PCOS – is not just a“cosmetic” or “Infertility” condition …………It can be WORSE!!!!
- Facial Hair Growth in early high school
- Cannot conceive easily
- Irregular painful cycles
- A lot of weight gain which cannot come off easily
- It is known that women with PCOS are significantly more likely to have type II diabetes, thyroid, heart disease and also appears to have a link to endometrial cancer…
CAN’T BE WORSE THAN THIS
PCOS IS HETEROGENOUS IN NATURE
Apart from the known co relation of PCOS and increased risk of type 2 Diabetes, there is increasing evidence of link between PCOS and Thyroid disorders as well.
Furthermore study also reveals high prevalence of thyroid disorders in PCOS patients.
Danish Cancer Registry found an almost fourfold increased risk for endometrial cancer in women with PCOS as compared to the normal population
PCOS HAS HIGH PREVALENCE RATE
Despite the high prevalence of PCOS, the diagnosis and differential diagnosis remains confusing.
This is partly due to the lack of a specific single diagnostic test for the disorder.
LAB TESTS ARE THEREFORE SIGNIFICANT IN PCOS
1. Elevated testosterone
- Androgen excess can be tested by measuring total and free testosterone levels.
- An elevated free testosterone level is a sensitive indicator of androgen excess
- Most normal or slightly high in PCOS
- If > 800 mcg/dl, consider adrenal tumor.
3. LH/FSH ratio
- Levels vary over menstrual cycle, released in pulsatile fashion, affected by OCPs
- LH/FSH ratio > 2 has little diagnostic sensitivity and need not be documented.
2. Absence of other disorders to account for these symptoms
- Hypothyroidism – TSH
- Hyperprolactinemia – Prolactin
- Late onset congenital adrenal hyperplasia – 17 – hydroxyprogresterone (r/o if < 200 ng/dl)
- Ovarian Tumor – Total Testosterone (esp if > 200 ng/dl)
– Adrenal Tumor – DHEA-S (esp if > 800 mcg/dl)
– Cushing’s Syndrome – cortisol
DIAGNOSIS OF PCOS IS INCOMPLETE WITHOUT USG EXAMINATION
3. Ultrasound Criteria for Polycystic Ovaries
1. presence of 12 follicles of 2-9 mm diameter and/ or ovarian volume >10 mL without a cyst or dominant follicle > 10mm
2. Polycystic Ovaries not specific for PCOS, & > 20 % normal women have incidental polycystic ovaries
RISK STRATIFICATION OF PCOS PATIENTS
The AE- PCOS SOCIETY recommends all women with PCOS to be assessed for CVD risk; to test for BMI, waist conference and blood pressure at each clinical visit. In women diagnosed with PCOS, a Lipid Profile as well as FBS, PPBS (if BMI > 30 kg/m2, age > 40 yrs, personal history of GDM of family history of T2DM) is recommended.
1. Sheehan MT et al. Clinical Medicine and Research. 2004;2(1):13-27. Polycystic Ovarian Syndrome: Diagnosis and Management.
2. Sinha Uma et al. Indian J Endocrinol Metab. 2013 Mar-Apr; 17(2): 304–309 Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India.
3. Gottschau M et al. Gynecol Oncol. 2015 Jan;136(1):99-103. doi: 10.1016/j.ygyno.2014.11.012. Epub 2014 Nov 20. Risk of cancer among women with polycystic ovary syndrome: a Danish cohort study.
The only diagnostic chain to offer combination of laboratory tests with usg examination
Suburban diagnostics offers comprehensive evaluation of PCOS
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CENTRAL PROCESSING LAB
Aston, 2nd floor, Sundervan Complex, Opp. Union Bank, Above Mercedes Showroom, Andheri West, Mumbai – 400053