The Polycystic Ovarian Syndrome Disorder Health And Social Care Essay
Info: 5434 words (22 pages) Nursing Essay
Published: 11th Feb 2020
Tagged: PCOSsleep apnea
Women of all ages have been faced with problems associated with gynecological issues. Particularly young women of childbearing years have dealt with disorders of the reproductive system. These disorders have lead to long term health problems. These disorders involve amenorrhea, infertility, hirsutism, and gargantuan polycystic ovaries. It was not until the 1930s did these problems seem to have a viable solution. Two scientists, Irving Stein and Michael Leventhal unearthed the fact that’s when women with these disorders had ovarian biopsies done, they began to menstruate regularly. 
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PCOS is defined as an endocrine disturbance that causes primarily anovulation and polycystic ovaries due to the continued stimulation of the ovary by pituitary luteinizing hormone. Its symptoms include infertility, obesity, acne, hirsutism, hair loss, insulin resistance and polycystic ovaries. Other symptoms include decreased sex drive, high cholesterol levels, exhaustion or lack of mental alertness, depression and anxiety, sleep apnea, and thyroid problems.  However, some of these symptoms such as excess body hair will depend on that particular person’s genetic makeup. For example, Asiatic people are not very hairy, so Chinese women with PCOS rarely suffer from this symptom whereas people from the Mediterranean have much more hair, so this is likely to be an indication. PCOS is a hormonal disorder that affects approximately seven percent of all women. In fact it is the most common among women.
It’s astonishing how often young women are witnessed at medical doctors’ office with health issues that can be followed back to insulin resistance. Insulin Resistance lies at the core of Polycystic Ovarian Syndrome by averting the efficient conversion of food into energy because cell walls have become de-sensitized to insulin. As a result, insulin levels in the bloodstream become severely unbalanced, leading to an spread in free-floating glucose which is sent to the liver and transformed to excess body fat. These can consequent in weight gain and obesity. Furthermore, insulin resistance can lead to more serious problems such as cardiovascular disease and Type 2 Diabetes. 
Because these symptoms vary so extensively, doctors may still misdiagnose PCOS. In fact eight out of ten women with polycystic ovarian syndrome could have insulin resistance, resulting in higher than normal insulin levels which may act on the ovaries by increasing male hormones.  Polycystic Ovarian Syndrome is one circumstance seen with increasing rates of reoccurrence. Five to ten percent of women of childbearing age are affected by PCOS. Stein-Leventhal Syndrome can transpire at any age prior to menopause. Women can go months without being diagnosed, because warning signs coincide with so many other women’s health issues.
PCOS is unknown to some women yet it causes a multiplicity of symptoms that has an impact on female reproductive health in many approaches that can be truly overwhelming. Although PCOS affects the reproductive system, it is imperative to understand that PCOS is an endocrine disorder. Proteins are secreted or released in to the bloodstream promptly. These are known as hormones.
Circadian rhythms or the body’s normal, everyday regularity are synchronized by those hormones. Hormonal substances include metabolism of mineral deposits, reactions to stress, sexual performance, reproduction, and management of fluids. Endocrine glands such as pituitary, hypothalamus, thyroid, parathyroid, pancreas and ovaries produce hormones in women. When there are glitches and breakdowns in the hormonal development, the woman’s body is significantly disturbed.
Women with Stein-Leventhal Syndrome have ovaries that created profusion of follicles each month without giving off an egg. PCOS can play a role in irregular periods, excessive weight gain despite the effort of diet and exercise. Acne and excessive facial hair are also caused by the syndrome. It is also the most common cause of infertility in the United States.
PCOS is often a short-term, yet in can lead to life-long illnesses. For example, young girls are seen going through puberty when their ovaries are trying to set a regular menstrual cycle. It is also noticed in women during the years of transition to perimenopause. Polycystic Ovarian Syndrome is temporary but can lead to insulin resistance. This leads to nonstop high levels of insulin in the bloodstream. It is possible that this extra insulin glitches onto the receptors lining the ovary and quickens cyst production. This is an issue that should be monitored because women with insulin resistance have a greater risk of developing other serious health problems, like diabetes, heart disease, and metabolic syndrome. 
