POLYCYSTIC OVARIAN SYNDROME Signs and symptoms The major features of PCOS include menstrual dysfunction, anovulation, and signs of hyperandrogenism. Other signs and symptoms of PCOS may include the following: ■ Hirsutism ■ Infertility ■ Obesity and metabolic syndrome ■ Diabetes ■ Obstructive sleep apnea Diagnosis On examination, findings in women with PCOS may include the following: ■ Virilizing signs ■ Acanthosis nigricans ■ Hypertension ■ Enlarged ovaries: May or may not be present; evaluate for an ovarian mass. Testing Baseline screening laboratory studies for women suspected of having PCOS may include the following: ■ Thyroid function tests [4] (eg, TSH, free thyroxine) -■ Serum prolactin level [4] ■ Total and free testosterone levels ■ Free androgen index [4] ■ Serum hCG level ■ Cosyntropin stimulation test ■ Serum 17-hydroxyprogesterone (17-OHPG) level ■ Urinary free cortisol (UFC) and creatinine levels ■ Low-dose dexamethasone suppression test ■ Serum insulin-like growth factor (IGF)–1 level Other tests used in the evaluation of PCOS include the following: ■ Androstenedione level ■ FSH and LH levels ■ GnRH stimulation testing ■ Glucose level ■ Insulin level ■ Lipid panel Imaging tests The following imaging studies may be used in the evaluation of PCOS: ■ Ovarian ultrasonography, preferably using transvaginal approach ■ Pelvic CT scan or MRI to visualize the adrenals and ovaries Management Lifestyle modifications are considered first-line treatment for women with PCOS. Such changes include the following ... ■ Diet ■ Exercise ■ Weight loss Pharmacotherapy Pharmacologic treatments are reserved for so-called metabolic derangements, such as anovulation, hirsutism, and menstrual irregularities. First-line medical therapy usually consists of an oral contraceptive to induce regular menses. If symptoms such as hirsutism are not sufficiently alleviated, an androgen-blocking agent may be added. First-line treatment for ovulation induction when fertility is desired are letrozole or clomiphene citrate. ■ Medications used in the management of PCOS include the following: ■ Oral contraceptive agents (eg, ethinyl estradiol, medroxyprogesterone) ■《Antiandrogens (eg, spironolactone, leuprolide, finasteride) ■ Hypoglycemic agents (eg, metformin, insulin) ■ Selective estrogen receptor modulators (eg, clomiphene citrate) ■ Topical hair-removal agents (eg, eflornithine) ■ Topical acne agents (eg, benzoyl peroxide, tretinoin topical cream (0.02–0.1%)/gel (0.01–0.1%)/solution (0.05%), adapalene topical cream (0.1%)/gel (0.1%, 0.3%)/solution (0.1%), erythromycin topical 2%, clindamycin topical 1%, sodium sulfacetamide topical 10%) Surgery Surgical management of PCOS is aimed mainly at restoring ovulation. Various laparoscopic methods include the following: ■ Electrocautery ■ Laser drilling ■ Multiple biopsy

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Really informative input. Thanks, I was waiting for PCOS input as few weeks back I came across 4 labelled cases asPCOS in my consulting room in a single session , however the 4 patients consulted me for other complaints .

Thanks sir. .
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Thanks for nice information sirji.

Good post.. Thanks for sharing..

Useful post .

Very nice post on pcod.regards

Informative post sir

THANKS A LOT FOR THE INFORMATIVE POST

Thanks 4 sharing

V nice and useful

Nice explantion Thnks for sharing

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