Polycystic Ovarian syndrome (PCOS) Flashcards
what is PCOS?
a syndrome of hyperandrogenism and chronic anovulation in which other causes have been ruled out
what is hyperandrogenism?
androgen excess (high testosterone)
how do patients present clinically with PCOS?
secondary amenorrhea / infertility
hirsutism
obesity
what is secondary amenorrhea?
when a woman who has been having normal menstrual cycles stops getting her periods for 6 months or longer
what is PCOS related to?
lack of pulsatile GnRH release
what happens in PCOS (with lack of pulsatile GnRH)?
many follicles begin to develop, but a dominant follicle is not selected to mature (lack of FSH)
what do the follicles in PCOS respond to?
pituitary hormones by producing an abnormal pattern of oestrogen secretion
why is chronic anoculation felt to occur in PCOS?
because of inappropriate feedback signals from the ovary to the hypothalamus / pituitary
how may PCOS be characterised biochemically?
by LH dependent excess androgen production from both ovaries and adrenals (perhaps due to enzyme abnormality)
why may the abnormal oestrogen secretion in PCOS put women at increased risk of?
endometrial malignancy
insulin resistance
what can insulin resistance lead to?
diabetes (type II)
CVS disease
what are the goals of therapy in management of PCOS?
prevention of long term risks (diabetes, CVS)
management of presenting problems of hyperandrogenism / anovulation
