Polycystic ovarian syndrome(Stein-Leventhal syndrome)

Posted by e-Medical PPT Friday, August 27, 2010
Polycystic ovarian syndrome (also known as functional ovarian hyperandrogenism,Stein-Leventhal syndrome, ovarian hyperthecosis and sclerocystic ovary syndrome)is one of the most common female endocrine disorders affecting approximately 5%-10% of women of reproductive age  and is thought to be one of the leading causes of female infertility.

Common symptoms of PCOS include
  • Oligomenorrhea, amenorrhea — irregular, few, or absent menstrual periods
  • Infertility, generally resulting from chronic anovulation
  • Hirsutism,acne due to excessive amounts of androgenic hormones
  • obesity

Pelvic ultrasound is a major diagnostic tool for PCOS.In PCOS, there is a so called "follicular arrest"(several follicles develop to a size of 5–7 mm, but not further). No single follicle reach the preovulatory size (16 mm or more). According to the Rotterdam criteria, 12 or more small follicles should be seen in a ovary on ultrasound examination. The follicles may be oriented in the periphery, giving the appearance of a 'string of pearls'. The numerous follicles contribute to the increased size of the ovaries, that is, 1.5 to 3 times larger than normal.Serum levels of androgens,including androstenedione, testosterone and Dehydroepiandrosterone sulfate may be elevated.The free testosterone level is thought to be the best measure,with ~60% of PCOS patients demonstrating supranormal levels.Other causes of irregular or absent menstruation and hirsutism, such as congenital adrenal hyperplasia, Cushing's syndrome, hyperprolactinemia, androgen secreting neoplasms, and other pituitary or adrenal disorders, should be investigated.

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