Polycystic ovary syndrome or PCOS is a syndrome that primarily affects women. In PCOS, the women hormone levels are affected enormously. Women produce a significant amount of luteinizing hormone (LH) than what is considered as the normal level. Luteinizing hormone mainly triggers the ovulation process. High level of LH causes premature menopause or the polycystic ovarian syndrome. The following part of the essay discusses about a case study on Sharon, a very young woman, having polycystic ovary syndrome or PCOS. Several types of assessments are required to understand the case study of the patient. The symptoms of Sharon can vary from mild to severe. The role of sex health workers is also important to convey a relationship between the patients and doctors or caregivers. Globally, most of the women are dealing with polycystic ovary and they are found living a healthy life (Bullock & Hales, 2012). One of the significant aspects of the essay is to deliver a helpful education to the patients. Proper health education to the patients can be useful in leading a healthy life. Most of the women around the globe are unaware of the methods for dealing with the disease or any menstrual problems.
Sharon Munroe, a 26 years old young woman is faced with several signs of menstrual problems due to which she visited a doctor for a check-up. Sharon’s report s were investigated by the doctors from different possible aspects which included physical as well as mental health. Several caregivers assessed Sharon during the assessments. The background and history of the patient should focus Oligomenorrhea (peri-pubertal versus the developed later in the life), the beginning and duration of several types of excess androgen levels in the body. The use of exogenous androgens and the medications history should be noted as well. A brief family history of the patient is required to understand, whether their family member contains any diabetic patient or a cardiovascular patient. Lifestyle pattern factors such as alcohol consumption, diet pattern, the frequency of exercise are essential for those who are having PCOS. Relevant studies showed that any family member having PCOS could increase the risk to the other members of the family. Fertility check-up and the ovarian study is also required for this case study. Physical exercise analysis is another aspect of assessing PCOS. Insulin and the insulin resistance should be assessed to understand the insulin level of the body since a high level of insulin may lead to Type-2 diabetes (Sirmans & Pate, 2014). Ovaries and adrenal glands contribute to the level of androgen in the body because from the adrenal glands androgen hormones are examined. Adrenal gland secretes weak androgen hormones, such as dehydroepiandrosterone (DHEA) or DHEAS. These hormones are the prohormones for dihydrotestosterone and testosterone (Marieb&Hoehn, 2007). When the mentioned hormonal level rises in the body, it leads to the formation of hair growth in the body. Assessment of DHEAS levels can be useful for this case study to evaluate the cases of rapid virilisation. The vision of the Alliance is to improve the lives of Australian women who have PCOS through the education, research and evidence-based health care. One of the priorities of the Alliance is to develop an evidence-based guideline for PCOS(Bergh, Moore &Gundell, 2016). Another important experiment is the Pap smear that can be performed on the patients who are having PCOS. However, a Pap smear is not a reliable experiment for detecting the syndrome. An ultrasound experiment can be a helpful test for the patients. Through the process of ultrasound, the lining of the uterus and the thickness of the ovaries can be detected which eventually leads to the detection of main female hormones (Rackow et al., 2018). Periodically checking of blood pressure, cholesterol, triglyceride levels and the glucose tolerance levels are also required check-ups for the patient. Screening for anxiety, depression level and detection for obstructive sleep apnea are also useful for this assessment (Helvaci et al., 2017). These are some of the relevant assessments that are required to understand the medical conditions of Sharon.
Nursing is a subject of a combination of science and caring. Sexual health team members play an important role in conducting several diagnostic procedures for the patient. Nurses play a significant role in the process of educating the patient and also in the screening processes. Sexual health team members hold a severe role in the modern health investigation that goes beyond their day to day investigation. Sharon has been suffering from obesity since childhood. Lifestyle modification for her is considered as primary care. The caregiver Natalie conducts a pelvic examination for Sharon. During the pelvic examination, the nurses examine the pelvic organs of the body which evaluate the size and the overall health of the ovaries. Often women are found to be more comfortable with the female nurses due to gender similarity. Natalie is a registered nurse highly experienced in her field. Evidence that is based on studies shows that referral to a nurse practitioner is required for the patients who have early menstrual problems or those who are pregnant and have gone proper gynaecological procedure (Brown et al., 2015). Nurses and midwives should target to make the pelvic examination as non-threatening and comfortable. According to the NMC Code of conduct, the sexual health workers or the caregivers bear the responsibility of providing the best performance to the patient, who reach out the nurses to receive safe and prominent care (Gillen, 2015). The health workers can give health education to the patient by explaining the problems which the patient will find helpful. Nurses can ask the intimate question, question regarding lifestyle and other minor details once the patient is comfortable, and provide knowledge which would be beneficial for the patients to maintain a healthy life. In this case study, the doctors and the caregivers analyse the laboratories examination results. Sharon will need to answer questions related to LH and FSH measurement on the days 1-3 menstrual cycle. LH and FSH are measured early in the menstrual cycle to understand the hormonal levels in the body. In normal condition, LH and FSH is about 1.1 ratio which means that both of them are similar, but patient having PCOS like, in the present case, of a high level of LH and low level of FSH. High level of LH in the bloodstream can cause a high level of a male hormone known as testosterone. Sharon should be given required medical knowledge that the pituitary gland secretes both the LH and FSH. According to evidence-based studies, it is typical for women with PCOS to have a high level of glucose about 18mlU/ml and an FSH level of about 6 mlU/ml. These are some of the roles of the health givers involved in the case study (Liu et al., 2017).
