Polycystic Ovarian Syndrome Questions & Answers

Updated: Sep 19, 2019
  • Author: Richard Scott Lucidi, MD, FACOG; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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Questions & Answers

Overview

What is polycystic ovarian syndrome (PCOS)?

What are the signs and symptoms of polycystic ovarian syndrome (PCOS)?

Which physical findings suggest polycystic ovarian syndrome (PCOS)?

Which lab tests are performed in the workup of polycystic ovarian syndrome (PCOS)?

Which imaging studies are performed in the workup of polycystic ovarian syndrome (PCOS)?

Which procedures are performed in the workup of polycystic ovarian syndrome (PCOS)?

What is the first-line treatment for polycystic ovarian syndrome (PCOS)?

What are the pharmacologic treatments for polycystic ovarian syndrome (PCOS)?

What are the surgical options for treating polycystic ovarian syndrome (PCOS)?

What are the signs and symptoms of polycystic ovarian syndrome (PCOS)?

What are the diagnostic criteria for polycystic ovarian syndrome (PCOS)?

What is the role of androgens and estrogen metabolism in the etiology of polycystic ovarian syndrome (PCOS)?

What is the role of insulin resistance in the etiology of polycystic ovarian syndrome (PCOS)?

What is the role of anovulation in the etiology of polycystic ovarian syndrome (PCOS)?

What is the role of hyperinsulinemia in the etiology of polycystic ovarian syndrome (PCOS)?

How are ovaries characterized in polycystic ovarian syndrome (PCOS)?

What functional abnormality may be found in women with polycystic ovarian syndrome (PCOS)?

What is the role of genetics in the etiology of polycystic ovarian syndrome (PCOS)?

Which gene linked to obesity may be an etiologic factor in polycystic ovarian syndrome (PCOS)?

Which genes have been associated with polycystic ovarian syndrome (PCOS)?

What is the prevalence of polycystic ovarian syndrome (PCOS) in the US?

What is the ethnic variability for hirsutism among women with polycystic ovarian syndrome (PCOS)?

In what age group is polycystic ovarian syndrome (PCOS) commonly diagnosed?

Polycystic ovarian syndrome (PCOS) increases the risk of developing which conditions?

What is the prevalence of insulin resistance in women with polycystic ovarian syndrome (PCOS)?

What are the AACE and the ACE recommendations for diabetes screening in women with polycystic ovarian syndrome (PCOS)?

What is the risk for endometrial hyperplasia and carcinoma in patients with polycystic ovarian syndrome (PCOS)?

What is the risk for breast or ovarian cancer in patients with polycystic ovarian syndrome (PCOS)?

What education should be given to patients with polycystic ovarian syndrome (PCOS)?

Presentation

Which family history suggests polycystic ovarian syndrome (PCOS)?

Which menstrual irregularities suggest polycystic ovarian syndrome (PCOS)?

Which manifestations of hyperandrogenism suggest polycystic ovarian syndrome (PCOS)?

What are the ACOG recommendations for screening with 17-hydroxyprogesterone levels in women with polycystic ovarian syndrome (PCOS)?

What effect does polycystic ovarian syndrome (PCOS) have on fertility?

What is the prevalence of obesity among women with polycystic ovarian syndrome (PCOS)?

What is the prevalence of metabolic syndrome among women with polycystic ovarian syndrome (PCOS)?

Which cardiovascular disorders are at increased risk in women with polycystic ovarian syndrome (PCOS)?

What are the ACOG recommendations for diabetes screening in women with polycystic ovarian syndrome (PCOS)?

How prevalent is sleep apnea among women with polycystic ovarian syndrome (PCOS)?

Which findings of hyperandrogenism suggest polycystic ovarian syndrome (PCOS)?

What is the modified Ferriman-Gallwey (mFG) scoring system and how is it used in the evaluation of suspected polycystic ovarian syndrome (PCOS)?

How prevalent is abdominal obesity in women with polycystic ovarian syndrome (PCOS)?

What causes acanthosis nigricans in women with polycystic ovarian syndrome (PCOS)?

How is acanthosis nigricans staged in women with polycystic ovarian syndrome (PCOS)?

What does a finding of high blood pressure suggest in women with polycystic ovarian syndrome (PCOS)?

What are the physical findings of ovaries in polycystic ovarian syndrome (PCOS)?

DDX

Which disorders should be included in the differential diagnosis of polycystic ovarian syndrome (PCOS)?

What are the differential diagnoses for Polycystic Ovarian Syndrome?

Workup

How is polycystic ovarian syndrome (PCOS) diagnosed?

What baseline screening tests are recommended by the RCOG for women with suspected polycystic ovarian syndrome (PCOS)?

When is an infertility evaluation indicated in women with suspected polycystic ovarian syndrome (PCOS)?

When should lab samples be obtained for the workup of polycystic ovarian syndrome (PCOS)?

How is late-onset congenital hyperplasia due to 21-hydroxilase deficiency differentiated from polycystic ovarian syndrome (PCOS)?

When is screening for Cushing syndrome or acromegaly indicated in the workup of polycystic ovarian syndrome (PCOS)?

