By Enda McVeigh, John Guillebaud, Roy Homburg

The Oxford instruction manual of Reproductive medication and kinfolk making plans, moment variation offers crucial functional details within the care of the adolescent and reproductive age ladies and men. Evidence-based and concise, this guide is the must-have source for all practitioners, trainees, and scholars in sexual and reproductive healthcare. totally up to date for the second one version, this guide now contains  Read more...

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Example text

Hyperandrogenism (biochemical or clinical). • Polycystic ovaries on ultrasound examination. g. congenital adrenal hyperplasia, androgen-secreting tumours or Cushing’s, should be excluded. • Oligo- or anovulation Ovulation occurs at a frequency of less than once in 35 days. • Hyperandrogenism Clinical signs of hyperandrogenism include hirsutism, acne, alopecia (male-pattern balding), and frank virilization. Biochemical indicators include raised concentrations of total testosterone and androstenedione, and elevated free androgen index.

Oral glucose challenge test. 47 48 CHAPTER 5 Polycystic ovary syndrome Prevalence • PCOS is the most common female endocrinopathy, affecting 5–10% of women in their reproductive years. • PCOS is associated with 75% of all anovulatory disorders causing infertility. • Polycystic ovaries can be found in 720% of the female population but are not necessarily associated with the typical symptoms.

The conversion of C27 cholesterol to the 18-, 19-, and 21-carbon steroid hormones involves the rate-limiting, irreversible cleavage of a 6-carbon residue from cholesterol, producing pregnenolone (C21) plus isocaproaldehyde. Steroids are extensively metabolized peripherally, notably in the liver, and in their target tissues, where conversion to an active form is sometimes required before they can elicit their biological responses. Steroid metabolism is therefore important not only for the production of these hormones, but also for the regulation of their cellular and physiological actions.

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