PCOS Flashcards
PCOS Diagnostic criteria
Rotterdam Criteria
PCOS Dx
2 out of 3 features of the Rotterdam criteria
Rotterdam Criteria
- Oligoovulation or anovulation, presenting with irregular or absent menstrual periods
- Hyperandrogenism, characterised by hirsutism and acne
- Polycystic ovaries on US (>12 cysts or ovarian volume of more than 10cm3)
PCOS clinical presentations
- Oligomenorrhoea
- Acne
- Hirsutism
- Obesity (70%)
- Male pattern hair loss
- Infertility
- Acanthosis Nigricans (secondary to insulin resistance)
PCOS Ix
- Testoterone
- SHBG
- LH
- FSH
- Prolactin
- TFTs
PCOS hormonal screen findings
- High LH
- High LH:FSH ratio >2
- Raised testosterone
- Raised insulin
- normal / raised oestrogen
- Normal / Low SHBG
PCOS gold standard imaging
TVUS
PCOS TVUS appearance
String of pearls
PCOS TVUS diagnostic criteria
- > 10cm3 ovarian vol.
- 20 or more developing follicles in an ovary
PCOS Acne Mx
1st: COCP - Co-cyprindiol
PCOS hirsutism Mx
1st: COCP - Co-cyprindiol
2nd: Topical eflornithine
PCOS triad
- Hyperandrogenism
- PCO morphology
- Ovulation disorder
PCOS complications
- Endometrial cancer
- T2DM
- CVD
- HTN
- Metabolic Syndrome
- Dyslipidaemia
- Infertility
- Obstructive sleep apnoea
PCOS endometrial hyperplasia/cancer reduction Mx
- Cyclical progesterone: induced regular withdrawal bleeding
- COCP
- IUS: Mirena coil
PCOS menses target
Aim for 4 menses per year
PCOS prolonged amenorrhoea Mx
- Cyclical progesterone for 14/7
- Refer for TVUS to assess endometrial thickness
When to refer PCOS endometrial sampling
Endometrial thickness >10mm
PCOS difficult conceiving Mx
Clomifene w/without Metformin
How do COCP reduce hirsutism/acne in PCOS
suppresses LF secretion and ovarian androgen production
Define PCOS
Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting women of reproductive age; characterised by Oligomenorrhoea (irregular periods), hyperandrogenism (excess androgen levels), and polycystic ovaries
