Polycystic ovary syndrome and hirsutism

Yıl 2011, Cilt: 46 Sayı: 11, 8 - 13, 01.03.2011

Olcay Evliyaoğlu

https://doi.org/10.4274/tpa.46.45

Öz

Polycystic ovary syndrome is a multi factorial heterogenous disorder characterized by chronic anovulation and hyperandrogenism Diagnosis is based on clinical or laboratory evidence of nbsp; hyperandrogenism nbsp; For diagnosis at least two of the three Rotterdam criteria oligo anovulation clinical or biochemical signs of hyperandrogenism polycystic ovaries nbsp; should be ensured Clinical symptoms usually begin around menarche nbsp; Oligomenorrhea amenorrhea hirsutism acne alopecia can be associated with central obesity İnsulin resistance hyperandrogenism LH excess and sonographic appearance of polycystic ovaries are the laboratory findings nbsp; Functional ovarian and adrenal hyperandrogenism can be demonstrated in the majority of the patients Although pathogenesis is multifactorial insulin resistance seems to play a central role nbsp; İrrespective of obesity there is insulin resistance in 50 70 of the patients Adolescents presenting with hirsutism menstrual irregularities and central obesity should be evaluated for differential diagnosis of nbsp; hyperandrogenism and the etiology be determined Treatment depends on the clinical signs and the source of hyperandrogenism nbsp; nbsp; In the patients with menstrual disorders and or functional ovarian hyperandrogenism oral contraceptives are the first line drugs nbsp; Antiandrogens are prefered in patients with hirsutism and functional hyperandrogenism nbsp; If insulin resistance is the heading symptom insulin sensitizers can be used Hirsutism is defined as excessive terminal hair growth at androgen dependent sites and is the most frequent symptom of hyperandrogenism Treatment consists of nbsp; androgen decreasing drugs related to the etiology of androgen excess and locally epilation of the hair In patients presenting with polycystic ovary syndrome and hirsutism initially the etiology of hyperandrogenism should be identified and treatment planned appropriate to the reason Turk Arch Ped nbsp; 2011; 46 Suppl: 97 102

Anahtar Kelimeler

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Polikistik over sendromu ve hirsutizm

Öz

Polikistik over sendromu kronik anovulasyon ve hiperandrojenizm ile kendini gösteren birçok etmenin birlikte oluşturduğu heterojen bir bozukluktur Tanısı hiperandrojenizmin klinik ve laboratuvar bulgularının gösterilmesine ve hiperandrojenizme neden olabilecek diğer bozuklukların dışlanmasına dayanır nbsp; Rotterdam kriterlerinden oligo anovulasyon hiperandrojenizm klinik ve veya biyokimyasal bulguları ve ultrasonografide polikistik overlerin görülmesi en az ikisinin bulunması ile tanı konulur Klinik bulgular menarş yaşı civarında ortaya çıkar Oligomenore amenore hirsutizm akne ve alopesi gibi kronik anovulasyon ve hiperandrojenizm bulguları yanı sıra olgularda santral obezite de bulunabilir İnsulin direnci hiperandrojenizm LH fazlalığı ve ultrasonografide polikistik over görüntüsü laboratuvar bulgularıdır nbsp; Fonksiyonel ovarian veya adrenal hiperandrojenizm olguların önemli bir kısmında belirlenebilir Patogenezinde tek bir etken rol oynamamak ile birlikte insulin direnci merkezde gibi görünmektedir nbsp; Obeziteden bağımsız olarak olguların 50 70 rsquo;inde insulin direnci bulunmaktadır Pubertede hirsutizm menstürel bozukluklar veya santral obezite ile başvuran bütün olgularda ayırıcı tanıda hiperandrojenizme neden olabilecek bozukluklar araştırılmalı hiperandrojenizm nedeni belirlenmeye çalışılmalıdır Tedavisi bulgulara ve hiperandrojenizmin kaynağına bağlı olarak değişkendir Menstürel bozuklukları ve veya fonksiyonel ovarian hiperandrojenizmi bulunan olgularda doğum kontrol hapları ilk seçenektir nbsp; Antiandrojenler hirsutizmi ve fonksiyonel hiperandrojenizmi olanlarda tercih edilir İnsulin direnci ön planda ise insulin duyarlılığını arttıran ilaçlar kullanılır Hirsutizm androjenik bölgelerde aşırı terminal kıllanma olmasıdır Hiperandrojenizmin en sık klinik bulgusudur Tedavisi nbsp; androjen kaynağına göre androjen nbsp; miktarını düşürücü ilaçlar ile birlikte kılların lokal olarak ortadan kaldırılmasıdır Polikistik over sendromu ve hirsutizm ile başvuran olgularda öncelikle hiperandrojenizmin nedeni bulunmalı ve nedene yönelik tedavi planlanmalıdır Türk Ped Arş 2011; 46 Özel Sayı: 97 102

Anahtar Kelimeler

Polikistik over sendromu, hirsutizm, hiperandrojenizm

Kaynakça

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