How is hyperprolactinemia differentiated from polycystic ovarian syndrome (PCOS)?

What is the role of androgen level testing in the workup of polycystic ovarian syndrome (PCOS)?

How are androgen-secreting ovarian or adrenal tumors differentiated from polycystic ovarian syndrome (PCOS)?

What is the role of follicle-stimulating hormone (FSH) level testing in the workup of polycystic ovarian syndrome (PCOS)?

How is hypothyroidism differentiated from polycystic ovarian syndrome (PCOS)?

What is the role of oral glucose-tolerance testing in the workup of polycystic ovarian syndrome (PCOS)?

When should pregnant women with polycystic ovarian syndrome (PCOS) be screened for gestational diabetes?

What does insulin resistance and inflammatory markers suggest in adolescents with polycystic ovarian syndrome (PCOS)?

What is the role of ultrasonography in the workup of polycystic ovarian syndrome (PCOS)?

When are CT scanning and MRI indicated in the workup of polycystic ovarian syndrome (PCOS)?

Which histologic changes in ovaries suggest polycystic ovarian syndrome (PCOS)?

Treatment

What is the first-line treatment for polycystic ovarian syndrome (PCOS)?

What do elevated mean platelet volume (MPV) levels suggest in women with polycystic ovarian syndrome (PCOS)?

Which specialists should be consulted in the management of polycystic ovarian syndrome (PCOS)?

What are the Endocrine Society practice guidelines for the diagnosis and treatment of polycystic ovarian syndrome (PCOS)?

How effective are lifestyle changes in the treatment of polycystic ovarian syndrome (PCOS)?

What are the goals of medical management of polycystic ovarian syndrome (PCOS)?

What is the first line medical therapy for polycystic ovarian syndrome (PCOS)?

How is infertility treated in women with polycystic ovarian syndrome (PCOS)?

What is the role of metformin in the treatment of polycystic ovarian syndrome (PCOS)?

What is the role of corticosteroids in the treatment of polycystic ovarian syndrome (PCOS)?

What is the role of leuprolide acetate (Lupron) in the treatment of polycystic ovarian syndrome (PCOS)?

Which medications can be used to treat acne in women with polycystic ovarian syndrome (PCOS)?

What are the FDA warnings for the use of statins?

What are the AE-PCOS recommendations for the treatment of metabolic complications of polycystic ovarian syndrome (PCOS)?

What is the role of metformin in the treatment of polycystic ovarian syndrome (PCOS)?

What do the ACOG and SOGC recommend as first-line therapy for ovulation stimulation in women with polycystic ovarian syndrome (PCOS)?

What is the second-line therapy for ovulation stimulation in women with polycystic ovarian syndrome (PCOS)?

Which drugs are effective in treating anovulation in women with polycystic ovarian syndrome (PCOS)?

What are the treatment options for infertility in women with polycystic ovarian syndrome (PCOS)?

What is the role of frozen-embryo transfer for the treatment of infertility in polycystic ovarian syndrome (PCOS)?

What are the treatment options for hirsutism secondary to polycystic ovarian syndrome (PCOS)?

What is the role of contraceptives in the treatment of hirsutism secondary to polycystic ovarian syndrome (PCOS)?

What is the role of antiandrogens for the treatment of hirsutism secondary to polycystic ovarian syndrome (PCOS)?

Is clomiphene citrate or metformin effective in reducing hirsutism secondary to polycystic ovarian syndrome (PCOS)?

How can women with polycystic ovarian syndrome (PCOS) lower their risk for developing diabetes mellitus?

What is the role of soy isoflavone in the treatment of women with polycystic ovarian syndrome (PCOS)?

How is dyslipidemia treated in women with polycystic ovarian syndrome (PCOS)?

Does vitamin D deficiency increase the risk for metabolic syndrome in women with polycystic ovarian syndrome (PCOS)?

What is the role of surgical intervention for the treatment of polycystic ovarian syndrome (PCOS)?

What monitoring is needed for women with polycystic ovarian syndrome (PCOS)?

What conditions are women with polycystic ovarian syndrome (PCOS) at increased risk for during pregnancy?

What are the benefits of peer support groups in the treatment of polycystic ovarian syndrome (PCOS)?

Guidelines

What are the AACE, ACE, and AE-PCOS guidelines for treatment and management of polycystic ovarian syndrome (PCOS)?

Medications

Which medications are used to treat polycystic ovarian syndrome (PCOS)?

What FDA warnings exist for medications used in the treatment of polycystic ovarian syndrome (PCOS)?

Which medications in the drug class Acne Agents, Topical are used in the treatment of Polycystic Ovarian Syndrome?

Which medications in the drug class Selective Estrogen Receptor Modulators are used in the treatment of Polycystic Ovarian Syndrome?

Which medications in the drug class Oral Contraceptives are used in the treatment of Polycystic Ovarian Syndrome?

Which medications in the drug class Topical Hair-Removal Agents are used in the treatment of Polycystic Ovarian Syndrome?

Which medications in the drug class Antiandrogens are used in the treatment of Polycystic Ovarian Syndrome?

Which medications in the drug class Hypoglycemic Agents are used in the treatment of Polycystic Ovarian Syndrome?