Polycystic ovarian syndrome: features and investigation
Polycystic ovary syndrome (PCOS) is a complex condition of ovarian dysfunction thought to affect between 5-20% of women of reproductive age. The aetiology of PCOS is not fully understood. Both hyperinsulinaemia and high levels of luteinizing hormone are seen in PCOS and there appears to be some overlap with the metabolic syndrome.
Features
Investigations
Features
- subfertility and infertility
- menstrual disturbances: oligomenorrhea and amenorrhoea
- hirsutism, acne (due to hyperandrogenism)
- obesity
- acanthosis nigricans (due to insulin resistance)
Investigations
- pelvic ultrasound: multiple cysts on the ovaries
- FSH, LH, prolactin, TSH, and testosterone are useful investigations: raised LH:FSH ratio is a 'classical' feature but is no longer thought to be useful in diagnosis. Prolactin may be normal or mildly elevated. Testosterone may be normal or mildly elevated - however, if markedly raised consider other causes
- check for impaired glucose tolerance