PCOS

Secondary Amenorrhea and PCOS: A Comprehensive Overview

• Secondary amenorrhea can be caused by various conditions such as PCOS, pituitary disease, and ovarian deficiency
• PCOS is diagnosed using the Rotterdam Criteria, which requires two of the following: menstrual irregularity, hyperandrogenism, and polycystic ovaries
• The etiology of PCOS is unknown, but it may be linked to factors such as obesity, genetic factors, and disruption in the H-P-O axis
• Obesity is often linked to PCOS and can lead to increased production of androgens due to compensatory hyperinsulinemia
• The management of PCOS includes weight-loss strategies, OCPs for menstrual dysfunction, and treatment for hyperandrogenic symptoms
• Hirsutism, a common symptom of PCOS, affects 5-10% of pre-menopausal women and is usually diagnosed clinically using the Ferriman and Gallwey scale
• Hirsutism can be caused by conditions such as PCOS, NCCAH, and ovarian and adrenal androgen-secreting tumors
• Virilization is a more severe form of hyperandrogenism with masculinizing features and may result from an androgen-secreting tumor
• The diagnostic work-up for hirsutism includes evaluating total testosterone, DHEAS, and 17-OHP levels, followed by imaging to rule out androgen-secreting tumors
• The text references various sources including "Essentials of Obstetrics and Gynecology," "UpToDate Online," and "APGO Medical Student Educational Objectives"
• The information provided includes details on the physical examination, laboratory tests, and diagnostic criteria for PCOS and secondary amenorrhea
• The text also emphasizes the importance of evaluating for cardiovascular risks and managing components of the PCOS syndrome such as weight loss, menstrual dysfunction, hyperandrogenic symptoms, and type 2 diabetes and lipid disorders

Test your knowledge of secondary amenorrhea and polycystic ovary syndrome (PCOS) with this comprehensive quiz. Explore the diagnostic criteria, etiology, management, and associated conditions of PCOS, as well as the causes and diagnostic work-up for hirsutism and virilization.