Polycystic ovary syndrome Flashcards
What are the clinical features of PCOS?
The clinical features of PCOS include ovulation disorders, polycystic ovarian morphology, and hyperandrogenism (excessive levels of androgens, leading to symptoms like hirsutism, acne, and menstrual irregularities).
What are the complications associated with PCOS?
PCOS can lead to cardiovascular disease, obstructive sleep apnoea, psychological disorders (anxiety, depression), infertility, endometrial cancer, pregnancy complications (gestational diabetes, pre-eclampsia), and metabolic disorders (insulin resistance, type 2 diabetes).
Which tests are used to diagnose PCOS?
To diagnose PCOS, the following tests are recommended:
Free androgen index to assess testosterone levels.
Luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin, and thyroid-stimulating hormone (TSH) to rule out other causes of menstrual irregularity.
Ultrasound scan for adults to assess polycystic ovarian morphology (20+ follicles in one ovary).
What is the diagnostic criterion for PCOS in adults?
In adults, PCOS is diagnosed if two of the following are present:
Clinical and/or biochemical signs of hyperandrogenism.
Ovulatory dysfunction.
Polycystic ovarian morphology on ultrasound.
What is the diagnostic approach for PCOS in adolescents?
In adolescents, the criteria for diagnosing PCOS are stricter and require both hyperandrogenism and irregular menstrual cycles due to the overlap with normal pubertal changes. If criteria are not met, the adolescent is considered at increased risk and should be reassessed later.
What is the role of Metformin in the treatment of PCOS?
Metformin is used for insulin resistance in PCOS. It improves insulin sensitivity, lowers blood sugar and insulin levels, and may help with symptoms like irregular periods and fertility, although there is limited evidence on long-term benefits.
What are common drug treatments for PCOS?
Common drug treatments for PCOS include:
Combined oral contraceptives (for acne, hirsutism, and menstrual irregularity).
Cyclical progestogen or levonorgestrel intrauterine system for menstrual irregularities.
Metformin for insulin resistance.
What screening is recommended for pregnant females with PCOS?
Pregnant females with PCOS should be referred for gestational diabetes screening, and any necessary changes to drug treatments should be considered.
