PCOS is an endocrine and metabolic disorder. It is considered in any woman with acne, hirsutism, menstrual irregularities, or obesity.
Patients with PCOS, have anovulation, that is, they may not produce follicle cycle. They may therefore occur with primary amenorrhea (i.e. none at all), very rarely (oligomenorrhea) or secondary amenorrhea i.e. absence of periods for six months or more. Some may also have severe, frequent and abnormal bleeding (dysfunction of the uterus).
Insulin resistance, as well as increased insulin levels are an important factor in PCOS. Obesity is present in about one-half of patients with PCOS. Waist: hip ratio can be greater than 0.85.
The cause of PCOS is unknown, but it is possible that PCOS may be a complex genetic disorder in which the gene interacts with a variety of environmental factors and causes hormonal imbalances.
The diagnosis of PCOS is based on clinical and biochemical factors. It is suspected in cases of adolescents with hirsutism, acne, menstrual irregularities, or obesity. Diagnosis is also confirmed when excessive androgen is shown by laboratory tests.
The Androgen panel contains total plasma testosterone, free testosterone, and other androgens such as DHEA sulfate. Plasma-free testosterone is one of the most critical tests for androgen overdose. DHEA sulfate is a major marker of androgens from the adrenals. Cortisol performance tests for thyroid function are indicated in obese patients to avoid other causes of obesity.
Pelvic ultrasound shows features of polycystic ovary. i.e. most small follicles (more than 10) have an elevated stroma.
The basic lipid panel and sugar tolerance tests are important as PCOS is related to insulin resistance. Fast glucose levels are a bad prediction of a two-hour rate on PCOS. Two-hour blood sugar higher than 140 mg / dL shows insulin resistance and this is important from a medical point of view.
PCOS treatment is based on symptoms. The choice of treatment will depend on the symptoms and goals of each patient.
Losing weight through diet and exercise is an important first step.
Menstrual irregularities should be treated in patients with PCOS because chronic ovulation is associated with an increased risk of developing endometrial hyperplasia and carcinoma.
