Polycystic Ovary Syndrome (PCOS) Lecture

Vocabulary flashcards covering the diagnostic criteria, symptoms, pathophysiology, and treatment methods for Polycystic Ovary Syndrome based on the lecture contents.

Polycystic Ovary Syndrome (PCOS)

A heterogenous collection of signs and symptoms that form a spectrum of mild to severe disturbance of reproductive, endocrine, and metabolic functions; first described by Stein and Leventhal in 1935.

Rotterdam Criteria

Revised diagnostic criteria established in 2003 requiring two of the following: Oligo- or anovulation, Hyperandrogenism and/or hyperandrogenemia, and Polycystic ovaries.

Cyp11a gene

A gene associated with the androgen biosynthetic pathway that shows dysregulation in patients with PCOS.

Insulin receptor gene

A gene located on chromosome $19p13.2$ that may be involved in the aetiopathogenesis of PCOS-related insulin resistance.

Hirsutism

The presence of coarse, dark, terminal hairs distributed in a male pattern, affecting $5$ to $25$ percent of women, often caused by PCOS.

Ferriman-Gallwey Scoring System

A research tool used to quantify the degree of hirsutism by assessing nine body areas on a scale of $0$ to $4$; a score of $8$ or greater typically defines the condition.

Propionibacterium acnes

A bacterium associated with acne, which is a frequent clinical finding in adolescents with PCOS.

Androgenetic alopecia

The most common form of hair loss in PCOS, characterized by a gradual onset starting in the midline with upward and lateral extension.

Acanthosis Nigricans

Thickened, gray-brown velvety plaques found in flexure areas (neck, axillae, groin) that serve as a reliable clinical diagnostic tool for insulin resistance (IR).

Dyslipidemia

A lipid profile common in PCOS characterized by elevated LDL, triglycerides, and total cholesterol:HDL ratios, alongside depressed HDL levels.

Obstructive Sleep Apnea

A condition with a $30$- to $40$-fold higher risk in women with PCOS compared to weight-matched controls, likely related to central obesity and insulin resistance.

Metabolic Syndrome

A clinical collection of insulin resistance, obesity, atherogenic dyslipidemia, and hypertension associated with increased risk of CVD and Type 2 DM.

Endometrial Hyperplasia (EH)

A condition found in almost half of anovulatory women with amenorrhea, associated with the long-term risk of endometrial cancer in PCOS patients.

Polycystic Ovaries (Ultrasound Criteria)

Defined as the presence of more than $12$ follicles measuring $2$-$9$ mm in diameter in each ovary or an ovarian volume greater than $10$ cc.

Ovarian Volume Formula

Calculated on 2D ultrasound by applying the formula $(xyz) \times 0.523$; a volume exceeding $10$ cc is diagnostic of polycystic ovaries.

Antral Follicle Counts (AFC)

The count of follicles in the ovary, which can be reliably done using 3D volume acquisition and Sono AVC (automatic volume calculation).

Multicystic ovary

Commonly seen in adolescents; an ovary of normal size containing $6$ or more follicles without peripheral displacement or increased central stroma.

Stromal Abundance

The most consistent ultrasound character for diagnosing PCOS, characterized by hyperechoic stroma.

Atypical Endometrium

Increased endometrial thickness and out-of-phase endometrium caused by chronic anovulation and prolonged exposure to estrogen.

LH:FSH Ratio

An investigation finding where LH levels measure at least twofold higher than FSH levels (ratio $> 2:1$), though not present in all PCOS cases.

17-hydroxyprogesterone

A hormone measured to rule out CAH; levels above $1000\,ng/dL$ are indicative of late-onset CAH.

Metformin

An insulin-sensitizing agent that improves peripheral insulin sensitivity and reduces hepatic glucose production to increase spontaneous ovulation.

LOD (Laparoscopic Ovarian Drilling)

A surgical therapy that restores ovulation in women with PCOS who are resistant to clomiphene citrate.

Ovarian Hyperstimulation Syndrome (OHSS)

A potential complication of ovulation induction medications (like Clomid and FSH) in PCOS patients who are often high responders.