PCOS

Question 1

What is PCOS

Answer 1

POLYCYSTIC OVARIAN SYNDROME

Question 2

Clinical manifestations of PCOS

Answer 2

Insulin insensitivity
Acanthosis nigricans
Obesity
Hyperandrogenism
Hirsutism
Elevated LH & estrogen
Low FSH & progesterone
Anovulation
Irregular periods
Infertility

Question 3

Causes of PCOS

Answer 3

Genetic
Environmental
Lifestyle
Unknown

Question 4

What is the diagnostic criteria used for PCOS

Answer 4

ROTTERDAM’S CRITERIA

Question 5

What is rotterdam’s criteria

Answer 5

OLIGOMENORRHEA/ AMENORRHEA
HYPERANDROGENISM
STRING PEARL SIGN (ENLARGED OVARIES) ON US

Question 6

Treatment of PCOS

Answer 6

1) WEIGHTLOSS
• weightloss- decreases adipose tissue - decreased aromatization - decreased estrogen secretion - FSH release

2) METFORMIN
Antidiabetic drug for insulin resistance

3) PROGESTERONE
Oral contraceptives
Negative feedback for LH secretion
No LH - no estrogen

4) INFERTILITY TREATMENT (OVULATION INDUCING DRUGS)
• CLOMIPHENE CITRATE
Drug of choice for ovulation
Partial estrogen receptor blocker
Side effects is hot flashes, multiple pregnancy, ovarian hyperstimulation syndrome, ovarian cyst, ovarian cancer, double vision, HI disorders, Breast disorders
• LETROZOLE
Drug of choice for PCOS
Aromatase inhibitor

5) HIRSUTISM TREATMENT
ORAL CONTRACEPTIVES/
• SPIRONOLACTONE (Antiandrogen)

Question 7

What is elevated in PCOS

Answer 7

LH
ESTROGEN
ANDROGENS
PROLACTIN (sometimes)
LDL
BLOOD INSULIN

Question 8

What is decreased in PCOS

Answer 8

FSH
PROGESTERONE
SEX HORMONE BINDING GLOBULINS
HDL CHOLESTEROL

Question 9

What is the key hormonal abnormality in PCOS

Answer 9

Elevated LH
Elevated estrogen
Elevated androgens

Question 10

What is the most common pathological cause of hirsutism

Answer 10

PCOS