Many case studies have shown that women from adolescents to adults are not diagnosed until they want to become pregnant or when they have other health issues. Women should be treated as soon as possible particularly when risks are shown such as infrequent menstrual cycles, weight gain, and facial hair. The advantage will be that the risk of long-term health problems such as obesity and diabetes do not occur.
Age is not a factor because case studies have shown that girl as young as nine years old have been diagnosed with the Stein-Leventhal Syndrome or Polycystic Ovaries. Regular menstrual periods are vital in order to avoid osteoporosis and sustain the defensive effects of estrogen in a different place body. Therefore more young women should be exposed to polycystic ovarian syndrome so that they can be tested in order to avoid further complications from diseases. Left untreated, PCOS can lead to detriment that occurs with such diseases.
Polycystic Ovarian Syndrome is not a disease but a disorder that no one is definite about what causes it in the first place. A disorder is a pathological condition that presents a group of symptoms peculiar to it and that sets the condition apart as an abnormal entity differing from other normal or pathological body states. In short, a disorder is curable through medicine and treatment, whereas a disease is not.
Polycystic Ovarian Syndrome is a true illustration of the domino theory, which states that if one act or event is allowed to take place then a series of similar events will follow. PCOS is a curable disorder, leading to other curable disorders then soon falls into the incurable category. It is a chain reaction. Starting with PCOS it continues, causing skin and thyroid disorders and sleep apnea, then it leads to diabetes and cardiovascular disease. It is also important to understand that PCOS causes stress and mental disorders.
Polycystic Ovarian Syndrome is more than an endocrine disorder. Also known as the Stein-Leventhal Syndrome, it is a systemic disorder. This means that instead of affecting one somatic part of the body, it affects other systems as well, including the Integumentary System, Central Nervous System, and Lymphatic System. Stein-Leventhal Syndrome goes beyond being a physical condition. It causes emotional and cognitive distress, affecting every aspect of life.
As an endocrine disorder, diabetes is the most common occurrence in Polycystic Ovarian Syndrome. In particular, mellitus diabetes is a disorder of carbohydrate metabolism, characterized by hyperglycemia, which is the increase of blood sugar. It is also set apart by glycosuria, which is presence of sugar in the urine. It results from inadequate production or utilization of insulin.
The basic cause of diabetes is unknown but direct cause is failure of beta cells of the pancreas to secrete an adequate amount of insulin. Beta cells are cells of islets of the pancreas that secrete insulin. In most instances, diabetes mellitus is the result of genetic disorder, but it may also result from a deficiency of beta cells caused by inflammation, malignant invasion of the pancreas or surgery. In the absence insulin, glycogenesis and glycolysis are inversely affected. It is currently thought that insulin acts primarily at the cell membrane, facilitating transport of glucose into cells.
PCOS influences the integumentary system causing alterations in the skin, consisting of the corium and dermis, and epidermis. It is also known for its manipulation on the skin and its appendage, including the hair and nails. Polycystic Ovarian Syndrome is known for causing acne, pimples, and oily skin. Other common conditions include skin tags, which are thick lumps of skin. These lumps darken and thicken around the neck, groin, underarms and skin folds, which can be easily removed by a dermatologist.
Approximately half of the women with Polycystic Ovarian Syndrome have a skin crisis, however, only a few of these women will suffer from scalp hair thinning or lost. There are two studies, “A Thousand Cases of PCOS” (Eden and Warren, 1999) and “The Resistant Acne Study” (Eden, 1991), that demonstrates vital details. PCOS is commonly found among women with acne, especially severe acne. According to doctors, there seem to be a correlation between excess body hair and blood androgen levels, but little or no evidence to prove the severity of this correlation. Hormonal therapies are effective in treatment of these conditions irrespective of whether or not there is an identifiable hormonal issue. 
Hair is made of Keratin, which is a protein. Hair strands will grow longer and longer as this protein is release into the root of the hair. Hair extends from the sebaceous follicle and each follicle has a growth cycle. Disturbance in androgen-estrogen balance affects the n sebaceous glands, causing acne. Increased secretion of androgens causes an increase in size and activity of the pilosebaceous glands. This causes vitamin deficiencies which trigger problems of the skin. PCOS relationship with the integumentary system explains the relevance of Hirutism.
