PCOS

PCOS

• Polycystic ovarian syndrome
• Requires 2/3 of following:
  • 1. Irregular bleeding or amenorrhea.
  • 2. Laboratory evidence of hyperandrogenism.
    • Serum total testosterone (normal: 0.69-2.1 nmol/L, >5.2 nmol/L = abnormal) 
      • Can also do free testosterone (more sensitive, but not consistent way to measure in labs)
    • DHEAS (>18.9umol/L = too high) produced by adrenals.  
      • Concern for adrenal tumor. (look for Cushing's, androgens, virilization).
    • 17-OH progesterone (morning value, early in follicular phase)  (>200ng/dL or >6.06 nmol/L = abnormal)  
      • (if abnormal, do ACTH stimulation test)
  • 3. Ultrasound evidence of polystic ovaries.