PCOS is one of the most common endocrine disorder in women. Affecting 5% to 10% of women who reach reproductive age.
The prevalence among infertile women is around 15% – 20%.
By definition PCOS may clinically be manifested in young women of reproductive age as oligo anovulation, bio chemical or clinical hyperandrogenism (hirsutism, acne, acanthosis nigricans, male pattern balding) and pcos.
Pcos may be diagnosed by the presence of two of three major recommended criteria:
– Any form of hyperandrogenism, either clinical (hirsutism and acne) or endocrine (the hormonal diagnosis of high androgen levels) and
– Ultrasound picture of polycystic ovaries (presence of either 12 or more follicles, measuring 2 to 9mm in diameter or an increased ovarian volume> 10 cm cube.
– TV – USG is highly valuable as a diagnostic tool using the Rotterdam’s criteria.
– LH/FSH ratio
– Free testosterone levels
– SHBG levels
Hyperandrogenism – This is a rare condition where there is an excess of male sex hormones in a woman.
Menstrual irregularities – Many a times, irregularities in the menstrual cycle can result in PCOS.
Multiple cysts in the ovaries – Formation of cysts is dangerous and should be treated to prevent PCOS.
Obesity – Being overweight or even obese is an added symptom which can result in PCOS.
Hirsutism/acne, alopecia – Acne and hair fall is also a symptom of PCOS.
– Weight loss
– Medical management
– Hormonal treatments – oral contraceptive pills can be given to control or manage PCOS.
– Insulin sensitizing agents – metformin, myo inositol,
– Fertility therapy – clomiphene citrate
– Treatment of Hirsutism – oral contraceptive pills, Spironolactone, finasteride
Vitamin D is known to increase insulin sensitivity and has beneficial effects on some CVD risk forms such as cholesterol, triglycerides and VLDL levels
Conclusion: PCOS is an entity with a long life span, requiring ‘control’ than ‘cure’. The treatment should be directed at the symptoms of PCOS such as anti androgens, fertility improving agents have shown to be effective in addressing the specific problems in PCOS. Lifestyle modification are weight management is essential in order to prevent PCOS.
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