PCOS Flashcards
What are the three clinical presentations of PCOS
Hyperandrogenism. Menstrual disturbances. Overweight or obese
What are the three proposed causes of PCOS
Inappropriate gonadotropin secretion. Excessive androgen production. Insulin resistance with hyper insulinemia
What treatment for PCOS is recommended for women who do not want to give birth
Combined oral contraceptive
What is the required starting dose for combined oral contraceptive for normal patients
Start with lowest effective dose of about 20 to 30 mcg ethinyl estradiol
What is the starting dose for obese or old patients with increased risk of VTE for combined oral contraceptives
Exactly 20 mcg EE
What are the progestins preferred for COC and why
Norgestimate and norethindrone because they have low androgenic effects
What are the progestins we should avoid for COC and why
Drosperinone, cyproterone acetate, gestodene, desogestrel
What must you do if you are taking spironolactone and why
Use it with reliable form of contraceptive cos it is teratogenic. You don’t wanna get pregnant
What is the problem with Finasteride or proscar
It is teratogenic. So you will use with reliable form of contraceptive
What is a potent aromatase inhibitor used by women with PCOS who wanna get pregnant
Letrozole
What is the mechanism of action of Letrozole
It inhibits aromatase from changing testosterone to estrogen leading to low estrogen in the body. Because we have low estrogen in the body, the hypothalamus will stimulate more in a positive feedback loop to make more FSH and LH leading to ovulation
What is the counter indication for Letrozole
Counter indicated in Pregnancy
What BMI is considered fat for PCOS
More than 20 BMI
