Care, Empathy and Trust
Obstetrician, gynaecologist, ivf specialist
PCOS
It is the most common Endocrinological disorder in the reproductive age group. It affects 12–21% of women of reproductive age and is a signifiant cause of distress to women. Treatment of the condition nearly costs $400 million per year in Australia. About 70% of women with PCOS in the community remain undiagnosed especially depending on the ethnicity and in a study in aboriginals, 15% of diabetics had PCOS
Criteria for Diagnosis
Two of the following three criteria are required:
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1. Oligo/an ovulation: oligo/an ovulation :> 35 or < 21 days.
2. Hyperandrogenism
3. Polycystic ovaries on ultrasound after excluding CAH, androgen secreting tumors, Cushing syndrome, thyroid dysfunction and hyper prolactinaemia.
In young women menstrual cycles may take up to 2 years to regulate after menarche. Irregular Cycles persisting into the third year post menarche should be investigated for PCOS. If commencing a young woman on hormonal contraception after 12 months of irregular cycles, Consideration should also be given to assessment of PCOS before commencement of the hormonal contraception.
Young girls are disturbed by acne and irregular periods while child bearing age group usually are concerned about the fertility. In pre-menopausal group ,there can be irregularity of cycles and sometimes hyperplasia, it is imperative to have at least 3-4 cycles / year to protect the lining.
Treatment
Weight loss of just 5 percent can help in improving all the symptoms. Commonly, young girls need treatment with oral pills, especially contain potent anti-androgens. Fertility can be assisted with Ovulation inducing drugs and IVF. Long term protection of the lining is ideally with Mirena. Oral Pills also can be continued for regularizing cycles.