”Kvinnornas kontakt med sjukvården”. Under dessa presenteras åtta underkategorier vilka visar att infertilitet orsakat av PCOS bidrar till nedsatt hälsa och livskvalitet.  Slutsats: Det är av vikt med fortsatt forskning för att kunna implementera tydligare riktlinjer kring vård och omvårdnad av denna patientgrupp för minskat lidande. Det krävs ökad kunskap och förståelse hos sjuksköterskan, för att kunna ge en personcentrerad vård vid infertilitet och PCOS. Likaså bör det finnas mer utbildning kring infertilitet och dess orsaker på sjuksköterskeutbildningar för att uppmärksamma detta problem. / Background: Involuntary childlessness means an inability to achieve a pregnancy within one year with unprotected sex. One of the most common causes of involuntary infertility is ovulation disorders, where polycystic ovary syndrome is the most common. Those who suffer from infertility usually end up in a life crisis that lasts for several years and therefore requires different interventions from the healthcare system. There is also a connection between mental illness and the stress of not achieving a pregnancy.  Aim: The aim of this study is to describe women's experience of living with infertility caused by polycystic ovary syndrome. Method: A literature study that includes eleven original articles. Data were analyzed using integrated data analysis. Result: Two categories are presented: "Infertility's impact on life" and " Women's contact with healthcare". Under these, eight subcategories are presented showing that infertility caused by PCOS contributes to reduced health and quality of life. Conclusion: It is important for continued research to be able to implement clearer guidelines regarding the care and nursing of this patient group for reduced suffering. Increased knowledge and understanding is required for the nurse, to be able to provide person-centred care for infertility and PCOS. Likewise, there should be more education about infertility and its causes in nursing schools to draw attention to this problem.

Polycystic ovary syndrome (PCOS) affects a substantial percentage of reproductive-aged females. Diagnosis criteria include irregular ovulation, elevated androgens, and polycystic ovaries. PCOS often presents with metabolic and reproductive symptoms, with insulin resistance being a symptom that exacerbates metabolic issues. Exercise as a non-pharmacological intervention is featured in the literature on management of PCOS. The objective of this thesis is to explore the role of exercising in mitigating insulin resistance in women with PCOS. A search for relevant articles that included different exercise methods such as high intensity training was completed using CINAHL and Medline. High intensity training appears to have a more comprehensive effect on metabolic levels, though other exercises offer benefits. Further research should include large and diverse sample sizes, longer research duration, and focus on defining an optimal exercise guideline for women with PCOS.

No description available.

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting up to 18% of all women, yet only 1.5% have been formally diagnosed. Untreated, PCOS is associated with the early onset of diabetes mellitus type II, heart disease, and cancer. One of the most common clinical symptoms of PCOS is mental health illness. The estimated lifetime prevalence of mental illness in women with PCOS is 80%. Therefore, mental health professionals may be especially poised to screen, refer, and address PCOS in their practices. This study was used to develop a survey tool as well as a brief educational intervention using framing theory to boost PCOS knowledge of diagnostic criteria and clinical symptoms, screening practices, and referrals for PCOS evaluation. The survey assessed mental health providers' knowledge about PCOS, estimates of PCOS prevalence in their practices, and evaluated attitudes about screening for PCOS in order to identify other potential barriers and facilitators to screening. This study was conducted using a randomized, two-group (experimental vs. attention control) design with three measurement periods: pre-intervention, 4-weeks, and 12-weeks. Participants were stratified by whether or not they had medical degrees. One-hundred and sixty three (N=163) participants completed the first survey and were randomized and completed one of the two educational interventions (PCOS related or attention control). Knowledge outcomes included number of correctly identified PCOS diagnostic criteria and clinical symptoms. Behavior outcomes included whether or not participants screened or referred clients for PCOS in the last 3 months. Fourteen attitude measures and two confidence measures were also separately evaluated as potential influencing factors of knowledge and behavior. The study resulted in no change in PCOS knowledge of diagnostic criteria or clinical symptoms or behavior based on intervention assignment in medical professionals; however, baseline knowledge in this group was high. Confidence in PCOS knowledge was associated with screening behavior. The PCOS educational intervention appears to have potential efficacy at increasing non-medical professional clinical symptom knowledge of PCOS (Chi-square(1)=5.341, p=0.021) but did not improve screening or referring behavior. The PCOS intervention resulted in greater confidence in PCOS knowledge in the PCOS intervention group than in the attention control group (p=.003). Framing theory appears to be a promising framework for messaging designed to increase knowledge about PCOS only in non-medical mental health practitioners. Results of this study should be interpreted with caution because sample size goals were not met and there was high attrition among medical mental health practitioners. Future intervention strategies should consider the inherent differences in the type of professional that are targeted (i.e. medical vs. non-medical) and the presence of specific barriers to screening and referral behavior. These strategies should improve upon the intensity of the intervention and the timing of the intervention to occur during provider training (i.e. during residency or early internships) in order to increase screening and referring behaviors for PCOS. / Public Health

