gynecology and obstetrics
Polycystic Ovary Syndrome (PCOS)
Key Points
Polycystic ovary syndrome (PCOS) is a common cause of ovulatory dysfunction. Suspect PCOS in women who have irregular menses, are mildly obese, and are slightly hirsute, but be aware that weight is normal or low in many women with PCOS. Test for serious disorders (eg, Cushing syndrome, tumors) that can cause similar symptoms and for complications (eg, metabolic syndrome) If pregnancy is not desired, treat women with hormonal contraceptives and recommend lifestyle modifications; if lifestyle modifications are ineffective, addmetforminor otherinsulinsensitizers. If women with PCOS are infertile and desire pregnancy, refer them to reproductive infertility specialists. Screen for comorbidities, such as endometrial cancer, mood and anxiety disorders, obstructive sleep apnea, diabetes, and cardiovascular risk factors (including hypertension and hyperlipidemia). 