NURS 6501 Knowledge Check: Women’s and Men’s Health, Infections, and Hematologic Disorders Scenario 1: Polycystic Ovarian Syndrome (PCOS)  What is the pathogenesis of PCOS?  

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1. How does PCOS affect a woman’s fertility or infertility?  

Infertility is mostly caused by chronic anovulation among women with PCOS. However, subfertility may be associated with the increase of plasma levels of luteinizing hormone in the follicular phase of the menstrual cycle leading to a resumption of the second meiotic oocyte division and the release of premature oocytes (Khmil et al., 2020). The increased LH levels reported in PCOS are associated with the increased frequency of spontaneous abortions. The main factors contributing to spontaneous abortion among women with PCOS are related to the factors associated with steroidogenesis, maturation of the oocyte, reduced endometrial receptivity, and folliculogenesis. Consequently, PCOS is associated with an increased risk of miscarriages in pregnant women.  

1. What is the pathophysiology of PID?  

The pelvic inflammatory disease normally results from ascending infection of the cervicovaginal microorganisms such as Chlamydia trachomatis and Neisseria gonorrhoeae (Hillier et al., 2021). The mechanism by which these microorganisms ascend from the lower genital tract is not clear. However, studies report that several factors may be involved. Despite cervical mucous serving as a form of functional barrier against the upward spread, hormonal changes and vaginal inflammation which normally occur during menstruation and ovulation can decrease the efficacy of this barrier. Additionally, the treatment of STIs with antibiotics can compromise endogenous flora balance in the lower genital tract leading to overgrowth of non-pathogenic microorganisms. Ascending of the infection can be promoted during intercourse through the rhythmic uterine contractions during orgasm. The bacteria can also move into the uterus and fallopian tubes through the sperm. 

1. What are the 4 stages of syphilis?  

Syphilis can be divided into 4 main stages such as primary, secondary, latent, and tertiary based on the patients presenting symptoms (Trivedi et al., 2019). A patient is normally diagnosed with primary syphilis when they present with a sore or several sores at the original infection site. These sources are normally seen in or around the genitals, anus, rectum, and mouth. Most of the time, the sores will be painless, firm, and round. Secondary syphilis is characterized by swollen lymph nodes, skin rash, and fever. The signs and symptoms presented in primary and secondary syphilis may be mild and unnoticed. In latent syphilis, the patient displays no signs and symptoms. Tertiary syphilis on the other hand is associated with severe health complications such as psychiatric manifestations, cardiovascular syphilis, or late neurosyphilis.  

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References 

Trivedi, S., Williams, C., Torrone, E., & Kidd, S. (2019). National trends and reported risk factors among pregnant women with syphilis in the United States, 2012–2016. Obstetrics and gynecology, 133(1), 27. https://doi.org/10.1097/AOG.0000000000003000