Rapid Review: Polycystic Ovarian Syndrome

Polycystic Ovarian Syndrome (PCOS)

• Patient will be an obese female
• Complaining of amenorrhea, obesity, hirsutism
• PE will show bilateral ovarian enlargement, acanthosis nigricans
• Labs will show high LH:FSH, androgen excess
• Most commonly caused by insulin resistance
• Treatment is combination OCPs, lifestyle changes, metformin

Sample question:

A 26-year-old obese woman with a 2-year history of increased acne, abnormal hair growth, and menstrual abnormalities presents to her obstetrician for an infertility workup. A pelvic ultrasound reveals enlarged cystic ovaries. She desires to become pregnant. Which of the following is the first-line treatment?