Essay Sample on Diagnosis and Clinical Features

Introduction

Polycystic ovary syndrome (PCOS) is a severe endocrine abnormality that usually affects women who are at the childbearing age. However, the condition can also affect younger women at the age of eleven. PCOS affects women by altering their menstrual cycle and even gaining weight which results in obesity (Teede, Deeks, & Moran, 2010). Besides, the condition is serious because it causes infertility. From Carrie Alves narration her clinical features and symptoms are consistent of PCOS which rules that she is suffering from an endocrine abnormality. Alves does not have a clinical history of the condition, but she has been experiencing irregular menstrual cycle, infertility, and acne which are synonymous to the clinical features caused by PCOS. Besides, Alves is psychologically disturbed because of her inability to get pregnant and irregular menstrual cycle which has appeared randomly thrice in the last six months.

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Pathophysiology

The primary pathophysiology of PCOS is very complex and involves different clinical disordered physiology such as insulin resistance, weight gain, and hormonal imbalance. The pathophysiology of PCOS is highly intertwined with other conditions such as obesity, diabetes, and infertility. The increased androgen and insulin production causes the hormonal imbalance underlying the condition. The causes of hormonal disturbances do not only cut across both genetic and environmental factors but also obesity, ovarian dysfunction, and the hypothalamic-pituitary abnormality. The lack of ideal methods to assess the pathophysiology of PCOS leading to the development of multiple pathophysiological factors (Teede et al., 2010). In the case of Alves, both ovarian dysfunction and obesity can be claimed to be the main pathophysiological factors due to weight gain, infertility, and irregular menstrual cycle. Besides, hyperandrogenism has also been established as a significant factor in the development of PCOS which from clinical evidence is the cause in 60% to 80% of all the diagnosed cases whereas insulin resistance has been reported in 50% to 80% cases of PCOS (Teede et al., 2010).

Metabolic Aspect of the Condition

Obesity which is caused by insulin resistance and Alves reported an increase in weight by 12 pounds which is synonymous to previous PCOS cases. Insulin resistance affects not only the metabolic system but also the reproductive system. The effect of insulin resistance on the reproductive system is by leading to a dysfunction in the production of androgen. Androgen is a hormone that has been related to hormonal disorders when it is in excess, or there is a deficiency in females (Palacios, 2007). In this case, the insulin resistance causing weight gain and the abnormal androgen production is the leading cause of Alves irregular menstrual cycle and infertility (Saylor & Friedmann, 2015). The patient weight gain is a significant factor of consideration in her infertility as well as PCOS due to increased hyperandrogenism associated with obesity. Besides, obesity leads to increased insulin resistance in PCOS. Therefore, the patient clinical features are consistent to the PCOS diagnostic characteristics.

PCOS Clinical Features

From the diagnosis of Alves, key PCOS clinical features such as psychological disturbance, anxiety, reproductive manifestation, and metabolic implications can be identified. Alves appears disturbed and filled with anxiety due to her menstrual cycle irregularity. Another positive clinical feature identified in the case of Alves is the metabolic dysfunction due to her weight gain which is a sign of insulin resistance. The clinical nature of PCOS, in this case, appears to be heterogeneous with the last presentation of the condition being infertility and menstrual irregularity.

Interventions and Preconceived Outcomes

Targeted Approach Therapy

Due to the heterogeneous nature of the clinical presentation in the case of Alves, a targeted approach therapy is a right approach of intervention which involves tailored treatment based on the clinical features identified positively with Alves (Teede et al., 2010). In this case, an interprofessional approach will be used which will include counseling, and lifestyle-related intervention will be useful in the case of Alves by mitigating weight gain and psychological features such as anxiety which can prepare the patient for the healing process based on the holistic patient care principles. Lifestyle changes such as exercising and diet changes can help reduce insulin resistance which will be vital in treating obesity and infertility (Perreault, Pan, Mather, Watson, Hamman, Kahn, & Diabetes Prevention Program Research Group. 2012).

Pharmacological Therapy

Besides the targeted approach therapy the pharmacological therapy can benefit Alves by helping to regulate her hormones which will help to correct infertility problems. Metformin can be administered to reduce insulin resistance which cannot be corrected using lifestyle change only and can be used to promote PCOS management. Besides, estrogen injections can be used to aid hormonal balancing which can help to lead to regular menstrual cycles and fertility (Teede et al., 2010).

References

Palacios, S. (2007). Androgens and female sexual function. Maturitas, 57(1), 61-65.

Perreault, L., Pan, Q., Mather, K. J., Watson, K. E., Hamman, R. F., Kahn, S. E., & Diabetes Prevention Program Research Group. (2012). Effect of regression from prediabetes to normal glucose regulation on long-term reduction in diabetes risk: results from the Diabetes Prevention Program Outcomes Study. The Lancet, 379(9833), 2243-2251.

Saylor, J., & Friedmann, E. (2015). Biopsychosocial contributors to metabolic syndrome: a secondary analysis of 2007-2010 National Health and Nutrition Examination Survey Data. Nursing Research, 64(6), 434-443.

Teede, H., Deeks, A., & Moran, L. (2010). Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan. BMC Medicine, 8(1), 41.