Polycystic Ovary Syndrome
It is a syndrome of hyperandrogenism
The syndrome is related to a lack of pulsatile GnRH release. Many follicles begin to develop but a dominant follicle is not selected to mature. These follicles respond to pituitary hormones by producing an abnormal pattern of oestrogen secretion.
a chronic painful oestrogen-dependent condition characterised by the growth of endometrial tissue in sites other than the uterus
In polycystic ovarian syndrome (PCOS), exposure of follicles to androgens may lead to inhibition of FSH, by what mechanism might FSH secretion be inhibited selectively?
Why might there be no LH surges in this condition?
Follicles may still secrete inhibin which selectively inhibits FSH, thus reducing FSH in respect to LH (hence, ratio changed)
Androgens may suppress LH surges (consider the role of testosterone in the male which inhibits LH release from the pituitary).
What features of excess androgens may be present? in PCOS
(which can be blocked by anti-androgen therapy) oily skin / acne
Why is there an increased risk of endometrial malignancy in prolonged and untreated PCOS?
Due to sustained oestrogen stimulation of the endometrium
what can it cause?
implanatatin at lower uterine segment
if it crosses the internal os of cervix>> can cause hemmorhage in preganacy
birth canal is blocked>> requires C- section
Ectopic pregancy where does it most commonly occur?
- most common in fallopian tube
- can be peritoneal as well
- life threatening
How might a patient with an ovarian cyst present?
-It can twist!
U can get torsion of these cysts!
What may be the consequence of infection in the uterine tubes?
inflammation causes fibrous tissue to form.
This forms adhesions and can cause infertility
Where would pain be felt with an ectopic pregnancy implanted in the ampulla of the uterine tubes?
lower abdominal pain
Explain why pain may be felt at the shoulder tip following rupture of an ectopic pregnancy?
When ruptured, blood enters the peritoneal cavity and reaches the level of the diaphragm. C3 C4 C5 diaphragm dermatomal referral pain.
consequence of a ruptured ectopic pregnancy
hemmorhage due to anastamoses of uterine artery and ovarian artery
HCG test & Ultrasound
what do tumors of the ovary most commonly arise from?