PCOS Flashcards
What is the typical presentation of PCOS?
Hirsutism and acne
oligo/amenorrhoea ( oligo/anovulation)
PCOS on ultrasound
Define PCOS?
Polycystic ovary syndrome (PCOS) includes symptoms of hyper-androgenism, presence of hyper-androgenaemia, oligo-/anovulation, and polycystic ovarian morphology on ultrasound
What are the risk factors/aetiology of PCOS?
family history of PCOS
premature adrenarche
obesity
summarise the epidemiology of PCOS?
6-8% of women of reproductive age
what are the presenting symptoms and signs of PCOS>
FEMALE OF REPRODUCTIVE AGE
- Irregular menses/ anovulatory cycles
- Infertility
- Hirsutism – thick and pigmented hair – important to ask as women may use methods to remove hair so may not be visible
- Acne – esp beyond adolescence but non-specific
- Overweight/ obese
- HTN is commonly seen
- Oily skin/ XS sweating
- Acanthosis nigricans – seen more often in obese women with PCOS; it is a reflection of hyperinsulinaemia
What are the appropriate investigations for PCOS and what are the results for the investigations?
serum 17- hydroxyprogesterone -> exclude 21-hydroxylase-deficient non-classic (adult-onset) adrenal hyperplasia (NCAH)
serum prolactin- exclude prolactinoma as cause of irregular menses
serum TSH-> exclude thyroid dysfunction as cause of irregular menses
OGTT – abnormal glucose tolerance is prevalent in this population->fasting glucose between 5.6-6. 9 is abnormal
Fasting lipid profile - elevated total cholesterol, LDL-cholesterol, triglycerides; low HDL-cholesterol
Serum total and free testosterone – normal/elevated
Serum DHEAS – elevated
Low SHBG
High LH, high LH:FSH
Hyperinsulinemia also stimulates ovarian androgen production by theca cells
Transvaginal USS
what can be seen on the pelvic ultrasound in PCOS?
≥20 follicles in each ovary measuring 2 to 9 mm in diameter, and/or increased ovarian volume (≥10 mL) in either or both ovaries
