Polycystic ovary syndrome history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
History
History-taking, specifically for menstrual pattern, obesity, hirsutism, and the absence of breast discharge. A clinical prediction rule found that these four questions[1] can diagnose PCOS with a sensitivity of 85% and a specificity of 85%.[2]
Symptoms
Common symptoms of PCOS include
- Ovarian Cysts — (also called Polcystic Ovaries or PCO) is not a necessary symptom to be 'PCOS', many do not have cyst issues. Likewise, having cysts does not prove PCOS as many women without any medical problems have cysts at some point in their lives.
- Oligomenorrhea, amenorrhea — irregular, few, or absent menstrual periods; cycles that do occur may be heavy (heavy bleeding is also an early warning sign of endometrial cancer(in post menopausal women), for which women with PCOS are at slightly higher risk)
- Infertility, generally resulting from chronic anovulation (lack of ovulation)
- Elevated serum (blood) levels of androgens (male hormones), specifically testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS), causing hirsutism and occasionally masculinization
- Dyspareunia — pain during sexual intercourse
- Androgenic alopecia — male-pattern baldness
- Acne, oily skin, seborrhea
- Acanthosis nigricans — dark patches of skin, tan to dark brown or black, a sign of insulin resistance, which is associated with PCOS
- Acrochordons (skin tags) — tiny flaps of skin
- Prolonged periods of PMS-like symptoms (bloating, mood swings, pelvic pain, backaches)
- Sleep apnea
Mild symptoms of hyperandrogenism, such as acne or hyperseborrhea, are frequent in adolescent girls and are often associated with irregular menstrual cycles. In most instances, these symptoms are transient and only reflect the immaturity of the hypothalamic-pituitary-ovary axis during the first years following menarche.[3]
Signs
Signs are:
- Multiple small follicles on the ovaries (10 or more) (one form of ovarian cyst). Sonographically they may look like a string of pearls.
- Enlarged ovaries, generally 1.5 to 3 times larger than normal(volume >20mls), resulting from multiple peripherally located small follicles and echogenic ovarian stroma.
- Thickened, smooth, pearl-white outer surface of ovary on laparoscopic examination.
- The ratio of LH (Luteinizing hormone) to FSH (Follicle stimulating hormone) is greater than 1:1, as tested on Day 3 of the menstrual cycle.
- High levels of testosterone.
- Low levels of sex hormone binding globulin.
- Hyperinsulinemia.
It is important to know that PCOS can present in any age. Many can be diagnosed as young children, some might not present until after menopause. It is vital to find a PCOS knowledgeable doctor to catch this disorder as many miss the diagnosis - sometimes for years.
References
- ↑ http://www.cfp.ca/cgi/content/full/53/6/1041/T50531041
- ↑ Pedersen SD, Brar S, Faris P, Corenblum B (2007). "Polycystic ovary syndrome: validated questionnaire for use in diagnosis". Canadian family physician Médecin de famille canadien. 53 (6): 1042–7, 1041. PMID 17872783.
- ↑ Christine Cortet-Rudelli, Didier Dewailly (2006). "Diagnosis of Hyperandrogenism in Female Adolescents". Hyperandrogenism in Adolescent Girls. Armenian Health Network, Health.am. Unknown parameter
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