Bakgrund Polycystiskt ovarialsyndrom (PCOS) är en hormonell störning hos fertila kvinnor. Den ger symtom som oregelbunden eller utebliven menstruation, övervikt, ökad kroppsbehåring samt risk för infertilitet. Kunskapen är bristfällig både i samhället och bland vårdpersonal. Det är viktigt att öka medvetenheten om PCOS för att erbjuda en personcentrerad vård och förebygga allvarliga hälsoproblem. Syfte Syftet var att beskriva kvinnors upplevelse av att leva med polycystiskt ovarialsyndrom. Metod En litteraturöversikt utifrån tio artiklar från Pubmed samt Cinahl Complete. Alla artiklar var granskade utifrån Fribergs kvalitetgranskningsmall. Resultat Två huvudteman framkom i resultatet. Det första huvudtemat var Kvinnors erfarenheter i mötet med sjukvården och det inkluderade undertemat Bristande kunskap inom hälso- och sjukvården samt Bemötande. Hälso- och sjukvårdspersonalen hade bristande kunskap om PCOS vilket ledde till försenade diagnoser och negativt bemötande. Kvinnorna upplevde en frustration och fann stöd i form av stödgrupper och internetinformation. Det andra huvudtemat fokuserade på Kvinnlig identitet med undertemat Övervikt, Hirsutism, Infertilitet och Femininitetsnormer. Dessa teman beskrev kvinnornas erfarenheter av PCOS-symtom och deras jämförelser med andra kvinnor utifrån samhällets normer. De upplevde stigma av symtomen och den emotionella påverkan av dessa symtom ledde till en påtaglig fysisk och psykisk påfrestning på kvinnornas välbefinnande. Slutsats Kvinnor med PCOS behöver utökat stöd av vården för fysiska och psykiska symtom. Ett lidande uppstår av försenade diagnoser och bristande kunskap. / Background Polycystic Ovary Syndrome (PCOS) is a hormonal disorder in fertile women. It presents symptoms such as irregular or absent menstruation, overweight, increased body hair, and a risk of infertility. Knowledge is deficient both in society and among healthcare professionals. It is crucial to raise awareness about PCOS to provide person-centered care and prevent serious health issues. Aim The aim was to describe women's experiences of living with polycystic ovary syndrome. Method A literature review based on ten articles from PubMed and Cinahl Complete. All articles were reviewed according to Friberg's quality assessment template. Results Two main themes emerged in the results. The first main theme was Women's experiences in the encounter with healthcare, and it included the subthemes Lack of knowledge in healthcare and Interaction. Caregivers lacked knowledge about PCOS, leading to delayed diagnoses and negative treatment. Women experienced frustration and found support in the form of support groups and online information. The second main theme focused on Female identity with subthemes of Overweight, Hirsutism, Infertility, and Femininity norms. These themes described women's experiences of PCOS symptoms and their comparisons with other women based on societal norms. They faced stigma related to their symptoms and the emotional impact of these symptoms resulted in a significant physical and psychological strain on women's well-being. Conclusions Women with PCOS need expanded support from healthcare for their physical and psychological symptoms. Suffering arises from delayed diagnoses and a lack of knowledge from healthcare providers.

Common, complex disorders are polygenic and multifactorial traits representing interactions between environmental, genetic and epigenetic risk factors. More often than not, contributions of these risk factors have been studied individually and this is especially true for complex reproductive traits where application of genomic technologies has been challenging and slow to progress. This thesis explores the potential of genetic and epigenetic components contributing to a better understanding of the biological pathways underlying disease risk in two specific female complex reproductive traits - polycystic ovary syndrome (PCOS) and preterm premature rupture of membranes (PPROM). The PCOS projects focus on characterization of a gene, DENND1A, whose association to PCOS has been established by Genome Wide Association Studies (GWAS) and is known to contribute to PCOS steroidogenic phenotype. In addition, differential microRNAs expression contributing to DENND1A expression regulation in PCOS theca cells was identified. The studies on PPROM utilize a Whole Exome Sequencing approach to identify rare variants in fetal genes contributing to extracellular matrix composition and synthesis contributing to PPROM risk. The results suggest that fetal contribution to PPROM is polygenic and is driven by a significant genetic burden of potentially damaging rare variants in genes contributing to fetal membrane strength and integrity. Tissue and location specific expression patterns of the Chromosome 21 miRNA cluster (miR-99a, miR-125b, let-7c) in fetal membranes from term pregnancies with spontaneous rupture were investigated. The results suggest that these miRNAs play potential roles in fetal membrane rupture and fetal membrane defects associated with T21.

