hyperandrogenic d/o & PCOS Flashcards
does PCOS typically have dysmenorrhea?
NO
2 most common sx of PCOS?
irregular periods (oligomenorrhea)
infertility (anovulation)
4 key physical signs of PCOS?
obesity
hirsutism
acne
acanthosis nigricans
what is hirsutism?
excess TERMINAL coarse hair in androgen dependent areas (face, chin, neck, btwn boobs, back, lower belly)
what is virilism
male secondary sex characteristics in a female
more extensive than hirsutism
what is hyperandrogenism
excess androgens in blood or excess acne or hirsutism
what levels should you check with hyperandrogenism?
zinc and thyroid levels
causes of PCOS
genetics (dad w/ DM2, bro w/ metabolic syn)
insulin resistance
how does insulin resistance cause PCOS?
insulin makes ovary overproduce androgens and reduces SHBG production from liver
less SHBG= more free androgen
what is oligoovulation
no ovulation
<8 menses/yr
cycles >35 days
risks associated w/ PCOS
infertility
AUB
endometrial cancer
T2DM
metabolic syndrome
labs for complications of metabolic syndrome w/ PCOS
fasting glucose
insulin & lipid panel
liver enzymes
oral glucose tolerance test
what is the diagnostic criteria for PCOS
must have hyperandrogenism & either oligo-ovulation or polycystic ovaries
expected DHEA levels with PCOS
it will be elevated
best imaging for PCOS evaluation. what will PCOS look like with imaging?
US
string of pearls
what lifestyle changes can help manage PCOS? benefits?
wt loss, lower carbs to decrease insulin resistance & improves ovulation
which sx does OCP help with PCOS?
acne and hirsutism (decreases them)
also helps with infertility
how (mechanism) does OCP help PCOS?
balances hormones and menstrual ycles
how does spironolactone help with PCOS?
blocks androgen receptors
what symptoms does spironolactone improve?
acne and hirsutism
effects of spironolactone during pregnancy
can cause birth defects in male fetus
how does vaniqua cream help PCOS?
prevents hair growth by blocking enzymes in follicle
how to improve infertility with PCOS
OCP then clomiphene or recombinant FSH for ovulation
add metformin
aromatase inhibitors
what are aromatase inhibitors?
they decrease estrogen feedback to hypothalamus
increase LHRH pulses to pituitary to increase LH and FSH secretion
benefits of using metformin with PCOS?
improves insulin sensitivity
improves wt loss
improves ovulation and hyperandrogenism
what should you keep track of if prescribing metformin for PCOS?
follow liver enzymes
annual Vit. B12 level
