Gynaecology - Polycycstic Ovary Syndrome

Question 1

Polycystic Ovary Syndrome?

What is it?

Answer 1

When a woman has polycystic ovaries. Diagnosed via Rotherham criteria 2/3:

• USS >12 small follicles measuring 2-9mm, vol >10ml
• Menstrual irregularity >5 weeks apart
• Endocrine - Hyperandrogenism - hirsutism, acne

Question 2

Polycystic Ovary Syndrome?

Symptoms?

Answer 2

May be asymptomatic but other features may be remembered as HAIR:

• H - Hirsutism
• A - Amenorrhoea
• I - Irregular periods
• R - Reduced fertility

Question 3

Polycystic Ovary Syndrome?

Investigations?

Answer 3

• FBC,U&E,TFTs
• Androgen levels, LH/FSH, Prolactin, SHBG
• Radiology : transvaginal USS for specific features

Question 4

Polycystic Ovary Syndrome?

Treatment?

Answer 4

Conservative:

• Patient education
• Lifestyle advice - weight loss

Medical - aims to treat symptoms:

• Hirsutism: oral contraceptive pill with anti-androgenic effect (Yasmin/Dianette)
• Subfertility: Metformin may help
• Inducing ovulation: clomifene

Question 5

Polycystic Ovary Syndrome?

Complications?

Answer 5

Infertility

Type 2 Diabetes

Gestational diabetes

Depression

Weight gain leading to:

• Sleep apnoea
• Metabolic syndrome
  
  • inc BP
  • high BM
  • Ab cholesterol/trygs
• Inc risk of diabetes
• High Blood pressure