Polycystic Ovary Syndrome (PCOS) – Pathophysiology ; Treatment

Introduction

Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder affecting reproductive-aged women. It is characterized by ovulatory dysfunction, hyperandrogenism, and polycystic ovaries.

Pathophysiology of PCOS

• Insulin resistance → Hyperinsulinemia → Increased androgen production.
• Excess androgens → Hirsutism, acne, menstrual irregularities.
• Ovarian dysfunction → Anovulation, infertility, polycystic ovaries.

Clinical Features

• Menstrual irregularities (Oligomenorrhea, amenorrhea).
• Hirsutism & acne due to excess androgens.
• Obesity & insulin resistance (Increased diabetes risk).
• Infertility & increased risk of endometrial cancer.

Diagnosis

• Rotterdam Criteria (Two out of three required):
  1. Oligo-ovulation or anovulation.
  2. Clinical/biochemical signs of hyperandrogenism.
  3. Polycystic ovaries on ultrasound.

Management

1. Lifestyle modifications (Weight loss, exercise).
2. Oral contraceptive pills (OCPs) for menstrual regulation.
3. Metformin for insulin resistance.
4. Clomiphene citrate or Letrozole for infertility.

Conclusion

PCOS requires a multidisciplinary approach involving lifestyle changes, hormonal therapy, and fertility treatments. These MBBS notes are essential for understanding PCOS management.