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Pcos
A Holistic Approach to Managing Patients with Polycystic Ovary Syndrome

Abstract
Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age. This disorder is characterized by ovulatory and menstrual dysfunction, hyperandrogenemia, metabolic abnormalities, and polycystic ovaries. Resulting from complex metabolic and endocrine dysfunctions, women with PCOS often suffer from menstrual irregularities, infertility, insulin resistance, lipid abnormalities, obesity, hirsutism, and acne. The long-term health risks of PCOS are significant as women with this disorder constitute the largest group of women at risk for the development of type 2 diabetes and cardiovascular disease. The social and emotional well-being of women with PCOS is also at stake as many women suffer from depression and social isolation due to burdening symptoms of their disorder. A holistic treatment approach to the management of PCOS is necessary to encompass the complexity of the disorder. Health care workers, specifically working in women’s health areas, have an excellent opportunity to screen for this disorder as well as counsel their patients and provide an individualized and holistic treatment plan.

Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality in young women today (Watkins-Smith & Taylor, 2011). Multiple studies have shown the prevalence of this disorder affecting anywhere from 4%-20% of women of reproductive age (Bargiota & Diamant-Kandarakis, 2012; Garad, 2011; Teede, Deeks, & Moran, 2010; Watkins-Smith & Taylor, 2011). Women with PCOS present to their healthcare provider with complaints of irregular menses, inability to become pregnant, as well as with physical complaints of acne and facial hair (Ahonen, 2010). While these clinical symptoms are unpleasant and psychologically disturbing, women are unaware of the multitude of additional health concerns they are at risk for. Women with



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The effects of old, new, and emerging medicines on metabolic aberrations in PCOS Barry, J., Kuczmiercyk, A., & Hardiman, P. (2011). Anxiety and depression in polycystic ovary syndrome: A systematic review and meta-analysis Chang, J. (2004). A practical approach to the diagnosis of polycystic ovary syndrome. American Journal of Obstetrics and Gynecology, 191, 713-717 Chavarro, J.E., Rich-Edwards, J.W., Rosner, B.A., & Willett, W. C. (2007). Diet and lifestyle in the prevention of ovulatory disorder infertility Chazenbalk, G., Chen, Y., Heneidi, S., Lee, J., Pall, M., Chen, Y., & Azziz, R. (2012). Abnormal expression of genes involved in inflammation, lipid metabolism, and wnt signaling in the adipose tissue of polycystic ovary syndrome Cho, L.W. (2011). Metabolic syndrome. Singapore Medical Journal, 52(11), 779-785. Connolly, M.P., Hoorens, S., & Chambers, G.M. (2010). The costs and consequences of assisted reproductive technology: An economic perspective Crete, J. & Adamshick, P. 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Therapeutic effects of calcium and vitamin d supplementation in women with PCOS Garad, R., Teede, H., & Moran, L. (2011). An evidence-based guideline for polycystic ovary syndrome Glueck, C.J., Pranikoff, J., Aregawi, D., & Wang, P. (2008). Prevention of gestational diabetes by metformin plus diet in patients with polycystic ovary syndrome Groot, P., Dekkers, O., Romijn, J., Dieben, S., & Helmerhorst, F. (2011). PCOS, coronary heart disease, stroke, and the influence of obesity: A systematic review and meta-analysis Herriot, A.M., Whitcroft, S., & Jeanes, Y. (2008). An retrospective audit of patients with polycystic ovary syndrome: The effects of a reduced glycaemic load diet Hill, K.M. (2003). Update: The pathogenesis and treatment of PCOS. The Nurse Practitioner, 28(7), 8-22. Hu, F. (2003). Overweight and obesity in women: Health risks and consequences. Journal of Women’s Health, 12(2), 163-170 Jason, J. (2011). Polycystic ovary syndrome in the United States: Clinical visit rates, characteristics, and associated health care costs Karakas, S.E., Kim, K., & Duleba, A.J. (2010). Determinants of impaired fasting glucose versus glucose intolerance in polycystic ovary syndrome Kumar, C.P. (2007). Application of Orem’s self-care deficit theory and standardized nursing languages in a case study of a woman with diabetes Lass, N., Kleber, M., Winkel, K., Wunsch, R., & Reinehr, T. (2011). Effect of lifestyle intervention on features of polycystic ovarian syndrome, metabolic syndrome, and intima-media thickness in obese adolescent girls Lawson, M., Jain, S., Sun, S., Patel, K., Malcolm, P., & Chang, R. (2008). Evidence for insulin suppression of baseline luteinizing hormone in women with polycystic syndrome and normal women Linn, J. & Mann, D.M. (2012). Application of persuasion and health behavior theories for behavior change counseling: Design of the ADAPT (Avoiding diabetes thru action plan targeting) program Lungu, A.O., Zadeh, E.S., Goodling, A., Cochran, E., & Gorden, P. (2012). Insulin resistance is a sufficient basis for hyperandrogenism in lipodystrophic women with polycystic oavrian syndrome Moore, A. (2011). Importance if collaboration in treating chronic disease. WebNP Online. Retrieved from http://www.webnponline.com/articles/article_details/importance-of-collaboration-in-treating-chronic-disease/ Moran, L., Gibson-Helm, M., Teede, H., Deeks, A. (2010). Polycystic ovary syndrome: A biopsychosocial understanding in young women to improve knowledge and treatment options National Conference of State Legislatures. (2012). State laws related to insurance coverage for infertility treatment O’Connor, A., Gibney, J., & Roche, H. (2010). Metabolic and hormonal aspects of polycystic ovary syndrome: The impact of diet Paiz, J., Angeli, E., Wagner, J., Lawrick, E., Moore, K., Anderson, M., …Keck, R. (2012). General format Panidis, D., Farmakiotis, D., Rousso, D., Kourtis, A., Katsikis, I., & Krassas, G. (2008). Obesity, weight loss, and the polycystic ovary syndrome: Effect of treatment with diet and Orlistat for 24 weeks on insulin resistance and androgen levels Percy, C., Gibbs, T., Potter, L., & Boardman, S. (2009). Nurse-led peer support group: experiences of women with polycystic ovary syndrome Pontikis, C., Yavropoulou, M., Touis, K., Kotsa, K., Kazakos, K., Papasizi, A.,….Yovus, J. (2011) Raja-Khan, N., Stener-Victorin, E., Wu, X., & Legro, R. (2011). The physiological basis of complementary and alternative medicines for polycystic ovary syndrome Sathyapalan, T. & Atkin, S.L. (2012). Mechanisms in endocrinology: Recent advances in cardiovascular aspects of polycystic ovary syndrome Sattar, N. (2009). Review: PCOS, insulin resistance, and long-term risks for diabetes and vascular disease Talbott, E.O., Zborowski, J.V., Rage, J.R., Kip, K.E., Xiaohui, X., & Orchard, T. J. (2007). Polycystic ovarian syndrome: A significant contributor to the overall burden of type 2 diabetes in women Teede, H., Deeks, A., & Moran, L. (2010). Polycystic ovary syndrome: A complex condition with psychological, reproductive, and metabolic manifestations that impacts on health

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