Polycystic Ovary Disease (PCOD)
Polycystic ovary syndrome is a clinical syndrome characterized by mild obesity, irregular menses or amenorrhea, and signs of androgen excess (eg, hirsutism, acne).
Sx - Premature adrenarche, early growth of axillary hair, body odor, and microcomedonal acne.
Mild obesity, slight hirsutism, and irregular menses or amenorrhea.
Signs of virilization, such as acne and body hair. Hair loss on scalp.
PE - body hair, acne, obesity
Next Steps
Dx - Refer to Endocrinology or OBGYN for a Full Diagnostic Work-Up Serum
testosterone,
LH,
FSH,
prolactin,
TSH, FT4 Pelvic ultrasound (> 10 follicles per ovary) LH/FSH ratio - This ratio is normally about 1:1 in premenopausal women, but with PCOS a ratio of greater than 2:1 or 3:1 may be considered diagnostic ⢠Glucose,
HbA1C, BUN,
CreatinineHealth Tips
Tx - OCP: Desogestrel / Ethinyl Estradiol 0.15mg / 30mcg QD, in combination with Spironolactone Spironolactone 50-100 mg PO BID (anti-androgen) Metformin 500mg BID (Metformin 500 to 1000 mg bid is used to help increase insulin sensitivity if weight loss is unsuccessful or menses do not resume) Eflornithine cream 13.9% bid may help remove unwanted facial hair. Weight loss is encouraged. It may help induce ovulation, make menstrual cycles more regular, increase insulin sensitivity. For women who desire pregnancy, infertility treatments (eg, clomiphene) are used.