PCOS

Question 1

features of PCOS

Answer 1

subfertility and infertility
menstrual disturbances: oligomenorrhoea and amenorrhoea
hirsutism, acne (due to hyperandrogenism)
obesity
acanthosis nigricans

Question 2

investigations for PCOS

Answer 2

pelvis ultrasound
FSH, LH, prolactin, TSH, testosterone, sec hormone binding globulin (SHBG) are useful
check for impaired glucose tolerance

Question 3

diagnostic criteria for PCOS

Answer 3

rotterdam criteria: 2 present
- infrequent or no ovulation
- clinical and/or biochemical signs of hyperandrogenism
- polycystic ovaries on ultrasound

Question 4

general management of PCOS

Answer 4

weight reduction
contraception: COCP

Question 5

hirsutism and acne management in PCOS

Answer 5

COCP may be helpful
topical eflornithine
spironolactone, flutamide and finasteride

Question 6

infertility management in PCOS

Answer 6

weight reduction
supervised by specialist
clomifene
metformin
gonadotrophins

Question 7

stereotypical PCOS results

Answer 7

raised LH:FSH ratio
testosterone mat be normal or elevated
SHBG is normal to low