Polycystic Ovary Syndrome

Question 1

Polycystic Ovary Syndrome Definition

Answer 1

Syndrome of polycystic ovaries, systemic symptoms causing reproductive, metabolic and psychological disturbances
-Most commonly present with infertility, amenorrhoea, acne or hirsutism

Question 2

Polycystic Ovary Syndrome Epidemiology

Answer 2

• Very common, can be seen in up to 33% of women of reproductive age
• Majority do not have symptoms and do not require intervention

Question 3

Polycystic Ovary Syndrome Pathophysiology

Answer 3

• Cause is unclear but likely to be multifactorial

- Raised androgens, insulin resistance, LH

Question 4

Polycystic Ovary Syndrome Presentation

Answer 4

• Often presents in peri-pubertal period up to mid 20s

- Oligomenorrhoea, infertility, acne, hirsutism, male pattern balding alopecia, obesity, psychological symptoms

Question 5

Polycystic Ovary Syndrome Diagnostic Criteria

Answer 5

Two of the three following criteria are diagnostic

• Polycystic ovaries
• Oligo-ovulation or anovulation
• Clinical signs of hyperandrogegism

Question 6

Polycystic Ovary Syndrome Differentials

Answer 6

• Hypothyroidism
• Hyperprolactinaemia
• Cushings
• Acromegaly

Question 7

Polycystic Ovary Syndrome Ix

Answer 7

• Total testosterone (normal to slightly raised)
• Free testosterone may be raised
• Sex hormones in general altered
• TFTs, cortisol
• Ask about snoring

Question 8

Polycystic Ovary Syndrome Management

Answer 8

• Educate, offer screening
• Advise on weight control, diet
• Co-cyprindrol for hirsutism
• COCP to control menstrual irregularity
• Treatments for infertility

Question 9

Polycystic Ovary Syndrome Complications

Answer 9

• Infertility
• Oligmenorrhoea and amenorrhoea predispose to endometrial cancer
• Higher CV risk
• Sleep apnoea