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    Pcos

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    Ragam Pesona Simangunsong
    This document discusses polycystic ovary syndrome (PCOS). It defines PCOS as a set of symptoms associated with hyperandrogenism and chronic anovulation related to endocrine and metabolic disorders in women without a primary disease of the pituitary or adrenal glands. The document covers the prevalence of PCOS in the US, potential etiologies, diagnostic criteria including ultrasound imaging and hormone levels, symptoms such as irregular periods, excess hair growth, acne and weight changes, and treatment options to induce ovulation.

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    Pcos

    Uploaded by

    Ragam Pesona Simangunsong
    38 views34 pages
    This document discusses polycystic ovary syndrome (PCOS). It defines PCOS as a set of symptoms associated with hyperandrogenism and chronic anovulation related to endocrine and metabolic disorders in women without a primary disease of the pituitary or adrenal glands. The document covers the prevalence of PCOS in the US, potential etiologies, diagnostic criteria including ultrasound imaging and hormone levels, symptoms such as irregular periods, excess hair growth, acne and weight changes, and treatment options to induce ovulation.

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    PPT PCOS

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    This document discusses polycystic ovary syndrome (PCOS). It defines PCOS as a set of symptoms associated with hyperandrogenism and chronic anovulation related to endocrine and metabolic disorders in women without a primary disease of the pituitary or adrenal glands. The document covers the prevalence of PCOS in the US, potential etiologies, diagnostic criteria including ultrasound imaging and hormone levels, symptoms such as irregular periods, excess hair growth, acne and weight changes, and treatment options to induce ovulation.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    38 views34 pages

    Pcos

    Uploaded by

    Ragam Pesona Simangunsong
    This document discusses polycystic ovary syndrome (PCOS). It defines PCOS as a set of symptoms associated with hyperandrogenism and chronic anovulation related to endocrine and metabolic disorders in women without a primary disease of the pituitary or adrenal glands. The document covers the prevalence of PCOS in the US, potential etiologies, diagnostic criteria including ultrasound imaging and hormone levels, symptoms such as irregular periods, excess hair growth, acne and weight changes, and treatment options to induce ovulation.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 34

    Sindroma

    Ovarium Polikistik
    Yuli Trisetiyono
    Sindroma Ovarium Polikistik

    Definisi

    • Serangkaian gejala yang dihubungkan


    dengan hiperandrogenisme dan
    anovulasi kronik yang berhubungan
    dengan kelainan endokrin dan metabolik
    pada wanita tanpa adanya penyakit
    primer pada kelenjar hipofise atau
    adrenal yang mendasari
    Hot Tip

    • How do I incorporate my logo to a


    slide that will apply to all the other
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    Master] or [Notes Master]. Change images to the one you
    like, then it will apply to all the other slides.
    What Are the Symptoms of PCOS?
     Irregular or Lack
    of
    Menses: Wome will
    “spotty” n have (1
    couple of periods
    months). every
    Also, in
    some women with PCOS they
    simply cease having a
    menses at all.
    PCOS: Menstrual Dysfunction

    – 25‐30% of women with oligo‐anovulation have PCOS


    • ≥35 day intervals or <10 bleeds per year

    – 2/3 of patients with PCOS have oligo‐anovulation

    – PCOS patients may describe “normal” menses, but


    further
    investigation reveals chronic anovulation in ~25%

    – Consequences:
    • Menstrual Dysfunction
    • Infertility
    • Endometrial hyperplasia/cancer
    Symptoms
     Hirsutism :
    body hair.
    Excessive women
    In with dark,
    PCOS hair will appear
    coarse
    on the face, neck, chest,
    arms, and in between
    the legs.
    Assessing Hirsutism

    • Modified Ferrimen‐Gallwey
    – 9 body parts, scored 0‐4 each
    – Score >6 hirsutism all the other slides.
    Symptoms
    Weight Problems :
    Depending on
    the woman, there
    could be
    a decrease of weight
    or a rapid fluctuation
    of weight that settles
    around the stomach
    that will lead to
    morbid obesity.
    Symptoms
    Acne : Because
    women with PCOS are
    producing more male
    hormone,
    that produces more
    sebum ( skin oils and
    old tissue) and causes
    blocked pores and
    more acne around the
    jawline, arms and
    chest.
    Symptoms
     Alopecia or Female
    Pattern Baldness :
    This is caused by the
    increase of male hormone
    in the women's body.
    Thinning or loss of hair is
    usually contained to top of
    the scalp, but in severe
    cases loss of hair in front
    or on the hairline has been
    documented.
    Other Symptoms
     “Dirty Skin” or
    Acanthosis Nigricans
    : This condition
    causes light
    brown to black
    rough patches around
    the neck and
    under arms.
    Migraines : Severe
    headaches that cause
    light
    sensitivity, nausea
    Hot Tip

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    Master] or [Notes Master]. Change images to the one you
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    Sindroma Ovarium Polikistik

    Definisi

    • Serangkaian gejala yang dihubungkan


    dengan hiperandrogenisme dan
    anovulasi kronik yang berhubungan
    dengan kelainan endokrin dan metabolik
    pada wanita tanpa adanya penyakit
    primer pada kelenjar hipofise atau
    adrenal yang mendasari
    Sindroma Ovarium Polikistik

    Prevalensi
    • Amerika Serikat berkisar 4-6%
    • Menurut Leventhal :
     1% - 3 % dari seluruh wanita steril
    3%-7% dari wanita yang
    pernah menderita ovarium
    polikistik

    Etiologi
    • Tidak diketahui secara pasti
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    slide that will apply to all the other
    slides?

