Talk:Polycystic ovary syndrome
|Ideal sources for Wikipedia's medical content are defined in the guideline, Wikipedia:Identifying reliable sources (medicine). Here are links to possibly useful sources of information about Polycystic ovary syndrome.
|WikiProject Medicine / Dermatology / Reproductive medicine||(Rated B-class, High-importance)|
- 1 Premature statements about simple genetic cause not supported in current scientific literature
- 2 prevalence
- 3 cortisol
- 4 To patients looking for advice about their own symptoms
- 5 Killing the link farm
- 6 Gestational diabetes
- 7 To Women Looking for Information on PCOS Research Studies
- 8 Alternative approaches - ayurveda
- 9 Trans fats as a cause?
- 10 Review about PCOS and insulin resistance
- 11 alternative treatments
Premature statements about simple genetic cause not supported in current scientific literature
Although this piece references "genetic causes" as an established scientific fact, nothing could be further from the truth, and of the two sources referenced, one is a 2002 paper which talks about a couple of gene loci, but not a genetic cause, and the other reference simply talks about genetic screening technologies but does not say that PCOS is "genetically caused". The reality is that it's probably gene-environment interactions(like most everything else), and this piece completely glosses over that issue and certainly could lead the unsophisticated or poorly informed reader to believe that a genetic cause in a simple sense was a virtual certainty – hardly the case. First of all, PCOS has a very strong association with maternal obesity, and with metabolic syndrome and insulin resistance, clues that this is not simply due to some 'aberrant' gene, but more likely an aberrant form of epigenetic metabolic programming associated with maternal obesity and its effects on the developing fetus. There are probably multiple Genetic polymorphisms that might contribute to PCOS, but that's really quite a far cry from dismissing all the environmental and lifestyle variables that look increasingly critical to this syndrome. This syndrome has only recently emerged in the context of the explosion of obesity in the United States, and it was thought to be exceptionally rare before that. I have cut and pasted a somewhat more balanced review of the genetic and environmental issues, which clearly needs some form of corrective attention in this treatment.
Steroids. 2011 Dec 8. [Epub ahead of print] Metabolic and cardiovascular genes in polycystic ovary syndrome: A candidate-wide association study (CWAS). Jones MR, Chua AK, Mengesha EA, Taylor KD, Chen YD, Li X, Krauss RM, Rotter JI; Reproductive Medicine Network, Legro RS, Azziz R, Goodarzi MO. Source
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States. Abstract
The role of metabolic disturbance in polycystic ovary syndrome (PCOS) has been well established, with insulin resistance and the resulting compensatory hyperinsulinemia thought to promote hyperandrogenemia. Genome-wide association studies (GWAS) have established a large number of loci for metabolic conditions such as type 2 diabetes and obesity. A subset of these loci has been investigated for a role in PCOS; these studies generally have not revealed a confirmed role for these loci in PCOS risk. However, a large scale investigation of genes related to these pathways has not previously been performed. We conducted a two stage case control association study of 121,715 single nucleotide polymorphisms (SNPs) selected to represent susceptibility loci associated with traits such as type 2 diabetes, obesity measures, lipid levels and cardiovascular function using the Cardio-Metabochip in 847 PCOS cases and 845 controls. Several hypothesis-generating associations with PCOS were observed (top SNP rs2129107, P=3.8×10(-6)). We did not find any loci definitively associated with PCOS after strict correction for multiple testing, suggesting that cardio-metabolic loci are not major risk factors underlying the susceptibility to PCOS.
- I'll try to take a look at that reference (a DOI would be nice - will try to check PubMed for one) and incorporate the various viewpoints once I'm able to take a look at all three articles in question (again) - I'm currently on vacation. Anyone else who wishes to come up with a compromise/reflecting-uncertainty/reflecting-disagreement version before I do is, of course, welcome to do so. (BTW, I disagree with you that associations with metabolic syndrome and insulin resistance necessarily imply a lack of Mendelian genetics being involved - these may be consequences, not causes, or both may be caused by the same thing - and, in regard to maternal obesity, I don't see why a relatively-simple genetic susceptibility is ruled out by this. Admittedly, as a geneticist I am biased...) I personally think that the article currently states that the causes are not purely genetic by any means, but as the author of much of the current version of these, I am again biased, and may (for instance) be seeing subtleties that the average reader may not. Allens (talk) 05:21, 3 January 2012 (UTC)
- I also don't see the problem here. For one thing, "we didn't find any SNPs when looking at heart disease and metabolic disease" is not the same thing as "it is not genetic". The same kind of study would equally have "proven" that BRCA mutations don't cause breast cancer. If anything, this study confirms the commonly held view that PCOS is its own genetic disease that happens to cause metabolic disturbances, rather than being caused by metabolic disturbances.
