Polycystic Ovarian Syndrome Flashcards
What is polycystic ovarian syndrome?
Heterogenous endocrine disorder
When does polycystic ovarian syndrome emerge?
Puberty
What type of condition is Polycystic ovarian syndrome?
Complex condition of ovarian dysfunction
How many women of child bearing age are affected by Polycystic Ovarian syndrome?
One fifth (20%)
What hormone imbalances tend to occur in Polycystic Ovarian Dysfunction?
Raised Luteinising Hormone
Insulin resistance (hyperinsulinaemia)
Raised oestrogen
Hyperandrogenism
How does Polycystic Ovarian Syndrome present?
Subfertility
Oligomenorrhea
Hirsutism (hair around face)
Acne
Obesity
Acanthosis nigricans (pigmented skin around neck folds)
How does Polycystic Ovarian Syndrome present?
Subfertility Oligomenorrhea Hirsutism Acne Obesity Acanthosis nigricans
What biochemical investigations are carried out for Polycystic Ovarian Syndrome?
LH:FSH ratio
Total testosterone
Fasting and oral glucose tolerance tests
What does the LH:FSH ratio exclude?
Excludes menopause when the ratio is normal
What LH:FSH ratio suggests Polycystic Ovarian syndrome?
More than 2
What testosterone level would indicate POS?
Normal or slightly raised
Why would you do a fasting and oral glucose tolerance test?
To diagnose insulin resistance
What clinical presentation would indicate insulin resistance in POS?
Acanthosis
nigricans
What imaging would you do in the investigation of POS?
Transabdominal and Transvaginal ultrasound
What would a ultrasound for POS show?
It would show increased ovarian volume and multiple cysts
What is the criteria for diagnosis for POS?
Rotterdam diagnostic criteria
How many points of the Rotterdam diagnostic criteria are required to diagnose POS?
Polycystic Ovaries (>12 cysts or ovarian volume >10cm)
Oligo-/anovulation (irregular ovulation)
Clinical or biochemical features of hyperandrogenism
What are forms of lifestyle management for POS?
Weight loss
Exercise control
What are forms of pharmacological management of Hirsutism and Acne?
COC pill
Co-cyprindrol
What are forms of pharmacological management of infertility?
Clomiphene
w/wo Metformin
What does a patient with POS need to be educated about?
The increased risk of diabetes
Endometrial cancer risk
What is acanthosis nigricans?
Dry dark patches of skin that appear in the armpits, neck or groin
What is the management of women trying to concieve with PCOS?
First: weight loss
Second: metformin
What medication can be given to women trying to concieve with PCOS?
Metformin
What medication is used first line in the management of infertility in someone with PCOS?
Clomifene
