Polycystic Ovarian Syndrome Flashcards
1
Q
What is the definition of PCOS?
A
Defined by at least 2 out of the 3:
- Anovulation
- Hyperandrogenism
- Polycystic ovaries on ultrasound
2
Q
What are the other possible causes we need to exclude that can cause hyperandrogenism?
A
- Cushing syndrome
- Congenital adrenal hyperplasia
- Androgen secreting tumours
- Thyroid abnormalities
- Hyperprolactinaemia
3
Q
What is the prevalence or incidence for PCOS?
A
3-11%
4
Q
What is the clinical presentation of the patients that present with PCOS?
A
- Menstrual irregularities
- Young
- Obese
- Infertility
- Hirsutuism
- Alopecia
7.
5
Q
What are the signs of an irregular menstruation/anovulation?
A
- <8 cycles per year
- Periods lasting <26 days or >35 days
- Day 22-24 being less than 4ng/ml in progesterone
6
Q
What are the signs of Hirsuitism?
A
- Deep voice
- Excessive hair growth
- Alopecia
- Acne
7
Q
What do we find on ultrasound in regards to PCOS?
A
- Follicles that are >12 on the ovaries measuring 2-9mm
2. The ovary volumes can be >10cm3
8
Q
How do we diagnose metabolic syndrome?
A
Based on at least 3 out of the 5:
- Waist circumference of >88cm
- BP of >130/85
- HDL <1,3
- Triglycerides >1,8
- HGT: fasting >6-7
2hr: >7,8-11,1
9
Q
What is the medical treatment for patients with PCOS?
A
- Encourage patient to lose weight
- Clomiphene citrate (oestrogen antagonist on the pituitary gland)
- Addition of dexamethasone
- Letrozole/anastrozole (aromatase inhibitors)
- Insulin sensitizers (metformin)
- \gonadotropin therapy
10
Q
What is the surgical treatment for PCOS?
A
- Ovary drilling
2. 3 punctures made on each ovary