Flashcards in PCOS Deck (10)
5 main complications of persistent anovulation?
High estrogen state:
Diabetes, endometrial cancer, hyperlipidemia, metabolic syndrome, cardiovascular disease
Patient with suspected PCOS – diagnostic labs?
1. TSH and prolactin
3. Serum testosterone
4. DHEA-S and 17-hydroxyprogesterone
Glucose intolerance screening, endometrial biopsy
Diagnostic criteria for PCOS?
2. Hyperandrogenism (acne, hirsutism) excluding other causes
3. Evidence of multiple cysts on the ovary via transvaginal ultrasound
Other causes of hyperandrogenism that must be ruled out?
1. CAH (High DHEA-S/17-hydroxyprogesterone)
3. Adrenal/ovarian tumors (Ovarian mass or leydig tumor)
5. Thyroid disorders
PCOS – definition?
Condition of unexplained hyperandrogenic chronic anovulation associated with excessive estrogen
When to do an endometrial biopsy in PCOS?
In patients with long-standing anovulation unopposed estrogen exposure
Treatment goals in PCOS?
1. Reduce circulating androgen levels
2. Protect endometrium from unopposed estrogen (to reduce cancer risk)
3. Weight loss and lifestyle changes
4. Monitor for diabetes and cardiovascular disease
Patient with PCOS desires pregnancy - Will likely need?
Clomiphene citrate – SERM that blocks estrogen receptor, causing increased estrogen production. Leads to better follicle recruitment.
Primary management of PCOS? Mechanisms? Can also give?
1. Regulates bleeding
2. Limits unopposed estrogen
3. Increases sex hormone binding globulin (decreases free androgen)
4. Suppresses ovarian Androgen production