5. Gynaecological conditions

Question 1

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PCOS (Polycystic Ovary Syndrome) cause

Answer 1

Caused by excess androgens

Question 2

PCOS clinical features

Answer 2

• Irregular periods (as ovaries do not regularly release eggs)
• Excess facial hair/body hair (due to excess androgens or male hormones)
• Oily skin
• Acne
• Difficulty getting pregnant

Question 3

PCOS complications

Answer 3

• Cardiovascular disease
• Sleep apnoea
• Anxiety/depression
• pregnancy complications: gestational diabetes, pre-eclampsia
• Insulin resistance

Question 4

PCOS treatment

Answer 4

1st line: non-drug treatment
healthy eating, regular exercise, weight loss (if overweight). Cardiovascular risks should be assessed and managed apropriately.

2nd line: drug treament
Managing symptoms:

For acne, hirsuitism, menstrual irregularity: Combined oral contraceptives. Alternatively, cyclical progestogen or levonorgestrel intra-uterine device system

For imapired glucose tolerance or if lifestyle modifications have not helped glucose tolerance:
Metformin