PCOS Flashcards
What is AMH?
Peptide hormone secreted from granulosa cells in ovarian follicles as they transition from primordial to primary and secondary follicles
Why test AMH?
Can be used as a marker of ovarian follicular reserve. As age advances towards menopause, AMH levels fall and the of follicles decline
What is the single most important measure of biochemical hyperadrogenism?
Free testosterone
Why is vitamin D an essential investigation in patients with oligomennorhoea?
Vitamin D deficiency increases testosterone, reduces oestradiol and lowers luteal progesterone levels
What percentage of women with PCOS also have endometriosis?
50%
What are 3 fertility awareness models used in Australia?
Billing ovulation method, Creighton model and the symptothermal method
What is the criteria used for making a diagnosis of PCOS?
Rotterdam Criteria
What is included in the Rotterdam criteria?
Menstrual irregularity or ovulatory dysfunction, hyperadrogenism (clinical or biochemical) PCOM on ultrasound
Clinical features consistent with hyperadrogenism?
Hirsutism, alopecia, acne, (can also get skin tags, ancanthosis nigoracans
Ultrasound threshold for polycystic ovarian morphology?
Follicle number > 20 and/or ovarian volume > 10ml (do not apply to women within 8 yrs of menarche
How long does hormonal contraception need to be stopped for when testing for hyperadrogenism in suspected PCOS?
3 months
Treatment for PCOS?
Lifestyle, vitamin D supplements if indicated, metformin for insulin resistance
How does letrozole work?
Blocks aromatase - mediated ovarian oestrogen production from testosterone. This causes the pituitary gland to realise higher than normal FSH, stimulating the development and maturation of ovarian follicles.
