Journal article

Polycystic ovarian syndrome and insulin resistance: implications for estrogen use in premenopausal and postmenopausal women.

Metab Syndr Relat Disord, vol. 3, issue 3 (2005) pp. 259-269

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Polycystic ovarian syndrome (PCOS) is the most frequent endocrine
disorder of reproductive age women, affecting an estimated 8-10%
of all women in this age group or approximately six million women.
Further, women with PCOS continue to manifest the metabolic alterations
inherent in the insulin resistance syndrome after menopause, rendering
them more susceptible to type 2 diabetes and cardiovascular disease.
Aging and obesity further contribute to these risks. Since estrogen-containing
therapy is commonly used for menstrual regulation in premenopausal
women with PCOS, it is important to evaluate the possible consequences
of hormonal therapy on subsequent metabolic and cardiovascular risk.
In postmenopausal women, a consensus regarding the appropriate role
of estrogen replacement therapy is currently in evolution. By examining
the effects of estrogen with or without progesterone on insulin resistance,
insight may be gained about the risk/benefit ratio of this therapy
in the subset of women with insulin resistance, PCOS, and type 2
diabetes. The goal of this review, then, is to examine the known
effects of estrogen on insulin sensitivity and its implications for
cardiovascular and metabolic risk.

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  • Rhoda H Cobin

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