Principi farmakološkog liječenja žena sa sindromom policističnih jajnika koje ne planiraju trudnoću

master's thesis

• Title (english): Pharmacological principles of treating polycystic ovary syndrome in women not seeking pregnancy
• Author: Iva Miličić
• Mentor: Dinka Pavičić Baldani (mentor)
• Committee member: Lana Škrgatić (predsjednik povjerenstva)
• Committee member: Željko Duić (član povjerenstva)
• Committee member: Dinka Pavičić Baldani (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Gynecology and Obstetrics); Zagreb
• Defense date and country: 2020-07-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Gynecology and Obstetrics

Abstract

Sindrom policističnih jajnika (engl. Polycystic ovary syndrome - PCOS) najčešći je endokrinološki poremećaj u žena reprodukcijske dobi. Cjelokupna etiologija ovog sindroma još uvijek je nedovoljno istražena, no poznato je da ovaj sindrom osim endokrinoloških manifestacija ima i one reproduktivne i metaboličke. Zbog složene i promjenjive kliničke slike bolesnica s PCOS, farmakoterapijske mogućnosti su brojne. Kombinirana oralna hormonska kontracepcija, metformin, anti-androgeni lijekovi kao što su flutamid i spironolakton, lijekovi za liječenje pretilosti i inozitol trenutne su farmakoterapijske mogućnosti preporučene po najnovijim svjetskim smjernicama. Kombinirana oralna hormonska kontracepcija u žena (KOHK) s PCOS smanjuje hiperandrogenemiju ili hiperandrogenizam, akne, bolne, produljene, neredovite menstruacije, anovulaciju i sideropeničnu anemiju, a primjena ovog lijeka tijekom duljeg niza godina djeluje preventivno na nastanak karcinoma endometrija i jajnika. Metformin je u žena s PCOS pogodan za smanjenje metaboličkih i reproduktivnih manifestacija ovog sindroma, dok su anti-androgeni povoljan odabir za liječenje kliničkih pokazatelja povišenih muških spolnih hormona u serumu kao što su hirzutizam ili androgena alopecija. Lijekovi za liječenje pretilosti osim gubitka težine pomažu i u povećanju osjetljivosti na inzulin te korekciji lipidnog profila. Inozitol se pokazao učinkovitim u uspostavi ovulatorne funkcije jajnika. Svaki od ovih lijekova sa sobom nosi svoje rizike i potencijalne nuspojave, a s obzirom na veliku varijabilnost u kliničkoj i laboratorijskoj manifestaciji PCOS izbor optimalnog liječenja žena s PCOS zahtijeva veliko kliničko znanje i iskustvo.

Abstract (english)

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive age women. The complete etiology of the symptom still remains unclear but it is known that the syndrome has reproductive and metabolic manifestations besides the endocrinological ones. Clinical representation of these patients can be complex and variable which is why the pharmacological options are numerous. Combined oral hormonal contraception, metformin, anti-androgens, anti-obesity agents and inositol are currently the only pharmacotherapy advised by the newest worldwide-accepted guidelines. Combined oral hormonal contraception is used to treat hyperandrogenemia or hyperandrogenism, acne, painful, prolonged, and unregular periods, anovulation and sideropenic anemia, and if taken for several years, this medication works preventive on endometrial and ovarian cancer. Metformin is useful in treating metabolic and reproductive manifestations of PCOS while the anti-androgen agents help with clinical presentation of elevated serum male sex hormones such as hirsutism or androgenous alopecia. Anti-obesity drugs are helpful in losing weight, repairing insulin sensitivity and lipid status of these patients. Inositol has shown to help restore ovarian activity. Each of these drugs has its own risks and side effects, and clinical representation of
the syndrome can vary - which is why the recognition of the optimal therapy of PCOS women seeks great clinical knowledge and experience.

• Keywords: sindrom policističnih jajnika; kombinirana oralna hormonska kontracepcija; metformin; inozitol; anti-androgeni lijekovi
• Keywords (english): polycistyc ovary syndrome; combined oral hormonal contraception; metformin; inositol; anti-androgen agents
• Language: croatian
• URN:NBN: urn:nbn:hr:105:751513
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2021-09-06 10:17:15