- PCOS was first identified in 1935 and described women who were obese, infertile with enlarged ovaries containing multiple cysts. - The etiology and pathophysiology of PCOS involves an abnormal "vicious cycle" of excess LH and low FSH secretion leading to hyperandrogenism which disrupts follicle maturation. Insulin resistance also contributes to elevated insulin levels. - Symptoms of PCOS include irregular or lack of menstruation, hirsutism, weight problems, acne, hair loss, and skin discoloration. Diagnosis involves evaluating hormone levels, ultrasound of ovaries, and ruling out other conditions. - Treatment aims to induce ovulation if pregnancy is desired using medications

1. Polycystic Ovary Syndrome
DR. DILIP B. GADHAVI Obstetrician & Gynecologist.,

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PCOS and Stein-Leventhal
Syndrome
oPCOS was first identified by Stein and
Leventhal in 1935
oThey described a group of women who
were obese and infertile, with enlarged
ovaries with multiple cysts
oFew of these original features are now
considered consistent findings in
PCOS

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Etiology & Pathopysiology
What we think we know.
“Vicious cycle”
Abnormal gonadotropin secretion
Excess LH and low, tonic FSH
Hypersecretion of androgens
Disrupts follicle maturation
Substrate for peripheral aromatization
Negative feedback on pituitary
Decreased FSH secreation
Insulin resistance, Elevated insulin levels

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0 2 4 6 8 10 12 14 16 18 20 22 24 26 28
Estradiol
Progesterone
FSH
LH
Hormone
Level
Ovulation Normal
Menstru
al Cycle
Endometrial
Thickness
0 2 4 6 8 10 12 14 16 18 20 22 24 26 28
Menstrual Cycle Day

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Hormone
Level
Estradiol
Progesterone
Endometrial
Thickness
0 2 4 6 8 10 12 14 16 18
20
0 2 4 6 8 10 12 14 16 18
20 Weeks
Withdrawal
Anovulatory
Bleeding in
PCOS
Lower limit
of normal
Withdrawal
Breakthrough

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Polycystic
Ovaries
Cystic
Follicles
Anatomic Features of
the Polycystic Ovary

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Pathology
 Ovaries: enlarged and/or polycystic ovaries
 endometrium: Lack of ovulation for an
extended period of time may cause
excessive thickening of the endometrium
(the lining of the uterus).

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Pathology

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What Are the Symptoms of PCOS?
Irregular or Lack of Menses:
Women will have “spotty”
periods (1 every couple of
months). Also, in some women
with PCOS they simply cease
having a menses at all.

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Symptoms
Hirsutism :
Excessive body hair.
In women with PCOS
dark, coarse hair will
appear on the face,
neck, chest, arms, and
in between the legs.

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Symptoms
Weight Problems :
Depending on the
woman, there could be
a decrease of weight
or a rapid fluctuation
of weight that settles
around the stomach
that will lead to
morbid obesity.

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Symptoms
Acne : Because women
with PCOS are producing
more male hormone, that
produces more sebum
( skin oils and old tissue)
and causes blocked pores
and more acne around the
jawline, arms and chest.

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Symptoms
Alopecia or Female
Pattern Baldness :
This is caused by the
increase of male hormone
in the women's body.
Thinning or loss of hair is
usually contained to top of
the scalp, but in severe
cases loss of hair in front
or on the hairline has been
documented.

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Other Symptoms
“Dirty Skin” or Acanthosis
Nigricans : This condition
causes light brown to black
rough patches around the
neck and under arms.
Migraines : Severe
headaches that cause light
sensitivity, nausea and
dizziness.

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Diagnosis
 BBT (basal body temperature)
 B ultrasound:
multiple small ovarian cysts
enlarged ovary
Endometrium biopsy(Curettage )
before menses reveal to proliferative glands
Determination of LH,FSH,E2,P,T,PRL，Ins，
(LH:FSH≧3:1)
Laparoscopy

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Treatment at Present
If pregnancy is desired ------ cause
ovulation
anti-estrogens(clomiphene)
Gonadotropins
insulin-lowering agents
anti-androgens (agents that lower
androgen levels)
gonadotropin releasing hormone
agonists (GnRHa)

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 If pregnancy is not desired
to reduce the risk of endometrial cancer ( birth
control pills)
cyclical progesterone (MPA, Provera)
insulin-lowering agents (metformin ,Glucophage)
anti-androgens.
Treatment at Present

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Long Term Effects: Infertility
Many women experience infertility while
having PCOS.
Many will have to go to an fertility doctor
to conceive.
To conceive women with PCOS have to
learn to monitor ovulation by taking their
Basal Body Temperature (BBT) and
examining cervical mucus.