Infertility is the number one cause of women being diagnosed with Polycystic Ovarian Syndrome. Infertility is characterized by the inability or diminished ability to produce offspring. Most factors responsible for infertility includes immature or abnormal reproductive systems, anomalies of other organ in that vicinity, infections, endocrine dysfunction and emotional problems.
Studies have shown that the Stein-Leventhal syndrome or PCOS is associated with sleep apnea. Research is now proving that hormone imbalances caused by Insulin Resistance and PCOS predisposes women to additional heath problems. One such problem is Obstructive Sleep Apnea (OSA), the uncontrolled closure of the upper airway which causes one to stop breathing while sleeping. Sleep disorder can therefore, negatively influence and/or slow down the most basic physiological functioning, triggering a ripple-effect throughout the body. Studies show that women with Polycystic Ovarian Syndrome have an exceptionally high risk of sleep apnea. Women are normally not awakened by the repeated nightly episodes, but others awake with the experience of being choked or asphyxiated. Symptoms of Sleep Apnea include chronic loud snoring, gasping/choking episodes during sleep, excessive daytime sleepiness and personality changes. 
Women with PCOS have an exceptionally high risk of sleep apnea. Increased weight and obesity may play a significant role. High Body Mass Index plays a role to an insulin imbalance that results in a flow of problems related to Insulin Resistance, the inability of the body to effectively manage glucose. Because of a series of biochemical errors, insulin is unable to successfully bind to cells, reducing its ability to transfer glucose into those cells to be converted into energy. This causes a buildup of both insulin and glucose in the blood that contributes to the gathering of plaque in blood vessels.
Studies also indicate that Insulin Resistance may be a solid risk factor than excessive testosterone in the incidence of PCOS. In a controlled study, women with PCOS were thirty times more likely to suffer from sleep disordered breathing and reported higher frequencies of daytime sleepiness than the control group.
Researchers also found that while testosterone levels between the two groups were parallel; their fasting plasma insulin levels were significantly higher, indicating that sleep apnea might suggest an insulin-related endocrine abnormality.  These findings further confirm the link between PCOS, Insulin Resistance and higher incidences of diabetic conditions. 
Some women who suffer from PCOS also correlates with factors such as high cholesterol. These victims are at a great risk of high LDL levels. This is commonly known as the “bad” cholesterol. Disregarding this condition can lead to strokes and heart attacks. In addition, women with PCOS frequently obtain low levels of HDL. This is known as the good cholesterol. Low levels of the “good” cholesterol increase the risk of cardiovascular disease. Hence, the lower the levels of LDL are and the greater the HDL levels are, there is a slim chance of damage to the cardiovascular disease.
Women with the Stein-Leventhal Syndrome are almost twice as likely to experience atherosclerosis. It is characterized by a variable combination of changes of the intima of arteries, consisting of the focal accumulation of lipids, complex carbohydrates, blood and blood products, fibrous tissue and calcium deposits, and associated with changes in the media of arteries.
Atherosclerotic plaques are of two major types. One is characterized by the prominent proliferation of cells with small accumulation of lipids. The other is distinguished by its makeup of intracellular and extracellular lipid accumulation and a small amount of cellular proliferation. The causes of atherosclerosis are unknown. However, other risk factors include hypertension, cigarette smoking, and stress. Family history also plays an important role.
Polycystic Ovarian Syndrome helps contribute to the number one killer of women in the United States, which is coronary heart disease. Continual high levels of insulin are produced in the pancreas. This it is liberated into the circulatory system. These high levels of insulin lead to obesity and hypertension, which are both antecedents of heart disease.
As insulin connects to artery walls, it impairs the tissue, causing the primary damage that generates plaque. Hence, having PCOS causes a drastic transformation in the blood lipids and overall health of the cardiovascular system that plays a role in the development of coronary heart disease. Suggestions for reducing heart disease are primarily the same as decreasing insulin resistance.
Polycystic Ovarian Syndrome leads to lifelong diseases such as cancer, heart disease, and diabetes. The onset of these diseases only declines the woman’s health even more and normally leads to her cause of death. There is a strong correlation between the Stein and Leventhal Syndrome and endometrial cancer. There is also a proportional relationship between PCOS and cholesterol levels that can eventually lead to some type of cardiovascular dysfunction.