Patient education is the procedure by which health professionals convey information to patients that will change their health behaviours or progression of their health status. Women with PCOS are at a higher risk of developing type 2 diabetes mellitus. In the present case, Sharon has a chance of getting diabetes; however, her thyroid-stimulating hormone (TSH) are within the reasonable limits. Her fasting insulin level was elevated; fasting blood sugar was 6.1mmol/L, and the 2-hour value on glucose tolerance test was 10.1mmol/L. Hence there is a chance of elevation of glucose level or acquiring type 2 diabetes in the future. Therefore the main reason why the patient needs to be informed is to make them aware of the rising hormone levels in the body. Although Testosterone and androgen hormones are typically for men, they are present in a tiny amount in women. The elevated level of hormones in women can cause absent or irregular menstrual period. Eventually, it results in the weight gain process and causes obesity. Researchers found that females with PCOS were more likely to develop Type -2 diabetes from that of the healthy women who do not have PCOS. 70% of the PCOS women are insulin resistant (Ollila et al., 2017). Increased insulin resistance causes the body to gain weight and eventually it leads to Type-2 diabetes. On understanding the causes of the rise of insulin resistance Sharon should be able to help herself to check the insulin level. Diet is another factor that can also influence the obesity problem (Seif et al., 2015).
Sharon is following a proper diet plan and exercise program for weight loss. The nurses and the doctors should educate Sharon about the benefits of exercise regime. Weight loss programme can reinstate the common purpose of the ovaries and result in normal hormone production in the body. Sharon is also expecting pregnancy in the future. To achieve Sharon’s expectations of pregnancy in the future, she needs to reduce her insulin level. One of the effective ways to get the patient’s insulin levels back to normal is to decrease weight. Bringing down 5 per cent of her body weight can help re-establish normal insulin levels (Coghlan& Hart, 2018). Weight loss can help to recover the insulin sensitivity and eventually it will decrease the risk of heart disease, diabetes and the other complications of PCOS. The effective weight loss can be achieved if Sharon visits her doctor periodically.
Sharon has been given medication due to her expectation of a pregnancy. She had been given Clomid 50mg on day 5 of her cycle each month. According to the case study, Sharon is not sure what is all about the medications, and the menstrual cycle, so proper information should be given to Sharon.
Menstruation is a woman’s periodically bleeding. When women menstruate, her body sheds the lining of her womb. Menstrual blood or the period blood flow from the uterus through the cervix, and it escapes out from the body through the vaginal opening. Menstrual periods last from 4-7 days of a healthy woman. When menstruation comes commonly, that is known as the menstrual cycle. Women having regular menstrual cycle is a sign of a good healthy body whereas not experiencing proper menstrual cycle is the opposite. A menstrual cycle is counted from the first day of the period to the first day of the next period (Tal, Seifer & Arici, 2015, May). Menstrual cycle ranges from twenty-one to thirty-five days in adults and from twenty-one to forty-five days in teenagers.
Clomid is an oral medicine that is used to increase the ovulation process. Clomid can be very helpful for those women who are trying to get pregnant while having irregular ovulation. Days from three to seven in a cycle will give more follicles though not the high quality of follicles. On the contrary, days from five to nine will provide less quantity of follicles, and it will give high quality of follicles (Bullock & Manias, 2013). Sharon is prescribed on day five of her cycle to increase the quality of follicles. The doctors have given the proper medication by understanding the medical condition of Sharon. PCOS is the common cause of anovulatory infertility (Balen et al., 2016). In simpler words, it means that ovulation does not occur in the menstrual cycle. Before starting the medication, women should check their body weight to increase the chance of ovulation and natural conception. Drug treatment can act well in the ovulation process and eventually it will maximise the health in pregnancy (Tiziani, 2015).
Conclusion
It can be concluded at this moment that Sharon is a patient who is 26 years of age and she has a polycystic ovarian syndrome. She is gaining her body weight, and she has obesity since childhood. The doctors investigated the clinical condition of her body and conclude that she may have Type-2 diabetes in the future. Proper medication is given to Sharon along with that appropriate diet plan. An exercise programme is also given to her. The polycystic ovary is a syndrome in which patient is experiencing a high amount of LH hormone which is secreted by the pituitary gland. High amount of LH eventually increase testosterone level in the body, and it increases the facial hair in the body as well as the insulin level of the body. Experienced health workers also provide proper guidance to Sharon during her pelvic exam and physical examination. Doctors gave adequate medications to increase the quality of her follicles so that she can become pregnant. Doctors have also recommended her for an exercise program which she had performed, and eventually, it helped her in weight loss program. After starting on a diet, and exercise programme, her body glucose level reverted to the normal limits. In the presence of other doctors and the medical attendants, Sharon has given proper education in medications to deal with the confusions which she had previously.
References:
Balen, A. H., Morley, L. C., Misso, M., Franks, S., Legro, R. S., Wijeyaratne, C. N., …&Teede, H. (2016). The management of anovulatory infertility in women with polycystic ovary syndrome: an analysis of the evidence to support the development of global WHO guidance. Human reproduction update, 22(6), 687-708.
Bergh, C. M., Moore, M., &Gundell, C. (2016). Evidence-based management of infertility in women with polycystic ovary syndrome. Journal of Obstetric, Gynecologic& Neonatal Nursing, 45(1), 111-122.
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Liu, E., Zhang, Y., Chen, L., Yan, J., Liu, X., & Mai, T. (2017). The study of daily glucose change in insulin resistance with polycystic ovary syndrome women. Journal of Chinese Physician, 19(8), 1144-1147.
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Rackow, B. W., Brink, H. V., Hammers, L., Flannery, C. A., Lujan, M. E., &Burgert, T. S. (2018). Ovarian Morphology by Transabdominal Ultrasound Correlates With Reproductive and Metabolic Disturbance in Adolescents With PCOS. Journal of Adolescent Health, 62(3), 288-293.
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