PCOS

Question 1

What are the Rotterdam criteria?

Answer 1

PCOS = 2/3

• lack of ovulation
• excessive androgens
• polycystic ovaries on USS

Question 2

What is PCOS?

Answer 2

Polycystic ovary syndrome
- excessive androgen production by ovaries (testosterone)

Question 3

Causes of PCOS:

Answer 3

Hyperinsulinaemia (more theca cells) =
Excessive LH production (inhibits FSH, LH)
- no dominant follicle
- remains in ovary as cyst (no ovulation)

Excessive adipose tissue (aromatase)
- androgens to oestrogens

Question 4

Risk factors for PCOS?

Answer 4

• obesity
• genetic (AD)
• hx gestational diabetes

Question 5

Complications of PCOS?

Answer 5

• DM
• hyperinsulinaemia
• infertility
• risk endometrial cancer

Question 6

What are the signs & symptoms of PCOS?

Answer 6

Virilisation:
- hirsutism
- male-pattern baldness
- acne
- oligo/amenorrhoea (infertility)

Insulin resistance
- obesity/OW
- acanthosis nigricans

Question 7

What is the first port of call for diagnosis of PCOS?

Answer 7

USS - follicles on both ovaries (cysts)
- well-circumscribed hypoechoic areas

Question 8

What lab results are indicative of PCOS?

Answer 8

• high LH:FSH ratio
• high androstenedione

Question 9

What is a additional diagnostic method for PCOS?

Answer 9

OGTT (oral glucose tolerance test) - establish insulin resistance

Question 10

How is PCOS managed?

Answer 10

Conservative
- WL
- low glycaemic index diet
- symptom control

Medications
- oral contraceptives (regular cycle)
- clomiphene citrate (ovulation)
- metformin (insulin sensitiser)

Surgery
- ovarian drilling (puncture ovary induce ovulation - not solution to hormone imbalance)