PCOS

Question 1

Anovulation pathophys

Answer 1

Increased LH production leads to anovulation and thus no progesterone.

Question 2

Why hyperandrogenism?

Answer 2

Increased LH -> Theca cell stimulation

lead to androstenedione production

Question 3

Presentation

Answer 3

Amenorrhea,
Infertility,
Obesity,
Hirsuitism
Enlarged, bilateral cystic ovaries.

Question 4

Complication

Answer 4

Increased risk of endometrial cancer

2/2 increased estrogen from the aromatization of testosterone in fat cells without progesterone to oppose.

Question 5

Lab

Answer 5

High LH,
low FSH,
High testosterone
High estrogen (from testosterone aromatization)

Question 6

Treatment

Answer 6

1) Weight reduction
2) Metformin (with DM or metabolic syndrome)
3) Low dose OCP
4) Medroxogesterone (decrease LH and androgenesis)
5) Spironolactone (acne and hirsutism)
6) Clomiphene (for pregnancy)