Flashcards in PMS & PCOS Deck (17):
What is premenstrual syndrome (PMS)?
Psychological, behavioural and physical symptoms that are experience on a regular basis during the luteal phase of the menstrual cycle and resolve by the end of menstruation
Common presentation of PMS?
*Feeling upset, anxious or irritable
*Tiredness, or trouble sleeping
*Bloating, tummy pain
*Spotty skin/greasy hair
*changes in appetite and sex drive
How is premenstrual syndrome diagnosed?
*Symptoms diary over 2 cycles
*GnRH analogues used is diary inconclusive
1st line management of PMS?
*Healthy balances diet
=all to reduce stress and pain
What medical treatments are there for PMS?
*Combined oral contraceptive pill
*Antidepressant i.e. SSRIs
What are the differentials for PMS?
What is polycystic ovarian syndrome?
Emcompasses a syndrome of polycystic ovaries, is association with systemic symptoms causing reproductive, metabolic and psychological disturbances
How does PCOS most commonly present?
*Amenorrhoea or oligomenorrhoea <9 periods a year
How is PCOS diagnosed?
Using the rotterdam criteria, must have 2/3
*clinical/biochemical signs of hyperandrogenism
What investigations are done in suspected PCOS?
*Pelvic ultrasound: multiple cysts on ovaries
*FSH, LH, prolactin, TSH and testosterone bloods
*Check for impaired glucose tolerance
What blood results will a woman with PCOS get back?
*FSH normal or low
*LH mey be elevated
*Prolactin normal or mildly elevated
*Glucose fasting may be elevated
*HbA1c may be elevated
What are the long-term complications of PCOS?
*insulin resistance type 2 diabetes
*increased risk of cardiovascular disease
*oligomenorrhoea/amenorrhoea predispose to endometrial hyperplasia/carcinoma
What drugs in women with PCOS can be used to stimulate ovulation to help with fertility?
What general management of PCOS should be done?
*weight reduction if appropriate
*combined oral contraceptive to help regulate cycle and induce monthly bleeds
What management in PCOS can help hirsutism and acne?
*combined oral contraceptive
What management in PCOS can help infertility?
*Metformin/clomifene used to stimulate ovulation