Polycystic Ovarian Syndrome (PCOS); At my last article i have described the various causes of ‘secondary amenorrhoea’;aetiology & mechanisms with common causes of secondary amenorrhoea. So from those aetiologies, Ovarian factors; ‘Polycystic ovarian syndrome’ is very common factor of our today’s clinic. So today i am going to discuss about ‘Polycystic ovarian syndrome ‘(PCOS). So what is Polycystic ovarian syndrome? Polycystic ovarian syndrome (PCOS) was originally described in 1935 by Stein and Leventhal as a syndrome menifested by amenorrhoea, hirsutism & obesity associated with enlarged Polycystic ovaries (Hirsutism :-excessive and increased hair growth in women in locations where the occurrence of terminal hair normally is minimal or absent, like face, neck).Secondary Amenorrhoea;Ovarian factors:-
This heterogeneous (diverse kind of)disorder is characterised by excessive androgen production by the ovaries mainly. PCOS is a multifactorial & polygenic condition. Diagnosis is based upon the presence of any two of the following three criteria:-
(1) Oligo and /or anovulation (2) Hyperandrogenism(clinical and/or biochemical) (3) Polycystic ovaries. Other aetiologies (CAH :-congenital adrenal hyperplasia, thyroid dysfunction, hyperprolactinemia, Cushing syndrome)are to be excluded. The incidence varies between 0•5- 4%,more common amongst infertile women. It is prevalent in young reproductive age group(20-30%). Polycystic ovary may be seen in about 20% of normal women.
Clinical features/Symptoms:- (1) The patient complains of increasing obesity (abdominal -50%) (2) Menstrual abnormalities (70%) in the form of oligomenorrhoea. (3) Amenorrhoea or DUB (Dysfunctional uterine bleeding)and infertility. (4)Presence of hirsutism & acne are the important features (70%). (5) Virilism(Development of the sex characteristics that are typically found in men)is rare. (6) Acanthosis nigrican is characterised by specific skin changes due to insulin resistance. The skin is thickened & pigmented (gray brown). Commonly affected sites are nape of the neck, inner thighs,groin & axilla. (7) HAIR-AN syndrome :-in patients with PCOS is characterised by Hyperandrogenism, insulin resistance & Acanthosis nigricans.
Internal examination reveals bilateral enlarged cystic ovaries which may not be revealed due to obesity.
Writer
Dr.Priyanka Baisya