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    Master] or [Notes Master]. Change images to the one you
    like, then it will apply to all the other slides.
    Resistensi insulin

    • Obesitas (IMT>27 Kg/m2)


    • Waist to hip ratio (WHR) > 0.85
    • Lipatan kulit subskapula > 50
    mm
    • Akantosis nigrikans
    • Kadar insulin puasa > 30
    mU/liter (>10.2)
    • Glukosa puasa : insulin puasa
    < 4.5 (<10)
    Achantosis nigricans
    • Kadar trigliserida serum > 5.5
    mmol/liter
    • Amenorea
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    slide that will apply to all the other
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    like, then it will apply to all the other slides.
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    slide that will apply to all the other
    slides?

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    Master] or [Notes Master]. Change images to the one you
    like, then it will apply to all the other slides.
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    slide that will apply to all the other
    slides?

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    Master] or [Notes Master]. Change images to the one you
    like, then it will apply to all the other slides.
    Diagnosis
     BBT (basal body temperature)
     B ultrasound:
    multiple small ovarian cysts
    enlarged ovary
     Endometrium
    biopsy(Curettage )
    before menses reveal to
    proliferative glands
     Determination of
    LH,FSH,E2,P,T,PRL ， Ins ，
    (LH:FSH≧3:1)
    2006-12-6 PCOS 21
    USG pada SOPK
     12 folikel atau lebih diameter 2-9 mm, atau
    peningkatan volume ovarium (> 10 cm3).
    (ovarian volume: 0.5xLxWxT)
     Satu OPK sudah cukup
     Perhatikan stroma ovarium yang dominan

    Swanson,M, et al. Medical implications of ultrasonically detected polycystic


    ovaries.
    J Clin Ultrasound 1981;9:219-222
    Balen, et al. Hum Reprod Update. 2003;9(6):505-14
    Diagnostic criteria for PCOS, based on a modified consensus
    of the NIH-NICHD conference on PCOS, April 1990

    Major Criteria
    Chronic anovulation
    Hyperandrogenemia
    Clinical signs of hyperandrogenism
    Exclusion of other etiologies
    Minor Criteria
    Insulin resistance
    Perimenarchal onset of hirsutism and obesity
    Elevated LH/FSH ratio
    Ultrasonographic evidence of PCOS
    Intermittent anovulation associated with
    hyperandrogenemia (free testosterone, DHEAS)

    Annal NY Academy of Sciences


    Diagnostic criteria for PCOS, based on a modified consensus
    of the NIH-NICHD conference on PCOS, April 1990

    Major Criteria
    Chronic anovulation
    Hyperandrogenemia
    Clinical signs of hyperandrogenism
    Exclusion of other etiologies
    Minor Criteria
    Insulin resistance
    Perimenarchal onset of hirsutism and obesity
    Elevated LH/FSH ratio
    Ultrasonographic evidence of PCOS
    Intermittent anovulation associated with
    hyperandrogenemia (free testosterone, DHEAS)

    Annal NY Academy of Sciences


    Diagnostic criteria for PCOS, based on a modified consensus
    of the NIH-NICHD conference on PCOS, April 1990

    Major Criteria
    Chronic anovulation
    Hyperandrogenemia
    Clinical signs of hyperandrogenism
    Exclusion of other etiologies
    Minor Criteria
    Insulin resistance
    Perimenarchal onset of hirsutism and obesity
    Elevated LH/FSH ratio
    Ultrasonographic evidence of PCOS
    Intermittent anovulation associated with
    hyperandrogenemia (free testosterone, DHEAS)

    Annal NY Academy of Sciences


    Hot Tip

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    slide that will apply to all the other
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    slides?

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    Master] or [Notes Master]. Change images to the one you
    like, then it will apply to all the other slides.
    Goal Specific Therapy

    • How do I incorporate my logo to a


    slide that will apply to all the other
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    Induksi Ovulasi pada SOPK

    • Turunkan berat badan


    • Clomiphene Citrate
    • Metformin
    • Aromatase inhibitor
    • Gonadotropin
    • Laparoscopic Ovarian Drilling
    • Fertilisasi Invivo + Transfer embryo
    Hot Tip

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    slide that will apply to all the other
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    slide that will apply to all the other
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    Master] or [Notes Master]. Change images to the one you
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    Hot Tip

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    slide that will apply to all the other
    slides?

    – On the [View] menu, point to [Master], and then click [Slide


    Master] or [Notes Master]. Change images to the one you
    like, then it will apply to all the other slides.
    Thank You!
    www.obgynundip.com

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