Polycystic ovary syndrome (PCOS)

4 Interesting Facts of Polycystic ovary syndrome (PCOS)

  1. Reproductive endocrinopathy characterized by chronic anovulation, hyperandrogenism, and polycystic ovarian morphology; typical onset occurs in adolescent or young adult
  2. There is extensive overlap with 21-hydroxylase deficiency, with common features of hirsutism, acne, and irregular menses (ie, oligomenorrhea, amenorrhea) developing slowly over time
  3. Formal diagnosis of polycystic ovary syndrome must include a combination of 2 of the 3 following findings: clinical or biochemical hyperandrogenemia, ovulatory dysfunction, and/or polycystic ovaries as identified on pelvic imaging
  4. Additionally, diagnostic criteria for polycystic ovary syndrome require exclusion of nonclassical congenital adrenal hyperplasia (in addition to thyroid disease and hyperprolactinemia) 
    • Polycystic ovary syndrome is clinically indistinguishable from congenital adrenal hyperplasia; thus, differentiation relies upon measurements of 17-hydroxyprogesterone, often using corticotropin stimulation 
    • Basal serum 17-hydroxyprogesterone level of 200 to 400 ng/dL is suggestive of congenital adrenal hyperplasia, whereas 17-hydroxyprogesterone level is typically within reference range (less than 200 ng/dL) in polycystic ovary syndrome 
    • Corticotropin-stimulated 17-hydroxyprogesterone level must be less than 1000 ng/dL to diagnose polycystic ovary syndrome 
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