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Polycystic Ovarian Syndrome
Unfortunately, according to studies, women with PCOs after the reproductive age, are associated to continuously increase risk of type II diabetes, with no increasingaltered glucose tolerance(20), CVD and hypertension(21).
The prevention and management
Polycystic ovary syndrome (PCOS) is unpreventable in Western medicine. Early diagnosis and treatment may reduce risk of its complications, including infertility, metabolic syndrome, obesity, diabetes, cardiovascular diseases, stroke, etc.
Although PCOS cannot be completely avoided, strengthening immunity has shown a significant reduction of chronic inflammatory diseases(266)(267)(268).
Tanshinones, a class of phytochemicals found abundantly in Salvia miltiorrhiza (Danshen or Tanshen in Chinese) has shown to process several pharmacological effects including anti-inflammatory(596), antioxidative stress(595)(597), antisenile dementia(598), antiplatelet aggregation(593), anti atherosclerosis(599), hypertension(600), and ischemic stroke(594) and anticancer activities(592)(593), etc. Recent study if a total of 100 eligible women with PCOs meeting certain criteria recruited from four centers in China, conducted by First Affiliated Hospital of Heilongjiang University of Chinese Medicine, suggested that tanshinones ameliorate excessive androgens by inhibiting steroid hormone produced by the theca cells in the ovary(601)(602) and improve insulin resistance and glucose metabolism(602)(603). Dr. Wenjuan Shen and the research team also said " CHM can regulate and strengthen the hormonal systems of the whole body and is a natural approach for treating PCOS. The significant advantages of CHM are that it provides several options for the safe, effective, multitargeted treatment of various aspects of PCOS including hyperandrogenism and poor quality of life"(604).
Berberine, a phytochemical found in many herbs, including Berberis aquifolium (Oregon grape), Berberis vulgaris (barberry), Berberis aristata (tree turmeric)], Hydrastis canadensis, etc., has been used in traditional medicine over thousand years for treatment of microbial infections(605)(606)(607)(608), trachoma(609), ,leishmaniasis(610).. Epedemiological studies suggested that the phytochemicals may also be effective for treatment of diabetes(611)(612), dyslipidemias(613)(614), hypertention(615), insulin resistance and the metabolic syndrome(616). cancers(617)(618)(619), etc.
Recent studies also showed that berberine also exerts its health benefits by improving some of the metabolic and hormonal derangements in a group of Eighty-nine subjects with PCOS and IR Chinese women with PCOS(620). When compare to metformin (MET), the phytochemical Berberine showed decrease in waist circumference and waist-to-hip ratio, fasting plasma glucose, fasting insulin, homeostasis model assessment for IR, area under the curve of insulin, cholesterol and triglycerides as well as increase in high-density lipoprotein cholesterol and sex hormone-binding(621). In combination with Letrozole for treatment of PCOs, the phytochemical showed the effectiveness in lowering blood sugar levels in db/db mice and exerted anti-dyslipidemia in human(622)
Turmeric is a perennial plant in the genus Curcuma, belonging to the family Zingiberaceae, native to tropical South Asia. (See Turmeric in the top 5 anti inflammation foods for the use of the herb in traditional medicine).
Immunohistochemical expression of VEGF may be associated to the pathophysiology of PCOS(623) as VEGF concentrations are found to increase in women with polycystic ovaries(624). Curcumin, according to the First Affiliated Hospital, Chongqing Medical University, lower the expression of VEGF in ovarian tissues of PCOS in high- and low-dose administrative rat model, and may have certain therapeutic effect on PCOS(625).
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(1) Adiposity and metabolic dysfunction in polycystic ovary syndrome by Sam S.(PubMed)
(2) A "kiss" before conception: triggering ovulation with kisspeptin-54 may improve IVF by Young SL.(PubMed)
(3.) Androgen hyperfunction and excessive heterosexual hair growth in women, with special attention to the polycystic ovarian syndrome by Lunde O1.(PubMed)
(4) Expression of anti-Müllerian hormone in letrozole rat model of polycystic ovary syndrome by Du DF1, Li XL, Fang F, Du MR.(PubMed)
(5) [Serum levels of anti-muller hormone in women with polycystic ovary syndromeand healthy women of reproductive age].[Article in Bulgarian] by Parahuleva N, Pehlivanov B, Orbecova M, Deneva T, Uchikova E.(PubMed)
(6) [Current opinions on the etiology and pathophysiology of hirsutism].[Article in Polish] by Krysiak R1, Kedzia A, Okopień B.(PubMed)
(7) The clinical evaluation of hirsutism by Somani N1, Harrison S, Bergfeld WF.(PubMed)