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Long Term Effects: Heart Disease
There is new evidence that finds women
with PCOS are at a higher risk for
metabolic cardiovascular disease.
Both diseases are characterized by insulin
resistance, high blood pressure, and obesity.

22. Endocrine Disruptors
Endocrine disruptors are chemicals that may interfere with
the production or activity of hormones in the human
endocrine system. These chemicals may occur naturally or
be manufactured. The term “endocrine disruptors”
describes a diverse group of chemicals that are suspected
or known to affect human hormones. Effects on human
hormones can range from minor to serious depending on
the specific endocrine receptor and the amount of
exposure. Because these chemicals are found in products
you use every day and you are exposed to many endocrine
receptors at the same time, it is difficult to determine the
public health effects of these chemicals.
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23. DISTRUPTORS
Endocrine disruptors include dioxins, PCBs, DDT,
and some other pesticides. Suspected endocrine
disruptors include phytoestrogens and fungal
estrogens, the herbicide atrazine, phenols such
as bisphenol A (BPA), and plasticizers such
as phthalates. Many products and industrial
processes use and release several naturally–
occurring heavy metals that affect hormone
actions and reproduction,
including arsenic, cadmium, lead, and mercury.
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24. How might we be exposed to
endocrine disruptors? - 1
 Chemicals that might be endocrine disruptors are commonplace in
daily life. You can be exposed to endocrine disruptors by
breathing, eating, drinking, or touching them. Exposure can occur
through air, water, soil, food, and consumer products. You may be
exposed through contaminated food, contaminated groundwater or
drinking water, combustion sources, and contaminants in consumer
products.
 At home, you can be exposed to minute amounts of possible
endocrine disruptors through food, beverages, and medicines. You
can be exposed if you use products that contain endocrine
disruptors, such as plastics, cleaning products, bottles, and cans.
You can be exposed if you eat contaminated species, including
contaminated fish. You can be exposed to the herbicide atrazine if
you live or work on a farm.
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25. How might we be exposed to
endocrine disruptors? - 2
You may be exposed if you use pesticides and other garden
chemicals. You can be exposed by leakage
from landfill areas. Sewage discharge and runoff may
carry pollution that includes endocrine disruptors from
factories, fields, and yards into waterways.
At work, you may be exposed to endocrine disruptors if
you work at a facility that manufactures products or uses
processes containing these chemicals or burns medical
waste. You may be exposed if you work on a farm or
facility that uses pesticides and herbicides.
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26. Evidence supporting the role of toxins in the
diabesity epidemic
 A while back I wrote about a study showing that a chemical called bisphenol-A
(BPA), found in packaged foods and beverages, causes obesity in mice.
 A more recent study published in JAMA found that BPA increases the risk of
diabetes, heart disease, and abnormal liver function.
 A 2010 study in Environmental Health Perspectives found that exposure to organic
pollutants leads to insulin resistance and metabolic dysfunction in rats.
 A review paper by researchers in Korea reached a similar conclusion:
 …the metabolic syndrome is the result of mitochondrial dysfunction, which in turn
is caused by exposure to persistent organic pollutants.
 A National Health and Nutrition Examination Survey 1999-2002 observed a
significant correlation between blood levels of six common persistent organic
pollutants and diabetes. Those who had the highest serum levels of pollutants had
a dramatically higher risk for diabetes.
 Canadian Aboriginals and Great Lakes sport fishermen both have higher rates
of diabetes from eating contaminated seafood.
 I could go on, but I think you get the point. Toxins are making us fat and
diabetic.
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27. CONCLUTIONS
We studied deep down and reach to roots of effect
of toxins and we realize that almost all dieses are
happening due to toxins. Initially we have studied
just one part which endocrine system and effect of
toxins on reproductive system.
Due to above PCOS patients are obese, hormones
are imbalance and having problem in Insulin
resistance
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28. Reverve Wellness Solution
We Reverve Wellness was doing research since last 2 ½
years using several minerals. We came into conclusion
that natural minerals with external treatment is getting
100% result to cleans human body and all toxins are
releasing out through skin pores.
We are using natural minerals and made formulation of
mixture of several minerals which all doing role to pulling
out heavy toxins from the human body through the skin
pores gradually in each treatments and once cleansing
happening hormones is getting balance and first of all
menstrual cycle is getting regular.
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29. OBSERVATION IN CLINICAL
STUDY
Study results revealed that majority of hormonal
level significantly changed post treatment
compared to pre-treatment.
There was statistically significant improvement in
Luteinizing Hormone (LH), Prolactin, AMH,
SGPT and LH/FSH ratio, post treatment from the
preoperative values (P < 0.05).
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30. Baseline Mean Value of FSH was 4.18±0.76
which was normal and remained almost
unchanged (Mean value 5.20±0.94) post
treatment. P-value provided by statistical
comparison of FSH level by paired t–test is 0.131
which revealed that there is no statistically
significant difference at post treatment.
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Follicle Stimulating hormone -FSH

