Polycystic Ovary Syndrome Flashcards
Define Polycystic Ovarian Syndrome (PCOS)?
Characterised by oligomenorrhea/amenorrhea and hyperandrogenism (clinical or biochemical)
What is PCOS frequently associated with?
Obesity
Insulin Resistance
T2DM
Dyslipidaemia
What is the aetiology of PCOS?
Environmental factors
Genetic variants
Hyperinsulinaemia results in increased ovarian androgen synthesis and reduced hepatic sex hormone binding globulin (SHBG) synthesis
This leads to an increase in free androgens (which gives rise to the symptoms)
What is the epidemiology of PCOS?
PCOS is the most common cause of infertility in women
Affects 6-8% of women
What are the presenting symptoms of PCOS?
Menstrual Irregularities
Dysfunctional Uterine Bleeding
Infertility
Symptoms of Hyperandrogenism
What are symptoms of hyperandrogenism?
Hirsuitism
Male-pattern hair loss
Acne
What are the signs of PCOS on physical examination?
Hirsuitism
Male-pattern hair loss
Acne
Acanthosis Nigricans (sign of severe insulin resistance)
What is Acanthosis Nigricans?
Velvety thickening and hyperpigmentation of the skin of the axillar or neck
What investigations would you do for PCOS?
Bloods Test other things Look for impaired glucose tolerance/T2DM Fasting Lipid profile Transvaginal USS
What bloods would you do for PCOS and what might you expect?
High LH
High LH:FSH ratio
High testosterone, androstenedione and DHEA-S
Low sex hormone binding globulin
What other things do you test for in PCOS?
Hyperprolactinaemia
Hypo/hyperthyroidism
Congenital adrenal hyperplasia (check 17OH-progesterone levels)
Cushing’s Syndrome
How do you look for impaired glucose tolerance in PCOS?
Fasting Blood Glucose
HbA1c
Why do we do a Transvaginal USS for PCOS?
Look for ovarian follicles and an increase in ovarian volume