(8) Polycystic ovary syndrome and insulin: our understanding in the past, present and future by Mayer SB1, Evans WS, Nestler JE.(PubMed)
(9) Association of mean platelet volume with androgens and insulin resistance in nonobese patients with polycystic ovary syndrome by Dogan BA1, Arduc A2, Tuna MM1, Karakılıc E1, Dagdelen I1, Tutuncu Y1, Berker D1, Guler S1.(PubMed)
(10) Approach to the patient: contraception in women with polycystic ovary syndrome by Yildiz BO1.(PubMed)
(11) Polycystic ovarian syndrome (PCOS): a significant contributor to the overall burden of type 2 diabetes in women by Talbott EO1, Zborowski JV, Rager JR, Kip KE, Xu X, Orchard TJ.(PubMed)
(12) Prevalence of vitamin D deficiency in Slovak women with polycystic ovary syndrome and its relation to metabolic and reproductive abnormalities by Figurová J1, Dravecká I, Javorský M, Petríková J, Lazúrová I.(PubMed)
(13) Role of Insulin Sensitizers on Cardiovascular Risk Factors in Polycystic Ovarian Syndrome: A Meta-Analysis by Thethi TK1, Katalenich B2, Nagireddy P3, Chabbra P4, Kuhadiya N5, Fonseca V1.(PubMed)
(14) Acne in hirsute women by Lumezi BG1, Pupovci HL1, Berisha VL1, Goçi AU2, Gerqari A3.(PubMed)
(15) Obesity and polycystic ovary syndrome by Naderpoor N1, Shorakae S, Joham A, Boyle J, De Courten B, Teede HJ.(PubMed)
(16) Polycystic ovary syndrome: a complex condition with psychological, reproductive and metabolic manifestations that impacts on health across the lifespan by Teede H1, Deeks A, Moran L.(PubMed)
(17) Metabolic Evidence of Diminished Lipid Oxidation in Women With Polycystic Ovary Syndrome. by Whigham LD1, Butz DE2, Dashti H3, Tonelli M3, Johnson LK1, Cook ME2, Porter WP4, Eghbalnia HR5, Markley JL6, Lindheim SR7, Schoeller DA8, Abbott DH9, Assadi-Porter FM10.(PubMed)
(18) Risk of endometrial, ovarian and breast cancer in women with polycystic ovary syndrome: a systematic review and meta-analysis by Barry JA1, Azizia MM1, Hardiman PJ2.(PubMed)
(19) Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study by Gottschau M1, Kjaer SK2, Jensen A1, Munk C1, Mellemkjaer L3.(PubMed)
(20) Polycystic ovary syndrome: metabolic consequences and long-term management by Carmina E1.(PubMed)
(21) Arterial stiffness is increased in asymptomatic nondiabetic postmenopausal women with a polycystic ovary syndrome phenotype by Armeni E1, Stamatelopoulos K, Rizos D, Georgiopoulos G, Kazani M, Kazani A, Kolyviras A, Stellos K, Panoulis K, Alexandrou A, Creatsa M, Papamichael C, Lambrinoudaki I.(PubMed)
(266) [Immunopathological responses in women with chronic inflammatorydiseases of the uterus and appendages and their therapeutic correction].[Article in Russian] by Medvedev BI1, Kazachkova EA, Kazachkov EL.(PubMed)
(267) Cross Talk Between ER Stress, Oxidative Stress, and Inflammation in Health and Disease by Dandekar A1, Mendez R, Zhang K.(PubMed)
(268) New dog and new tricks: evolving roles for IL-33 in type 2 immunity by Lott JM1, Sumpter TL1, Turnquist HR2.(PubMed)
(596) Anti-inflammatory effect of tanshinone I in neuroprotection against cerebral ischemia-reperfusion injury in the gerbil hippocampus by Park JH1, Park Ok, Cho JH, Chen BH, Kim IH, Ahn JH, Lee JC, Yan BC, Yoo KY, Lee CH, Hwang IK, Kwon SH, Lee YL, Won MH, Choi JH.(PubMed)
(597) Blocking of JB6 cell transformation by tanshinone IIA: epigenetic reactivation of Nrf2 antioxidative stress pathway by Wang L1, Zhang C, Guo Y, Su ZY, Yang Y, Shu L, Kong AN.(PubMed)
(598) In Salvia miltiorrhiza, phenolic acids possess protective properties against amyloid β-induced cytotoxicity, and tanshinones act as acetylcholinesteraseinhibitors by Zhou Y1, Li W, Xu L, Chen L.(PubMed)
(599) Anti-Inflammatory and Immunomodulatory Mechanism of Tanshinone IIA for Atherosclerosis by Chen Z1, Xu H2.(PubMed)
(600) The complex regulation of tanshinone IIA in rats with hypertension-induced left ventricular hypertrophy by Pang H1, Han B1, Yu T1, Peng Z2.(PubMed)
(601) [Effects of cryptotanshinone in lowering androgens synthesis for the prenatally androgenized male rats].[Article in Chinese] by Li XH1, Yang XM, Wu XK.(PubMed)
(602) Xing J, Zhang Y, Hu M, et al. Tanshinone effect on the expression of IRS-1 and p-ERK in trophoblastic cells under insulin resistance. Sci Technol Rev2009;27:75–9
(603) Yan M, Yang L, Wu X. Effects of insulin-sensitizing agents on insulin resistance of porcine granulosa cells. Sci Technol Rev 2008;26:77–81
(604)Effects of tanshinone on hyperandrogenism and the quality of life in women with polycystic ovary syndrome: protocol of a double-blind, placebo-controlled, randomised trial by Wenjuan Shen,1 Yuehui Zhang,1 Wei Li,1 Jing Cong,1 Ying Zhou,2 Ernest H Y Ng,3 and Xiaoke Wu.(PubMed)
(605) Birdsall TC, Kelly GS (1997). "Berberine: Therapeutic potential of an alkaloid found in several medicinal plants" (PDF). Alternative Medicine Reviews 2 (2): 94–103.