The endometrial cancer is very important when discussing Polycystic Ovaries. The endometrium is the inside layer of the uterus and is made up of tissue that is loaded in blood vessels. Every month the lining of a menstruating woman is developed in arrangement for a potential pregnancy. If a pregnancy does not occur then the lining will shed. Endometrial cancer is developed inside the uterus. As stages develop it broaden beyond the borders of the pelvis. Endometrial cancer usually is curable. However factors such as the stage and outcome of hormones on the cancer can establish each individual’s prognosis.
Women with the Stein-Leventhal Syndrome do have a greater risk for developing endometrial cancer, while small. The woman is at a greater risk the more irregular or absent her cycle is. During the normal menstrual, the lining of the uterus or endometrium is open to elements like hormones, including estrogen. This causes the lining to proliferate and thicken. When ovulation does not take place, which is usual in PCOS, the endometriun does not shed and is exposed to greater amounts of estrogen, which causes the endometrium to grow much more than normal. This is what enhances the likelihood of cancer cells beginning to cultivate. 
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Women with Stein Leventhal Syndrome or Polycystic Ovarian Syndrome experience psychological effects that are minimal while most women may experience moderate to severe effects. Women with this disorder can lead to diseases such as obesity and diabetes which affect the entire body. Depression can also develop in patients with PCOS. Most women who experience PCOS need emotional and social support. This support is needed to deal constructively with the impact that this have on their lives.
Studies have shown that a strong network of family and friends is a tremendous asset to have. This network enhances patients with PCOS to strive to win the battle for a healthy lifestyle. The endocrine gland relative to the hormone issue can cause depression to evolve. PCOS causes a decrease of vital function causing mental depression characterized by altered moods. Significant weight gain usually occurs with PCOS and sometimes worthlessness, self-reproach or excessive guilt. For example, women may feel guilt or distressed when they are unable to produce offspring or they are infertile.
Stress can occur when demands of Polycystic Ovarian Syndrome are placed for a woman to adjust or adopt. Stress is a major risk factor for illnesses and diseases. The body reacts to stress in a series of stages known as the general adaptation syndrome (GAS), which involves three stages: alarm, resistance, and exhaustion. Studies show that stress lowers the body’s resistance to disease by weakening the immune system. Events seem to be more stressful when they involve pressure, a lack of control, unpredictability, and intense or repeated emotional shocks.
Stress is intensified when a situation is perceived as a threat and when a person does not feel competent to cope with it. The body’s reactions to stress can directly damage internal organs and stress impairs the body’s immune system, increasing susceptibility to disease. The impact of life changes on long range susceptibility to illness. Intense or prolonged stress may cause damage in the form of psychosomatic problems, including heart attacks, strokes, etc.
Stress is often the start Insulin Resistance, which contributes to Polycystic Ovarian Syndrome. More insulin is secreted when women eat foods that are high in sugar, fat, and carbohydrates. As sugar or glucose levels ascend in reply to stress, they fuel the production of insulin. This has a large amount of depressing affects. It uphold the synthesis of cholesterol, which a cause dysfunction of the kidneys and high blood pressure. Furthermore, hormones used to respond to excess insulin, such as noradrenalin, are stress-related chemicals that are responsible for raising blood pressure and storing fats.
In addition to stress factors, Polycystic Ovarian Syndrome is deeply linked to pathophysiology , Alzheimer’s disease, indications of depression and other mental disorders. The evidence underlying the theory of Alzheimer’s disease includes neuro-endocrine conditions described in both disorders and test show that increased levels of glucose in the blood stream and decreased cerebral blood flow in specific areas of the brains of patients put them at risk for Alzheimer’s disease. Scientists also found that Alzheimer patients had better memory after increased doses of glucose in the blood stream.
Women with Polycystic Ovarian Syndrome experience depression and mood swings. A study found that women with PCOS are more likely to develop depression or depressive symptoms. This may have some relationship with the psychological and metabolic effects of obesity. Depression is a severe mood disorder which may or may not affect the way that people function in their daily life.  These functions include difficulty with sleeping, changes on eating habits, lost of interest in sex and activities and physical pains.
Further research is needed but since there has been some studies that linked depression to Diabetes, thus to Polycystic Ovarian Syndrome. Diabetic women who have twice the risk of being depressed have shown improvement when they received therapy. Natalie Rasgon’s study showed that women with PCOS are depressed not just only because of the symptoms but also because of underlying biology.
