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General Medicine

Polycystic Ovarian Syndrome (PCOS)

Melissa Dennis, MD and Rachel Soffer Parritz, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Polycystic ovarian syndrome (PCOS) is a common endocrine disorder with heterogeneous manifestations that affects 6–10% of the U.S. population.

  • Hyperandrogenism, insulin resistance, an...

DIAGNOSIS

HISTORY

  • A comprehensive history, including a family history of diabetes and premature onset of cardiovascular disease, is important in the differential diagnosis.

  • Focus on the onset and durati...

TREATMENT

GENERAL MEASURES

Lifestyle changes including appropriate nutrition and exercise to decrease body weight by as little as 5% can restore ovulation and increase insulin sensitivity (4)[A]. Treat...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

6-month intervals to evaluate response to therapy and to monitor weight and medication side effects 

Patient Monitoring

  • Counsel patient about the risk of endometria...

REFERENCES

1
Azziz R, Carmina E, Dewailly D, et al; for Task Force on the Phenotype of the Polycystic Ovary Syndrome of The Androgen Excess and PCOS Society. The Androgen Excess and PCOS Society criter...

SEE ALSO

Algorithm: Amenorrhea, Secondary 

CODES

ICD10

  • E28.2 Polycystic ovarian syndrome

  • L68.0 Hirsutism

ICD9

  • 256.4 Polycystic ovaries

  • 704.1 Hirsutism

SNOMED

  • 69878008 Polycystic ovaries (disorder)

  • 66520009 Female hirsutism (disorder)

CLINICAL PEARLS

  • Based on Rotterdam criteria, PCOS is diagnosed based on 2 of 3 of: (i) oligo-ovulation, (ii) clinical or biochemical signs of hyperandrogenism, (iii) polyctic ovaries.

  • Polycystic ovarie...

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Related Images
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Figure 6.67 Polycystic ovarian disease. Both ovaries are enlarged and contain multiple subcortical follicle cysts.
Figure 6.67 Polycystic ovarian disease. Both ovaries are enlarged and contain multiple subcortical follicle cysts.
FIG. 34.4.The ovaries in polycystic ovary syndrome shown in a woman with polycystic ovary syndrome at laparotomy. Note the large size of the ovaries, relative to the uterus, with a smooth ovarian capsule without evidence of ovulatory events.
FIG. 34.4.The ovaries in polycystic ovary syndrome shown in a woman with polycystic ovary syndrome at laparotomy. Note the large size of th...
Figure 37.3. A mechanism for polycystic ovarian syndrome proposed by Yen. LH = luteinizing hormone; LRF = luteinizing-releasing factor.
Figure 37.3. A mechanism for polycystic ovarian syndrome proposed by Yen. LH = luteinizing hormone; LRF = luteinizing-releasing factor.
Polycystic Ovarian Syndrome Labeled
Polycystic Ovarian Syndrome Labeled
Polycystic disease of the ovary. Cut sections of an ovary show numerous cysts embedded in a sclerotic stroma.
Polycystic disease of the ovary. Cut sections of an ovary show numerous cysts embedded in a sclerotic stroma.
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