(606)Gibbs PJ, Seddon KR (April 2000). "Berberine". Alternative Medicine Review(British Library) 5 (2): 175–7. ISBN 0-7123-0649-8. PMID 10767672.
(607) Development of novel nanoparticles shelled with heparin for berberinedelivery to treat Helicobacter pylori by Chang CH1, Huang WY, Lai CH, Hsu YM, Yao YH, Chen TY, Wu JY, Peng SF, Lin YH.(PubMed)
(608) Conjugating berberine to a multidrug efflux pump inhibitor creates an effective antimicrobial by Ball AR1, Casadei G, Samosorn S, Bremner JB, Ausubel FM, Moy TI, Lewis K.(PubMed)
(609) Berberine, a potential drug for trachoma.[Article in English, French] by Khosla PK1, Neeraj VI, Gupta SK, Satpathy G.(PubMed)
(610) Antifungal, Antileishmanial, and Cytotoxicity Activities of Various Extracts of Berberis vulgaris (Berberidaceae) and Its Active Principle Berberine by Mahmoudvand H1, Ayatollahi Mousavi SA2, Sepahvand A3, Sharififar F4, Ezatpour B5, Gorohi F6, Saedi Dezaki E2, Jahanbakhsh S1.(PubMed)
(611) Application of berberine on treating type 2 diabetes mellitus by Pang B1, Zhao LH2, Zhou Q3, Zhao TY1, Wang H1, Gu CJ1, Tong XL1.(PubMed)
(612) Efficacy of berberine in patients with type 2 diabetes mellitus by Yin J1, Xing H, Ye J.(PubMed)
(613) The effects of berberine on hyperhomocysteinemia and hyperlipidemia in rats fed with a long-term high-fat diet by Chang XX1, Yan HM, Xu Q, Xia MF, Bian H, Zhu TF, Gao X.(PubMed)
(614) Berberine decreases cholesterol levels in rats through multiple mechanisms, including inhibition of cholesterol absorption by Wang Y1, Yi X2, Ghanam K2, Zhang S3, Zhao T3, Zhu X3.(PubMed)
(615) Nutraceuticals for treatment of high blood pressure values in patients with metabolic syndrome by Rozza F1, de Simone G, Izzo R, De Luca N, Trimarco B.(PubMed)
(616) Cheng Z, Guo S, Copps K, Dong X, Kollipara R, Rodgers JT et al. (November 2009). "Foxo1 integrates insulin signaling with mitochondrial function in the liver". Nature Medicine 15 (11): 1307–11. doi:10.1038/nm.2049.PMID 19838201.
(617)Akt signaling is associated with the berberine-induced apoptosis of human gastric cancer cells by Yi T1, Zhuang L, Song G, Zhang B, Li G, Hu T.(PubMed)
(618) Berberine induces autophagic cell death and mitochondrial apoptosis in liver cancer cells: the cellular mechanism by Wang N1, Feng Y, Zhu M, Tsang CM, Man K, Tong Y, Tsao SW(PubMed)
(619) Berberine induces apoptosis in SW620 human colonic carcinoma cells through generation of reactive oxygen species and activation of JNK/p38 MAPK and FasL by Hsu WH1, Hsieh YS, Kuo HC, Teng CY, Huang HI, Wang CJ, Yang SF, Liou YS, Kuo WH.(PubMed)
(620) A clinical study on the short-term effect of berberine in comparison to metformin on the metabolic characteristics of women with polycystic ovary syndrome by Wei W, Zhao H, Wang A by Sui M, Liang K, Deng H, Ma Y, Zhang Y, Zhang H, Guan Y.(PubMed)
(621) Effect of Berberine on Hormonal and Metabolic Features in Obese Women With Polycystic Ovary Syndrome (PCOS)14:32 EST 15th January 2014 |BioPortfolio
(622) Developmental toxicity evaluation of berberine in rats and mice by Jahnke GD, Price CJ, Marr MC, Myers CB, George JD.(PubMed)
(623) Role of vascular endothelial growth factor in women with PCO and PCOS: a systematic review.
Peitsidis P1, Agrawal R.(PubMed)
(624) Serum vascular endothelial growth factor concentrations and ovarian stromal blood flow are increased in women with polycystic ovaries.
Agrawal R1, Sladkevicius P, Engmann L, Conway GS, Payne NN, Bekis J, Tan SL, Campbell S, Jacobs HS.(PubMed)
(625) Effect of curcumin on expression of VEGF in polycystic ovary syndrome rat models by WANG Lian-lian, LI Cong, MENG Jiang-ping, YANG Xi (Journal of Shanghai, Jiaotong Uncersity)