• PCOS is the commonest endocrine disorder in women (prevalence 15-20%).
• PCOS runs in families and affects approximately 50% of first-degree relatives.
• PCOS is a heterogeneous condition. Diagnosis is made by two out of the following three criteria: (1) oligo- and/or anovulation, (2) hyperandrogenism (clinical and/or biochemical), (3) polycystic ovaries, with the exclusion of other aetiologies.
• Management is symptom orientated.
• If obese, weight loss improves symptoms and endocrinology and should be encouraged. A GTT should be performed if the BMI is >30 kg/m2 (or >25 kg/m2 if Asian). Dietary advice and exercise are essential components of a weight-reducing programme. Anti-obesity drugs or surgery may be indicated.
• Menstrual cycle control may be achieved by cyclical oral contraceptives or progestogens.
• Ovulation induction may be difficult and require progression through various treatments which should be monitored carefully to prevent multiple pregnancy.
• Hyperandrogenism is usually managed with Dianette, containing ethinyloestradiol in combination with cypro-terone acetate. Anew COCP, Yasmin may also be of benefit. Alternatives include spironolactone. Flutamide and finas-teride are not routinely prescribed because of potential adverse effects. Reliable contraception is required.
• Insulin-sensitizing agents (e.g. metformin) are showing promise for ovulation induction but require further long-term evaluation and should only be prescribed by endocrinologists/reproductive endocrinologists. Weight loss is not guaranteed.
Was this article helpful?
The first trimester is very important for the mother and the baby. For most women it is common to find out about their pregnancy after they have missed their menstrual cycle. Since, not all women note their menstrual cycle and dates of intercourse, it may cause slight confusion about the exact date of conception. That is why most women find out that they are pregnant only after one month of pregnancy.