Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a complex disorder charaterized by cysts in the ovaries, high levels of male hormones (hyperandrogenism) and an irregular or no menstrual cycle. Affects around 10% of women of reproductive age.

Hyperandrogenism (particularly testosterone) prevents the normal release of egg cells from the ovaries (ovulation) and the regular menstrual periods leading to fertility problems. In polycystic ovary syndrome, the abnormal hormone levels prevent the follicles in the ovaries from developing to to release egg cells normally and these immature follicles accumulate in the ovaries to create the cysts.

Aetiology:
Exact cause is unclear.
Genetics (family history is common, thought pattern not clear).
Up to 70 percent of women with PCOS have insulin resistance (ovaries respond to excess insulin by producing androgens).

Clinical Features:
Irregular or no menstrual cycle; hirsutism; acne; alopecia; weight gain or difficulty losing weight; darkening of skin in body creases; skin tags; pelvic pain, difficulty getting pregnant; sleep apnoea.
Enlarged ovaries and cysts on ultrasound.
Elevated luteinizing hormone (LH) and gonadotropin–releasing hormone (GnRH) levels.

Diagnostic criteria: Hyperandrogenism; oligo-ovulation/anovulation; polycystic ovaries; exclusion of other related disorders

Management:
Weight reduction decreases androgen, luteinizing hormone and insulin levels.
Oral contraceptives to regulate ovulation.
Clomiphene to induce ovulation.
Metformin to improve insulin levels.
Gonadotropins
Aromatase inhibitors (Letrozole)

Page last updated: Jun 22, 2022 @ 4:08 am

 
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