SAVREMENI TERAPIJSKI PRINCIPI U LEČENJU BOLESNICA SA SINDROMOM POLICISTIČNIH JAJNIKA
Sažetak
Poremećaj funkcije jajnika predstavlja stanje u kojem dolazi do neravnoteže, odnosno poremećaja stvaranja polnih hormona; usled toga nastaju poremećaji u menstrualnom ciklusu i smanjena sposobnost začeća ili održavanja trudnoće. Poremećaj funkcije jajnika može biti primaran, usled patofiziologije na nivou jajnika, ili sekundaran; tada poremećaj nastaje kao posledica poremećaja drugih žlezda poput hipofize i štitne žlezde. Sindrom policističnih jajnika složen je endokrinološki poremećaj, a prvi put je opisan 1935. godine. Najčešći je uzrok sekundarne amenoreje, a smatra se i najčešćim uzrokom ovulatorne disfunkcije žena u reproduktivnom periodu. Termin sindrom odnosi se na skup kliničkih karakteristika ili fenotip. Specifične karakteristike klasičnih fenotipova sindroma policističnih ovarijuma podrazumevaju kliničke znakove viška androgena, povišene koncentracije androgena u serumu, neredovne menstruacije i neplodnost kao posledicu. Takođe, zbog česte udruženosti sa insulinskom rezistencijom i hiperinsulinemijom mora se posmatrati i lečiti i kao metabolički poremećaj. Upravo je zbog kompleksnosti različitih poremećaja koji se mogu videti u različitim fenotipovima terapijski pristup vrlo kompleksan i individualizovan. Ovaj pregledni rad zasnovan je na pretraživanju celokupne raspoložive literature u dostupnim bazama podataka i praktično daje prikaz svih terapijskih opcija u lečenju bolesnica sa sindromom policističnih ovarijuma koje su danas dostupne. U svakom slučaju, potrebno je sprovesti još istraživanja da bi se razjasnila složena patofiziologija sindroma policističnih ovarijuma. Stoga, neophodne su dodatne prospektivne epidemiološke studije.
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