Fertile Health, LLC, USA
Posters & Accepted Abstracts: Endocrinol Metab Syndr
Polycystic ovary syndrome (PCOS) is a common endocrine disorder found in reproductive age women. Although the cause is uncertain, it is hypothesized that insulin resistance (IR) , and then compensatory hyperinsulinemia, is responsible for generating many of the hormonal and metabolic abnormalities found in this subset of patients. High levels of insulin potentiate ovarian androgen production, resulting in a disordered ovarian environment which is detrimental to folliculogenesis and, therefore, ovulation. In addition, it generates the clinical and/or serum signs of hyperandrogenism that affect many of these patients and can contribute to a decreased quality of life. Interventions which reduce insulin resistance, then, can improve the metabolic, reproductive and psychological consequences of PCOS. More than half of patients with PCOS are overweight or obese. Excess weight (particularly abdominal obesity) is closely linked to IR. Abdominal adipose cells are metabolically active and contribute to insulin resistance and chronic inflammation. Therefore, weight management is crucial to patients with PCOS. For many clinicians, discussing weight in their practice can be so uncomfortable that it is not done properly or at all. Clinicians must overcome this discomfort in order to discuss weight in the office setting in a sensitive manner while still underscoring the importance of weight loss or maintenance. Reproductive endocrinology (RE) offices should also strongly consider partnering with an experienced nutritionist or dietician, particularly one with an endocrine background. Finally, since PCOS is a heterogeneous condition, a multidisciplinary approach is best. In addition to a nutritionist, clinicians need to form and cultivate a referral network of complimentary care providers.