Exam Cram

• Disease part of the metabolic syndrome, obesity

• Presentation: irregular menstruation, infertility, hirsuitism

• Investigations: increased BMI, androgen excess, cysts on ovaries on imaging, elevated LH: FSH ratio

• Management: weight loss

Outline

Assessment

History

• Infertility

• Heavy periods

Examination

• Increased BMI

• Hirsuitism

Investigations

• Abnormal FSH: LH ratio

• USS: multiple cysts on ovaries

Diagnosis

Rotterdam Criteria (2/3 required)

• Hyperandrogenism: LH 2x > FSH

• Ovulatory dysfunction- irregular/ absent periods 

• Polycystic ovaries (on imaging)

Management

Weight loss if first step.

• Metabolic: metformin, liraglutide

• Hormonal: COCP

• Infertility: clomiphene and letrozole

Page written in 2024. 

Resources and References

1. https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html#:~:text=Polycystic%20ovary%20syndrome%20(PCOS)%20is,ovulatory%20dysfunction%2C%20and%20polycystic%20ovaries.

2. https://cks.nice.org.uk/topics/polycystic-ovary-syndrome/diagnosis/diagnosis/