PCOS Flashcards
What is PCOS?
heterogenous endocrine disorder that emerges at puberty
What are hormone levels in PCOS?
[LH]»_space; [FSH]
What does this PCOS cause?
drives hyperinsulinism and hyperandrogenism
What crtieria is used for PCOS?
Rotterdam criteria: 2 of 3 possible features must be present
What are parts of the Rotterdam criteria?
- Oligo/amenorrhoea
2 Clinical / biochemical features of hyperandrogenism - Polycystic morphology on pelvic USS
What do the levels of LH and FSH lead to?
- Levels of LH outweigh levels of FSH
- LH drives androgen production and FSH aromatises these androgens to oestrogen
- If there is an imbalance as in this case, there will be higher levels of androgens that are not all able to be aromatized to oestrogen
What are signs and symptoms of PCOS?
- excessive hair growth
- acne and hirsutism
- weight gain
- oligo/dys/amenorrhoea
- signs of hyperinsulinism
What are signs of hyperinsulnism?
- impaired glucose tolerance
- acanthosis nigricans
What bloods are done in PCOS?
- FSH / LH
- Total serum testosterone: normal or raised
- SHBG: normal or low
- Prolactin and TSH
What can TV USS show in PCOS?
> =12 follicles in >=1 ovary
What is the management for PCOS?
- Conservative
- Medical
- Fertility
What is the conservative management for PCOS?
- Encourage healthy lifestyle
- Screen for depression
- Offer regular monitoring for weight, CV risk factors and glucose levels
What is the medical management for PCOS?
- COCP / hormonal therapy
2. Laser hair removal
What is the fertility treatment for PCOS?
- Fertility treatment referral for those unable to conceive after a year of UPSI (specialist based)
- Hormonal therapies or ovulation induction
How is free androgen index calculated?
calculated using 100x total testosterone / SHBG (>5%)