Proper management of polycystic ovary syndrome primarily concentrates on each woman’s main concerns. Each woman’s symptoms differ, so it ranges from indications such as infertility, hirsutism, acne or obesity. Long term, which is the most important aspect of treatment, is managing cardiovascular risks such as obesity, high blood cholesterol, diabetes and high blood pressure. Other symptoms need to be rid as well such as depression, stress, and mental or emotional disorders.
Treatment options vary based on the doctor and patient. Often times, the diagnosis is solved by simple methods but sometimes the solution or treatment is complex. Many times oral contraceptives are prescribed because they are effective for regulating menstrual cycles. It is also known for the reduction of male hormones and minimizing the risks of uterine cancer. Weight lost diets and other ovulation medications are recommended for treatment.
The most common treatment for Polycystic Ovarian Syndrome is oral contraceptives, also known as birth control pills. Oral contraceptives help maintain periods, a reduced amount of unwanted hair, clearer skin, and other therapeutic benefits. Oral contraceptive pills can help to normalize the menstrual period in order that the cycle comes about every twenty eight days. Normally, the pill causes lighter cycles as well.
Oral contraceptive pills can lower androgen hormone levels and lessen the amount of excess hair growth, or hirsutism. It can take six months before there is a decrease in unwanted hair on the face, chest, back and stomach. Oral contraceptive pills can improve acne. The hormones in most types of the Pill can help stop acne from forming. Because there is less menstrual bleeding with the use of oral contraceptive pills, women taking the Pill are less likely to become anemic. Oral contraceptive pills also decrease your chance of getting endometrial (lining of the uterus) cancer, ovarian cancer, and ovarian cysts, which are all factors of Polycystic Ovarian Syndrome.
A recent study uncovered another treatment for Polycystic Ovarian Syndrome. There was a case where a 35 year old woman was suffering from Amenorrhea, acne on the face and chest, and habitual abdominal pain. She was diagnosed with Polycystic Ovaries. Her doctor prescribed D-pinitol with a dosage of 600mg twice a day. The prescribed D-pinitol supplement resulted in normal menstruation and resolved the acne and abdominal pains. D-pinitol or 3-O-methyl-D-chiro-inositol is also found in foods such as legumes and citrus fruits as an effective supplement for the treatment of PCOS.(Gaby,2009)
D-Pinitol can develop glucose metabolism and help intensify cellular energy. Furthermore, its increase prolongs energy output by improving glucose metabolism. In other words, this medication mimics the hormone insulin. Thus, this medicine can regulate insulin levels, prohibiting the trigger of Diabetes and other metabolic factors. 
Losing weight is also a well-known solution that reduces certain hormones that curb or eliminate the projection of male hormones. Progestins (synthetic progesterones) which increase ovulation are often used to decrease certain hormones. Insulin-sensitizing anti-diabetic drugs can be used to decrease the presence of Stein Leventhal Syndrome or PCOS. Anti-androgens are used to stop the androgen increase which is a form of a male hormone. Treatment or non-treatment may have psychological effects.
In order to take control of weight, it is suggested to choose nutritious, high-fiber carbohydrates instead of sugary or refined carbohydrates. Also, it is necessary to balance carbohydrates with protein and healthy fats. One should eat small meals and snacks throughout the day instead of large meals. Most importantly, exercising regularly will help manage insulin levels and weight levels.
Other solutions to PCOS include non-steroidal agents, such as Clomiphene and Gunastotropin, which are used to stimulate ovulation in women who have potentially functioning pituitary and ovarian systems. Women treated with this medicine who become pregnant have an increased incidence of multiple births.
Gunastotropin is a hormone produced by the fetal placenta that maintains the function of the corpus luteum. The purpose of the hormone is to induce ovulation in infertility that is caused by in adequate stimulation of the ovary by endogenous gunastotropic hormones. These are hormones produced by anterior lobe of the hypophysis, which includes the follicle-stimulating hormone and the luteinizing hormone. 
