pcos management Flashcards
What criteria are used to diagnose Polycystic Ovarian Syndrome (PCOS) according to the Rotterdam Criteria?
PCOS is diagnosed using the Rotterdam Criteria which includes at least 2 of the following: Oligo/anovulation (> 2 years), clinical or biochemical features of hyperandrogenism, polycystic ovaries on ultrasound (> 12 in one/both ovaries measuring 2-9 mm or ovarian volume > 10cm3).
What is the first-line treatment for menstrual issues in women with PCOS who are not planning pregnancy?
Lifestyle advice, including weight reduction and dietary modification, is the first-line treatment for menstrual issues in women with PCOS who are not planning pregnancy.
What are the screening recommendations for women with PCOS regarding diabetes and cardiovascular disease?
Women with PCOS should be screened for Type 2 Diabetes (OGTT) and cardiovascular disease.
What medications can be used to manage amenorrhea or dysfunctional uterine bleeding in women with PCOS?
COCP, cyclical oral progesterone, or LNG-IUS can be used to manage amenorrhea or dysfunctional uterine bleeding in women with PCOS.
What is the mechanism by which COCP helps relieve androgenic symptoms in PCOS?
COCP increases sex hormone-binding globulin, which helps relieve androgenic symptoms in PCOS.
What are the options for women with PCOS who have too many risk factors for COCP?
Women with PCOS who have too many risk factors for COCP can take 3-monthly progesterone to induce withdrawal bleed, ensuring it occurs at least every 3-4 months to protect the endometrium.
What treatments are available for hirsutism and androgenic symptoms in PCOS?
Treatments for hirsutism and androgenic symptoms in PCOS include topical eflornithine cream, co-cyprindiol (dianette), cyproterone acetate, metformin, GnRH analogues, and surgical treatment (laser or electrolysis).
What is the first-line treatment for subfertility in women with PCOS who are planning pregnancy and have a normal BMI?
Clomiphene is the first-line treatment for subfertility in women with PCOS who are planning pregnancy and have a normal BMI.
What are the risks associated with clomiphene use for ovulation induction in PCOS?
Clomiphene use for ovulation induction in PCOS carries an increased risk of multiple pregnancies.
What procedure may be considered for women with PCOS to prompt ovulatory cycles?
Laparoscopic ovarian drilling (LOD) may be considered for women with PCOS to prompt ovulatory cycles.
What are the risk factors for PCOS?
Risk factors for PCOS include family history and obesity.
How should the diagnosis of PCOS be explained to patients?
PCOS is a condition with no clear cause that leads to abnormalities in hormone levels, resulting in the symptoms experienced.
What are the main consequences of PCOS?
The main consequences of PCOS include irregular periods, subfertility, metabolic syndrome (sugar dysregulation, easier to gain weight), cardiovascular disease, and acne.
What management strategies should be recommended for women with PCOS who are concerned about fertility?
For women with PCOS concerned about fertility, recommend weight loss, clomiphene +/- metformin, and consider laparoscopic ovarian drilling (LOD).
What management strategies should be recommended for women with PCOS who are concerned about irregular periods?
For women with PCOS concerned about irregular periods, recommend COCP or progestogens, aiming for at least 3-4 bleeds per year.