Introdução:A síndrome dos ovários policísticos (SOP) é a endocrinopatia mais comum em mulheres no menacme, com prevalência variando de 5 a 10%. A SOP está associada à elevação do risco cardiovascular e eventos metabólicos adversos, incluindo obesidade, resistência à insulina, dislipidemia e inflamação crônica de baixo grau. Apesar dos fatores de risco cardiovascular serem mais prevalentes em mulheres com SOP, não existe evidência científica de maior incidência de doença cardiovascular (DCV) nestas mulheres. Vários estudos reportaram alterações em marcadores de risco para DCV na SOP, porém ainda não foram determinados quais os marcadores ideais para a detecção precoce da DCV. Objetivo:Avaliar a presença de marcadores precoces de DCV em mulheres jovens e não-obesas com SOP. Casuística e Métodos:Foram incluídas 39 pacientes com SOP e 50 mulheressaudáveis, com ciclos menstruais regulares e pareadas por idade e índice de massa corporal (IMC). Através da ultra-sonografia foram avaliados os seguintes marcadores de DCV: índice de rigidez da artéria carótida comum, distensibilidade da artéria carótida comum, espessura da camada íntima-média da artéria carótida comum (IMT) e dilatação mediada pelo fluxo da artéria braquial (DMF). Foram avaliadas ainda variáveis antropométricas, hormonais e marcadores de inflamação em todas as participantes. Resultados: A idade e o IMC nas mulheres com SOP não apresentaram diferença quando comparados às mulheres do grupo controle (24,5 ± 3,80 vs 24,5 ± 5,1, 0,6, respectivamente).O índice de rigidez da carótida comum foi mais elevado no grupo SOP comparado ao grupo controle (3.6 ± 0.96 vs 3.1 ± 0.96, p= 0.04, respectivamente) e a distensibilidade da artéria carótida comum foi menor nas pacientes com SOP em comparação àquelas do grupo controle (0.3 ± 0.08 vs 0.4 ± 0.09, p=0.02, respectivamente). As pacientes com SOP apresentaram maior circunferência da cintura, testosterona total e free androgen index(FAI) em relação ao grupo controle (78.2 +10.0 vs 71.6 +7.2, p= 0,0004; 85.0 +32.4 vs 52.0 +21.3, p<0.0001 e 8.9 +28.7 vs 4.4 +2.3, p<0.0001, respectivamente), enquanto a sex hormone binding globulin(SHBG) mostrou-se reduzida na SOP quando comparadaao grupo controle (37.8 +19.1 vs 47.8 +18.3, p=0.01). As demais variáveis não diferiram entre os dois grupos. Conclusão: Nosso estudo demonstra que mulheres jovens com SOP apresentam alterações na elasticidade vascular mesmo na ausência de clássicos fatores de risco para DCV, como: resistência à insulina, hipertensão ou obesidade. / Introduction: The polycystic ovary syndrome (PCOS) is a common endocrine disease affecting 5% to 10% of women of reproductive age. PCOS is associated with an adverse metabolic and cardiovascular risk profile, including obesity, insulin resistance, dyslipidemia and low-grade chronic inflammation. Although cardiovascular risk factors are more prevalent in women with PCOS, definitive evidence for an increased incidence of cardiovascular disease (CVD) is lacking. Several studies reported disorders in markers of CVD in PCOS patients, however they were not still certain whichare the best subclinical markers of CVD in these young women. Objective:To evaluate the early markers of CVD in young PCOSwomen. Material and Methods:Thirty nine PCOS women and 50 healthy age and bodymass index (BMI)-matched ovulatory controls were enrolled in this cross-sectional study. Carotid stiffness index (?), carotid compliance, Carotid intima-media thickness (IMT) and brachial arterial flow-mediated dilation (FMD) were measuredby ultrasonography. Anthropometric measurements, complete hormonal and metabolic (including inflammatory biomarkers) evaluation were done in all subjects. Results: ?was significantly higher in PCOS subjects than in healthy controls (3.7 ± 0.96 vs 3.3 ± 0.96, p= 0.04, respectively) and carotid compliance was lower in PCOS than in healthy controls (0.3 ± 0.08 vs 0.4 ± 0.09, p=0.02 respectively). PCOS patients also present elevated WC, total testosterone and free androgen index compared to control group (78.2 +10.0 vs 71.2 +7.2, p= 0,0004; 86.2 +32.1 vs 57.4 +21.2, p<0.0001 and 12.7 +15.7 vs 4.7 +2.4, p<0.0001. respectively). The sex hormone biding globulin was lower in PCOS women than in control group (37.3 +19.2 vs 47.8 +18.3, p=0.01). The other variables did not differ between the groups. Conclusions: Comparing to non-obese ovulatory controls, non-obese PCOS patients present impaired elastic properties in carotid artery, thatcould reflect vascular dysfunction associated with PCOS. However, endothelial function and inflammatory biomarkers remain unaffected.

