INVESTIGATIONS & DIAGNOSIS, TREATMENT PLAN, COMPLICATIONS & KEY INFORMATION
INVESTIGATIONS & DIAGNOSIS
- Diagnosis requires 2+ of 3 cardinal features in adults Free androgen index = (total testosterone/SHBG) x 100 • Blood tests to exclude other causes:
- FSH & LH (Primary ovarian failure), prolactin (Hyperprolactinemia), TSH (Hypothyroidism)
- Ultrasound: confirms polycystic ovarian morphology
- Oral glucose tolerance test if BMI >25 (>23 if Southeast Asian)
- Endometrial thickness assessment.
TREATMENT PLAN
COMPLICATIONS
• Infertility
• Cardiovascular disease
• Sleep apnoea
• Anxiety/depression
• Type 2 diabetes
• Non-diabetic hyperglycaemia
• Endometrial cancer
• Pregnancy complications: preeclampsia, gestational diabetes
KEY INFORMATION
• Adolescents: reassess 8 years post-menarche if not meeting full criteria
• Pre-pregnancy care (if at high risk of PCOS): OGTT at booking, 20 weeks, 24-28 weeks o Regular glycaemic monitoring every 1-3 years if indicated
EXTRA’S
• Differential diagnoses to consider:
o Primary ovarian failure o Hypothyroidism o Hyperprolactinaemia o Congenital adrenal hyperplasia o Cushing’s syndrome.