Hirsutism + PCOS

Question 1

What is hisutism?

Answer 1

Common (10% of women) and usually benign

It implies male pattern hair growth in women

Question 2

Causes of hirsutism?

Answer 2

Familial

idiopathic

or are due to increased androgen secretion by the ovary (eg PCOS, ovarian cancer, OHCS)
adrenal gland (eg late-onset congential adrenal hyperplasia, ovarian cancer, OHCS, cushing’s syndome, adrenal cancer) or drugs (eg steroids)

Question 3

PCOS clinical presentation?

Answer 3

oligo- or amenorrhoea

infertility

obesity

acne

hirsutism

Question 4

PCOS diagnosis

Answer 4

Ultrasound: bilateral polycystic ovaries

Blood tests: increased testosterone, decreased sex hormone binding globulin, increased LH:FHS ratio (not consistent), TSH, lipids

Question 5

Management of PCOS

Answer 5

healthy eating, optimize weight, shaving, laser photoepilation, wax creams

Oestrogens: COCP

Metformin (helps with insulin resistance)

Clomifene is used for infertility