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Síndrome de ovario poliquístico, el enfoque del internista
Resumen
El síndrome de ovario poliquístico es un estado hiperandrogénico que ocasiona alteraciones de la fertilidad y la menstruación en mujeres en edad fértil. El tratamiento se ha centrado en intervenciones ginecológicas y endocrinológicas para modificar estas alteraciones, las cuales junto con el fenotipo de exceso de hormonas androgénicas provocan el cuadro clínico clásico y motivan la búsqueda de atención. Sin embargo, cada vez se apoya más el papel de diferentes factores como la obesidad y la resistencia a la insulina. Se ha demostrado la interacción de estos factores con el exceso de hormonas androgénicas y con las alteraciones ovulatorias que conforman el cuadro clínico, aunque no se conocen con precisión los mecanismos de los que depende la manifestación de la enfermedad. Esta asociación tiene importantes repercusiones en el desarrollo de enfermedades cardiovasculares. Siendo el síndrome de ovario poliquístico tan frecuente, comúnmente no se diagnostica y atiende de forma integral. Además de buscar la fertilidad y disminuir las manifestaciones hiperandrogénicas, se debe reconocer los riesgos derivados de esta condición y que su manejo incluya la temprana atención de enfermedades crónicas con mejora de los hábitos alimentarios, actividad física y tratamiento farmacológico.
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