Furocyst - Poly Cystic Ovary Syndrome Study
Condition: PCOS
MeSH terms: Ovarian Cysts
Study type: Interventional

Summary: 
      Poly cystic ovary syndrome (PCOS) is the most common endocrine disorder in women of
      reproductive age, affecting approximately 5%-10% of all females worldwide . PCOS is a
      hormonal disorder that involves multiple organ systems within the body. Its cardinal features
      are Hyperandrogenism and polycystic ovary (PCO) morphology. Women with PCOS may complains
      about irregular menstrual periods or heavy menstrual bleeding, infertility, excessive growth
      of coarse facial and body hair, obesity, oiliness of the skin, seborrhea, and cystic acne.
    

Detailed description: 
      The symptoms of PCOS are anovulation, resulting in irregular menstruation (amenorrhea and
      oligomenorrhea) ovulation-related infertility, and polycystic ovaries, often associated with
      obesity, Type 2 diabetes, and high cholesterol levels. The level of serum insulin and insulin
      resistance are higher in women with PCOS (Hyperinsulinemia).Insulin resistance, defined as
      the decreased insulin mediated glucose utilization it is more common in women with PCOS up to
      50 % in both obese and non obese women . It has also been recognized that some women with
      this syndrome will have PCO without clinical evidence of androgen excess, but will display
      evidence of ovarian dysfunction .

      It is believed to be that, the Hyperinsulinemia of PCOS stimulates the androgens production
      and increase the activity by decreasing the sex hormone binding globulin (SHBG) thus
      increasing the free active testosterone level and by the activating the cytochrome P 450 C 17
      alpha enzymatic system that controls androgens production.

      The diagnosis of PCOS is based on Hyperandrogenism and chronic anovulation in the absence of
      specific pituitary or adrenal disease , and have disrupted ovulatory function with chronic
      oligomenorrhea (cycle length > 35 day) or amenorrhea (cycle length > 12 week) and typical
      appearance of polycystic ovaries by ultrasound according to the criteria of the Rotterdam
      consensus meeting 2003 for diagnosis of PCOS. The different diagnostic tests needed to
      adequately assess for the possibility of PCOS e.g. Pregnancy test, TSH level (for
      Hyperthyroidism), Prolactin test (for Hyperprolactinemia), Total testosterone (for ovarian
      tumor) and some tests forevaluating the insulin resistance syndrome in women: Waist
      circumference (>88 cm), Triglycerides (>150 mg/dL), HDL Cholesterol (<50 mg/dL), Blood
      pressure (>130/85) and Fasting glucose (>110 mg/dL). Fasting glucose- to- insulin ratio and 2
      hour oral glucose tolerance test (2h- OGTT 140 - 199 mg/dL) may be better predictor of
      insulin resistance .

      The management of the PCOS is symptoms specific e.g.

        1. Oral contraceptives, periodic progesterone withdrawal for the control of irregular
           menstruation.

        2. Oral contraceptives, Metformin and anti-androgens (Spironolactone) for the

           Hirsutism.

        3. Clomiphene citrate, Metformin and thiazolidinediones for infertility. A recent study
           shown that, the combination of Metformin plus Clomiphene citrate should be considered as
           the First line treatment for infertile women with PCOS .

        4. Metformin and lifestyle modification for the insulin resistance and diabetes mellitus.

      All these management options are only for "acute" not for "chronic". The long-term management
      approach for the PCOS is needed which will be based on management of most affecting factor
      insulin resistance.
    

Intervention name(s): Furocyst
Intervention type(s): Dietary Supplement
Intervention description(s): Furocyst caps BD
Other intervention name(s): Standardized fenugreek extract
Intervention MeSH terms: Fenugreek seed meal
Intervention model: Single Group Assignment
Intervention model description: open level
Masking: None (Open Label)
Primary purpose: Supportive Care
Keywords: Furocyst; PCOS