PCOS Flashcards
1
Q
What is PCOS?
A
- Development of multiple cysts in the ovary due to arrested follicular development and increased androgen production
- Androgens in this case produced and released more from ovaries than adrenals
2
Q
What are the risk factors of PCOS?
A
- Family History of PCOS
- Premature adrenarche
- Low body weight
- Fetal androgen production
- Obesity
3
Q
What are the possible causes of PCOS?
A
- Increased amplitude and frequency of LH
- Damage to ovaries causing increased androgen production
- Insulin resistance leading to compensatory hyperinsulinaemia
4
Q
What are the clinical features of PCOS?
A
- Sub fertility and infertility
- Hirsutism
- Acne
- Acanthosis nigricans
- Obesity
- Oligomenorrhea/ amenorrhea
5
Q
What is hirsutism?
A
Male pattern hair growth in women
6
Q
What is the theorised pathophysiology of PCOS?
A
- Insulin resistance leads to compensatory hyperinsulinaemia
- Insulin is thought to promote androgen production and modular GnRH release
- Rapid GnRH release from hypothalamus increases LH release from pituitary
- LH promotes androgen production through stimulation of ovaries and adrenal glands
- Androgens further exacerbate insulin resistance
7
Q
What are the investigations in suspected PCOS?
A
=> Pregnancy test
=> Ultrasound
Detection of bilateral polycystic ovaries
=> Bloods
Increased testosterone, Prolactin, Impaired Glucose Tolerance
8
Q
What is the management of PCOS?
A
=> Conservative or Medical
=> Conservative:
- Healthy eating
- Shaving
- Optimise weight
=> Medical:
- COCP
- Spironolactone, flutamide, and finasteride tried under supervision
- Metformin for insulin resistance
- Clomifene used for infertility