31. Luteinizing Hormone (LH)
Baseline Mean Value of LH was 11.52±2.16 which was
normal and it was changed but within normal ranged
remained (Mean value 4.27±0.65) post treatment. . P-
value provided by statistical comparison of LH level by
paired t–test indicated highly statistically significant
difference at post treatment in LH level. LH/FSH Ratio at
pre-treatment was 2.76:1 which was high compared to
healthy female with usual hormonal level, which was
reduced positively to 1.21:1 at post-treatment. This
reduction is significant clinically as well as statistically
(p<0.001).
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32. AMH level was found higher than normal
at baseline . (Mean 10.84±1.25, p<0.001)
at pre-treatment and observed normal
(Mean 6.79±0.18) at post treatment.
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Anti-Mullerian Hormone - AMH

33. Thyroid Stimulating Hormone -TSH
Baseline Mean Value of TSH was
3.63±0.65 which was normal and stable
(Mean value 3.62±0.64) at post treatment.
There is no statistically significant
difference at post treatment in TSH value (p
= 0.207) compared to pre-treatment.
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34. PROLACTIN
Initial Prolactin level pre-treatment was
little higher (Mean 36.36±1.94) at baseline
was reduced to normal level with mean
value 29.35±1.32 at post treatment.
(<0.001). AMH level was observed normal
(Mean 6.79±0.18) at post treatment which
was found higher than normal at baseline.
(Mean 10.84±1.25, p<0.001).
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35. S.G.P.T
Initial SGPT level pre-treatment was little
higher (Mean 35.83±1.41) at baseline was
reduced to normal level with mean value
29.40±1.68 at post treatment (p<0.001).
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36. LH/FSH RATIO
Study results had shown that all hormonal
levels and LH/FSH had reduced little or
more at post treatment except FSH level.
LH/FSH ratio was also significantly
reduced.
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37. TREATMENT PROCESS
 Total of approximately 30 Nos. of bandages were soaked in
specialized water heating tank along with 1 kg natural mineral at least
for 60 min. of time in 4.5 litres of water. Every 15 min., bandages were
turned around in water heating tank so that all minerals were getting
absorbed by elasticated cotton bandages. Participants were be wrapped
from neck to toe, from legs upwards and then covered with Vinyl suit,
to maintain body temperature. The patients were in lied down position
for one hour.
 After one hour we Vinyl suit is removed and after unwrapping the
patient wipe the body. Patient did not required to take even shower
after treatment.
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38. Minerals Composition:
Bentonite Clay
Magnesium Chloride
Magnesium Sulphate
Sodium Chloride
Zinc Oxide 2%
Note: Each part of research and process patented
worldwide by Reverve Wellness.
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39. Thanks for Your Attention
DR.DILIP B. GADHAVIObstetrician & Gynecologist,