PCOs Flashcards
(16 cards)
SBA
Porportion of circulating testosterone in the female produced by the ovaries?
25%
Androgens produced by the ovaries
- 25% of circulating testosterone
- 20% of dehydroepiandrosterone
- 50% of androstendione
Incidence of PCOs
10-15% of females
Endocrinology of PCOs
- Inc or normal androgens
- Inc or normal LH (inc in 40%)
- Normal FSH
- Inc or normal fasting insulin
- Inc or normal E2
- Inc AMH
Do we use LH/FSH ratio for dignosis of PCO
No
Only rotterdam crietria
How to doagnose PCOs in adolescents
Must have all the criteria 3/3
Which is worse buttock fat or belly fat
Belly fat as it is responsible for insulin resistance
Lifelong consequences of PCOS
1.DM : GDM OR TYPE II
2. Sleep apnea: more in obese
3. CVD
4. Depression and anxiety
5. Hyperplasia and endometrial cancer
How to reduce risks of PCOs
- Weight reduction and life style modification
- Insulin sensitizers: metformin
- Weight reduction drugs: orlistat
- Lap ovarian drilling
- Bariatric surgery
Percent of patients with pcos that develop metabolic disease
33%
Dietary goals in obese woman with PCOS
- Carbohydrates with low glycemic index
- Fibers
- Proteins
- More omega 3 ( not omega 6)
Pco management
• Withdrawal bleeding at least every 3 months.
• In amenorrheic women : US to measure ET every 6-12 M, if greater than 10 mm: artificially induced bleed, followed by repeat us and end biopsy if the end has not been shed. Or mirena.
Percent of ovulation with CC
AND WHAT PERCENT WILL BE PREGANANT
ovulation 70-85%
Pregnancy: 60-70%
How to perfrom ovarian drilling
4 drillings per ovary
For 4 seconds
At 40 watt
Dose of gonadotropins
25-50 iu of rFSH or hMG for 2w
If no respomse
Inc 50% of initial dose for 1 w till max 35 days
Once dominant follicle 17 mm -> hcg 5000Iu
Normal testosterone level in females
0.5 - 2.5 nmol/l
