Clinical Evaluation of Furocyst in Patients With Poly Cystic Ovary Syndrome
Clinical Evaluation of Furocyst in Patients With Poly Cystic Ovary Syndrome
Poly cystic ovary syndrome (PCOS) is a disease which is prevalent in women of reproductive
 age facing obesity along with increased risk of type-2 diabetes and high cholesterol levels.
 The genetically determined cause of the PCOS includes disturbed levels of insulin and
 androgens. Standardized fenugreek seed extract (Furocyst) contains compounds such as saponins
 & flavonoids which act on the insulin and indirectly helps to regulate the androgen levels in
 the body.
Polycystic ovary syndrome is considered as clinical and public health consequence involving
 increase in number of cysts in women at reproductive age. These cysts are under-developed
 sacs in which eggs are developed. In PCOS, these sacs are unable to release an egg which
 means ovulation doesn't take place.

 The estimated 5-10% prevalence of PCOS is reported in women of reproductive age. A study from
 Spain also reported that 28.3% prevalence rate of PCOS is among 113 overweight or obese women
 who were referred to an endocrinology clinic for weight loss. This data was compared with a
 previously reported prevalence of 6.5% which suggests that the prevalence of PCOS might be
 markedly increasing with obesity.

 PCOS impacts significantly on various hormonal cycles. With PCOS, luteinizing hormone (LH)
 levels become higher than follicle stimulating hormone (FSH) levels. Because of this increase
 in LH levels, the LH surge does not take place and ovulation doesn't carry out which results
 in irregular menstrual cycle. The irregular menstrual period produces oligomenorrhea (few
 menstrual periods) or amenorrhea (no menstrual periods) and infertility due to irregular or
 lack of ovulation. PCOS also produces high levels of masculinizing hormones with symptoms of
 acne and hirsutism, hypermenorrhea involving heavy and prolonged menstrual periods and
 androgenic alopecia (increase hair thinning and diffused hair loss). The other metabolic
 syndromes associated with PCOS are increased risk of type 2 diabetes, high cholesterol levels
 and obesity.

 These complications arise because of the genetically determined cause of the PCOS i.e. hyper-
 secretion of androgens from the ovary which favours excess luteinizing hormone (LH) secretion
 and insulin resistance. However, insulin resistance with or without a genetic mutation may be
 the initiator, followed by hyper-androgenism. Thus, insulin resistance is an important
 contributing factor to abnormal steroidogenesis in PCOS because hyper-insulinemia stimulates
 the pathway of insulin like growth factor-I (IGF-I) in theca cells of the ovary by
 cross-reacting with the receptors of IGF. Stimulation of the ovarian theca cells increases
 the production of androgens (eg, testosterone, androstenedione) which in turn, blocks the
 down-regulation of androgens by LH surge and leads to the hyper-androgenic environment in the
 ovary. Because of a decreased level of FSH relative to LH, the ovarian granulosa cells cannot
 aromatize the androgens to estrogens, which lead to decreased estrogen levels and results in
 anovulation.

 Treatments for PCOS are chosen based on woman's symptoms, age and future pregnancy plans
 which may include birth control pills to regulate menstruation, insulin-sensitizing
 medications, ovulation induction to treat infertility, androgen-blocking medications, topical
 anti-hair-growth medications, etc.

 Standardized fenugreek (Trigonella foenum graecum) seed extract (Furocyst) plays an important
 role in the management of PCOS. It improves glucose-tolerance and insulin-sensitivity,
 thereby promoting weight loss and moderation of androgen levels in the blood. Standardized
 fenugreek seeds extract contains a group of furostanolic saponins, derived from fenugreek
 seeds by an innovative process. It contains rich variety of saponins and flavonoids which
 have been known to lower the blood lipid levels and play valuable role in improving insulin
 sensitivity. Standardized fenugreek seeds extract is a dual insulin-sensitizer. In the
 presence of high fiber furostanolic saponins, cells become more sensitive to insulin & an
 increase in number of insulin receptor sites occurs. These receptor sites are responsive to
 insulin to stimulate the cells ability to burn glucose. This decrease in insulin resistance
 helps in the management of PCOS.

 Considering the beneficial effects of standardized fenugreek seed extract, present study was
 conducted to evaluate the efficacy of fenugreek seeds extract in patients with poly cystic
 ovary syndrome by assessing reduction in ovarian volume and decrease in the number of ovarian
 cysts.
Inclusion Criteria:

 -  Premenopausal women between 18-45 years of age and BMI less than 42

 -  Diagnosed with PCOS

 -  Adequate hepatic, renal and hematological functions

 -  Patients willing to give informed consent in writing

 Exclusion Criteria:

 -  Males

 -  Post menopausal women

 -  Women with hysterectomy

 -  Patients with congenital adrenal hyperplasia

 -  Patients suffering from Cushing's syndrome

 -  Patients diagnosed with androgen secreting tumors

 -  Patients with thyroid dysfunction (T3, T4 level is higher than that in normal women of
 reproductive age)

 -  Patients with Hypo-gonadotropic and Hypo-gonadism (central origin of ovarian
 dysfunction)

 -  Pregnancy or desire for pregnancy or lactating mothers