Herbs and Vitamins are also considered in order to promote a more natural approach to treat Polycystic Ovarian Syndrome. Chromium, B vitamins, Zinc and Magnesium are just some of the vitamins that are affected by Polycystic Ovarian Syndrome and are needed to maintain a healthy body and lifestyle. For example, Magnesium levels have been found to be low in people with diabetes and there is a strong link between magnesium deficiency and insulin resistance. It is, therefore, an important mineral to include when Polycystic Ovarian Syndrome is involved.
Chromium is an extremely important mineral when discussing PCOS. It helps to encourage the formation of glucose tolerance factor which is a substance released by the liver and required to make insulin more efficient. A deficiency of chromium can lead to insulin resistance, which is a key problem in the case of PCOS; too much insulin can be circulating but it is unable to control blood sugar levels. Chromium is the most widely researched mineral used in the treatment of overweight. It helps to control cravings and reduces hunger. Chromium also helps to control fat and cholesterol in the blood.
Vitamins B2, B3, B5 and B6 are particularly useful for controlling weight. Vitamin B2 helps to turn fat, sugar and protein into energy. B3 is a component of the glucose tolerance factor, which is released every time blood sugar rises, and vitamin B3 helps to keep the levels in balance. Vitamin B5 has been shown to help with weight loss because it helps to control fat metabolism. B6 is also important for maintaining hormone balance and, together with B2 and B3, is necessary for normal thyroid hormone production. Any deficiencies in these vitamins can affect thyroid function and consequently affect the metabolism. The B vitamins are also essential for the liver to convert your old hormones into harmless substances, which can then be excreted from the body.
Zinc is an important mineral for appetite control and a deficiency can cause a loss of taste and smell, creating a need for stronger-tasting foods, including those that are saltier, sugary and/or spicier often more fattening, Zinc is also necessary for the correct action of many hormones, including insulin, so it is extremely important in balancing blood sugar. It also functions together with vitamins A and E in the manufacture of thyroid hormone. 
Polycystic Ovarian Syndrome, also known as PCOS and the Stein-Leventhal Syndrome is one of the most perilous of endocrine and hormonal disorders that a woman can undergo. It inflicts disorder in a number of vicinities of the human body. It varies from infertility and skin conditions to Insulin Resistance and Diabetes. These instances lead to a number of cardiovascular diseases.
Polycystic Ovarian Syndrome is depicted by excessive high levels of insulin initiated by Insulin Resistance. This is a circumstance that stops the effective change of food into energy, simply because it causes the cell wall to be negligent toward insulin. Insulin allows sugar, or glucose to permeate the cell wall and be transformed into energy. Instead of the insulin going through the cell wall, it stays there allowing a large amount of insulin to penetrate into the bloodstream. This will inflate hormone stages to an extent to where it causes the woman to be really unhealthy.
When this occurs, glucose, or blood sugar, stays in the blood stream, which make its high levels be transported to the liver. When the sugar makes it to the liver, it is then turned into fat and stored all over the body. In essence, this course of action leads to obesity and weight gain. Insulin that floats freely in the body can clog the lining of the arteries, which causes atherosclerosis. It is depicted as a harmful upsurge that proliferate the danger to the cardiovascular system, allowing strokes and heart attacks to occur.
The extreme, unnecessary amounts of insulin levels that are related to Polycystic Ovarian Syndrome also arouse the ovaries to release irregular levels of testosterone. These are particularly male hormones that can stop the ovaries from secreting an egg each month. This causes the woman to be infertile, or unable to conceive children. Women who suffer from the Stein-Leventhal Syndrome also have a higher risk of getting diabetes. The development of diabetes increases women’s chance of having cardiovascular disease. Researchers have proved that women with Polycystic Ovarian Syndrome have a much greater risk of developing heart trouble than women who do not have it.
When testosterone levels are at its peak, women with the Stein-Leventhal Syndrome have excessive hair growth or increasingly male features. Testosterone levels affect patterns of baldness and other conditions such as acne. Obesity is a huge fundamental cause of Polycystic Ovaries. Stress develops in the cardiovascular system when weight increases.
The weight gain causes the lungs and the heart to work harder in order that there is a sufficient amount of blood throughout the body that is oxygenated. Also, an increase in LDL, which is bad cholesterol and low levels of good cholesterol, HDL, amplifies the risk of heart attack and stroke. Because of the variety of possible symptoms, diagnosis can be a complex and lengthy proce
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