Introdução: A síndrome dos ovários policísticos (SOP) é a desordem endócrina mais comum em mulheres durante o período reprodutivo. Contudo, representa ainda um desafio, principalmente, quando há infertilidade. Portanto, há necessidade de mais estudos nesta área, em especial, no endométrio. Nosso estudo tem como objetivo realizar a análise da expressão gênica e proteica de marcadores de receptividade endometrial em pacientes com Síndrome dos Ovários Policísticos, comparando-a com a de mulheres com ciclos menstruais regulares. Casuística e métodos: Foram avaliadas 36 mulheres na menacme, divididas em dois grupos: Grupo SOP (n=23) e Grupo Controle - mulheres com ciclos menstruais regulares (n=13). As pacientes do grupo SOP receberam progesterona micronizada na dose de 400mg ao dia, por via vaginal, durante 10 dias. Após o 14º dia do fluxo menstrual, receberam novamente a mesma dose de progesterona natural, por 10 dias. A biópsia de endométrio foi feita durante os últimos dias do emprego da progesterona (6º ao 10º dia de tratamento). No Grupo Controle, a biópsia foi feita na fase secretora (janela de implantação - 20º ao 24º dia). Além disso, foi feita biópsia endometrial em um grupo de mulheres com SOP durante a fase proliferativa. O material coletado foi processado e analisado por técnicas de biologia molecular (avaliação gênica por microarray) e análise imunoistoquimica relacionada à angiogênese. Resultados: As mulheres com SOP apresentaram alterações do metabolismo de carboidratos, hiperinsulinemia e hiperandrogenismo. Após o uso de progesterona natural, o endométrio revelou, na janela de implantação, modificações secretoras, assemelhando-se ao das mulheres com ciclos menstruais regulares. Os dados imunoistoquímicos mostraram haver redução da expressão do VEGF nas mulheres com SOP tratadas com progesterona natural em relação às com ciclo menstrual regular. Após a análise gênica, registrou-se predomínio de genes que podem interferir negativamente com a angiogênese no endométrio das pacientes com SOP tratadas com progesterona natural. Conclusão: O endométrio das mulheres com SOP, mesmo após tratamento com progesterona natural, mostra-se inadequado para a implantação endometrial devido à redução da angiogênese local / Introduction: The Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women during the reproductive period. However, it still presents a challenge, especially when there is infertility. Therefore, there is a need for further studies in this area, mainly in the endometrium. Our study aims to perform the analysis of gene and protein expression of endometrial receptors in patients with PCOS, comparing it with that of women with regular menstrual cycles. Patients and methods: Thirty-six women in the study were divided into two groups: PCOS group (n = 23) and Control Group - women with regular menstrual cycles (n = 13). Patients in the PCOS group received micronized progesterone at a dose of 400mg per day, vaginally, for 10 days. After the 14th day of menstrual flow, they again received the same dose of natural progesterone for 10 days. Endometrial biopsy was performed during the last days of the use of progesterone (6th to 10th day of treatment). In the Control Group, the biopsy was done in the secretory phase (implantation window - 20th to 24th day). In addition, endometrial biopsy was performed in a group of women with PCOS during the proliferative phase. The collected material was processed and analyzed by molecular biology techniques (microarray gene evaluation) and immunohistochemical analysis related to angiogenesis. Results: PCOS women had some changes in carbohydrate metabolism, hyperinsulinemia and hyperandrogenism. After the use of natural progesterone, the endometrium revealed, during the implantation window, secretory modifications, resembling that of women with regular menstrual cycles. Immunohistochemical data showed reduced expression of VEGF in PCOS women treated with natural progesterone compared to those with a regular menstrual cycle. After gene analysis, there was a predominance of genes that could negatively interfere with the endometrial angiogenesis in patients with PCOS treated with natural progesterone. Conclusion: The endometrium of women with PCOS, even after treatment with natural progesterone, may be inadequate for endometrial implantation due to the reduction of local angiogenesis