Polycystic ovarian syndrome

The definition for polycystic ovarian syndrome varies, but the one adopted by the RCOG is 2 of 3 of: 
  • Polycystic ovaries (12 or more peripheral follicles or ovarian volume >10cm^3) 
  • Oligo or anovulation 
  • Clinical and/or biochemical signs of hyperandrogenism (hirsuitism, acne, alopecia) 

Features associated with polycystic ovarian syndrome include: 

Biochemically:
  • Raised LH (40% of women) 
  • Raised testosterone 
  • Low or normal FSH 

Management 
  • Lifestyle changes to encourage weight loss 
  • OCP to block androgen effects
  • Topical eflornithine hydrochloride (an inhibitor of the enzyme ornithine decarboxylase) for hirsuitism 
  • Metformin
  • Clomifene if fertility issues 
  • ?ovarian drilling 


References

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