Polycystic Ovarian Syndrome

Question 1

What is Polycystic Ovarian syndrome (POS)?

Answer 1

• Is a common condition, causing metabolic and reproductive problems.

Question 2

PCOS criteria?

Answer 2

• Anovulation (absence of ovulation)
• Oligoovulation (irregular or infrequent ovulation)
  • These 2 presenting with irregular or absence of menstrual periods
• Hyperandrogenism (characterized by hirsutism and acne)
• Polycystic ovaries on US (volume of more than 10cm3(mok3ab)
  🚩 Only having one of these three features does not meet the criteria for a diagnosis

Question 3

Clinical presentation?

Answer 3

• Oligomenorrhoea or Amenorrhea
• Infertility
• Obesity
• Hirustism
• Acne
• Hair loss

Question 4

Investigations ?

Answer 4

• Testosterone (high)
• Sex hormone-binding globulin (maybe low)
• LH (high)
• FSH (high)
  • 🚩 High LH compared to FSH
• TSH
• Prolactin (might be mildly elevated)
• Estrogen (normal or high)
• Insulin (high)
• US (string of pearls)

Question 5

Complications?

Answer 5

• Insulin resistance and diabetes
• Cardiovascular disease
• Hypercholesterolaemia
• Endometrial hypertrophy and cancer
• Sexual problems
• Depression and anxiety
• Acanthosis nigricains (thickened rough skin)

Question 6

PCOS differential diagnosis?

Answer 6

• Cushing syndrome
• Hyperprolacactinemia
• Congenital adrenal hyperplasia
• Thyroid disease

Question 7

Management?

Answer 7

• Theres is no cure for PCOS but treatment can help manage the symptoms and reduce the risk of complications:
• Oral contraceptive to regulate menstrual cycle and reduce androgen level.
• Insuline-sensitizing medication to improve insulin resistance (e.g metformin)
• Lifestyle changes, maintaining a healthy weight through diet and exercise