1
Q
What is PCOS
A
Anovulation disorder that results in Hirsutism, infertility and AUB
Common presents in young
2
Q
Symptoms and signs
A
HAIR- AN Hirsutism Hyperandrogenism Infertility Insulin Resistance Acanthuses Nigricans
Other teens to young adults Oligomenorrhea acne hirsutism Abnormal/irregular uterine bleeding, obesity virilization FmHx of DM Associated with Syndrome X - refer to notes obesity infertility HTN Insulin resistance that can develop into T2D
3
Q
Diagnosis of PCOS
A
Diagnosis based on 2 of any of the following 3 and and exclusion of other aetiologies such as hyperthyroidism, hyperprolactinaemia, congenital adrenal hyperplasia, androgen-secreting tumours and Cushing’s syndrome.
oligomenorrhea/irregular menses for 6 mo
clinical or lab evidence of hyperandrogenism
polycystic ovaries on U/S
4
Q
Cx of PCOS
A
Risk of endometrial hyperplasia and cancer Long term health consequences Hyperlipidemia Adult onset DM endometrial hyperplasia Infertility Obesity Sleep apnea
5
Q
Ix
A
17 hydroxyprogesterone level should be normal Prolactin, free testosterone, DHEA TFT LH:FSH = 2:1 USS: TA, TV OGTT
6
Q
Mx
A
6 steps 1. Wt loss, Laser hair removal, lifestyle changes 2. COCP 3. anti androgens - Spirolactone. 4. Clomiphine - if you want to have babies - Infertility 5. metformin. 6. Manage CVS risk factor 7 . Pys support