- Also, I think that part of the difference in opinions here is how you define "disease". Environmental factors clearly affect the severity of clinical symptoms, but they cannot produce the condition in someone who doesn't have the genetic susceptibility. I've never seen a report on a truly isolated or spontaneous case of PCOS without any hint of it in the family history; have you? But it's perfectly typical to find PCOS in a woman whose normal-weight mother or aunt is known to have had intractable acne, long menstrual cycles, enlarged ovaries, or unexplained infertility, but who was never properly worked up for PCOS. WhatamIdoing (talk) 05:57, 3 January 2012 (UTC)
Prevalence in this article is stated as 5%, based on a single study. Yet there have been a plethora of studies attempting to establish the prevalence of PCOS, with results ranging from 5 to 15% (iirc). A single percentage ignores that range. It also ignores the fact that the diagnostic criteria for PCOS is in dispute, which means that to be specific (rather than giving a range), you need to specify which definition was used to establish that percentage. How is this usually dealt with here on Wikipedia? 220.127.116.11 (talk) 05:01, 15 January 2010 (UTC)milara
- By finding the best sources we can—ideally from high-quality reviews or medical textbooks—and trying to accurately summarize what they say. It's often appropriate to avoid extremely recent publications, but on a relatively common medical condition like this, we shouldn't have any need to resort to studies more than approximately five years old. In addition to providing an overall range, it may be appropriate to provide information on prevalence in different racial groups.
- When you believe an article needs improvement, please feel free to make those changes. Wikipedia is a wiki, so anyone can edit almost any article by simply following the edit this page link at the top. The Wikipedia community encourages you to be bold in updating pages. Don't worry too much about making honest mistakes—they're likely to be found and corrected quickly. If you're not sure how editing works, check out how to edit a page, or use the sandbox to try out your editing skills. New contributors are always welcome. You don't even need to log in (although there are many reasons why you might want to).
- You are also welcome to read the doctors' mess, which is a page open to anyone who is interested in improving Wikipedia's articles about medical conditions. WhatamIdoing (talk) 05:35, 15 January 2010 (UTC)
To patients looking for advice about their own symptoms
All you have to do is google "PCOS support group" and you will get literally scores of precise links where there are hundreds of people waiting to answer all your questions in warm fuzzy manners. Once again, wikipedia is not a source of medical advice unless you want to risk getting it from an anonymous 15 year old (I am not exaggerating), nor is it a support group or discussion forum. It seems harsh, but this page is especially hard hit. I will move all the above to an archive. Thanks for understanding. alteripse 21:05, 28 May 2007 (UTC)
I have deleted a bunch of external links to support groups and magazine articles about PCOS. The biggest problem is that half of the websites were listed twice (except the Australian group, which had four links), but in general I believe we need to remember that Wikipedia is not an advertising opportunity for our favorite organizations. Women with PCOS are smart enough to do their own Internet searches if they want more resources. WhatamIdoing (talk) 03:00, 27 November 2007 (UTC)
An anon added unsourced information about gestational diabetes recently. It was promptly removed. It might be worth sorting that out. PMID 18710713 is a (very) recent systematic study on the issue, and I found its conclusion slightly unusual: The odds ratio is 2.89, but they'd don't trust it. WhatamIdoing (talk) 15:00, 2 September 2008 (UTC)
To Women Looking for Information on PCOS Research Studies
Thought my source could be used as an additional resource for those accessing this PCOS page. Northwestern University's Feinberg School of Medicine (http://www.pcos.northwestern.edu/) provides information for those women wanting to get involved in PCOS research studies and whether certain genes increase a woman's chance of getting PCOS. Makofin (talk) 20:14, 19 November 2008 (UTC)Makofin
The University of Pennsylvania and Penn State University are conducting a NIH clinical randomized research trial to establish the relative roles of treatment of hyperandrogenism versus obesity in treating infertility and improving pregnancy outcomes among PCOS women. For more information about this study, acccess this link. (http://webapp.hmc.psu.edu/owlpcos/website/index.cfm)Owlpcos (talk) 18:53, 29 July 2009 (UTC)
Alternative approaches - ayurveda
The recently added paragraph about ayurvedic remedies is uncited and poorly worded. I am not sure the information belongs in the article, but would have felt brash to delete it without discussion. --shingra (talk) 12:15, 27 May 2010 (UTC)
- It didn't sound very encyclopedic, and I support its removal. WhatamIdoing (talk) 19:45, 2 June 2010 (UTC)
Trans fats as a cause?
This article previously mentioned trans fats as a potential cause of PCOS, but the entry was removed, mainly because the two sources ( and ) actually had not studied on people with PCOS, so their conclusions cannot be held as be valid for people with PCOS. My opinion in this case is that, because of the potential controversy of the subject, a reliable medical source (and one that specifically includes people with PCOS) is necessary for any mention of trans fats in the Cause section.Mikael Häggström (talk) 10:45, 21 September 2011 (UTC)
Review about PCOS and insulin resistance
this is for the discussion of the myo-inositol reference inserted a few minutes ago. As mentioned, this is a primary source, and so frowned upon by WP:MEDRS standards. But I've already engaged on user's talk page, so this is mainly for completeness' sake. I think the discussion should probably go here before re-inserting it, if it's found to be worthwhile to re-insert. -- [ UseTheCommandLine ~/talk ]# ▄ 04:03, 17 August 2013 (UTC)