Polycystic ovary syndrome physical examination: Difference between revisions

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{{Polycystic ovary syndrome}}
{{Polycystic ovary syndrome}}
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==Overview==
==Overview==
Patients with polycystic ovary syndrome usually appear [[obese]]. The physical examination findings of PCOS include signs of [[Androgen|androgen excess]], [[insulin resistance]], and the presence of unopposed [[estrogen]].


==Physical Examination==
==Physical Examination==
Your doctor will take a '''medical history''', perform a '''physical exam''', and possibly take some tests to rule out other causes of your symptoms. He may also check your [[body mass index]].
The physical examination findings of PCOS include signs of [[androgen]] excess, [[insulin resistance]], and the presence of unopposed [[estrogen]].<ref name="pmid9536213">{{cite journal |vauthors=Rosenfield RL |title=Current concepts of polycystic ovary syndrome |journal=Baillieres Clin Obstet Gynaecol |volume=11 |issue=2 |pages=307–33 |year=1997 |pmid=9536213 |doi= |url=}}</ref><ref name="pmid9429864">{{cite journal |vauthors=Goudas VT, Dumesic DA |title=Polycystic ovary syndrome |journal=Endocrinol. Metab. Clin. North Am. |volume=26 |issue=4 |pages=893–912 |year=1997 |pmid=9429864 |doi= |url=}}</ref><ref name="pmid18844713">{{cite journal |vauthors=Rosenfield RL |title=What every physician should know about polycystic ovary syndrome |journal=Dermatol Ther |volume=21 |issue=5 |pages=354–61 |year=2008 |pmid=18844713 |doi=10.1111/j.1529-8019.2008.00217.x |url=}}</ref>
 
=== General appearance ===
==Symptoms==
Patients with PCOS may appear [[obese]] and [[tired]].<ref name="pmid16085166">{{cite journal |vauthors=Buggs C, Rosenfield RL |title=Polycystic ovary syndrome in adolescence |journal=Endocrinol. Metab. Clin. North Am. |volume=34 |issue=3 |pages=677–705, x |year=2005 |pmid=16085166 |pmc=3477606 |doi=10.1016/j.ecl.2005.04.005 |url=}}</ref>
Signs are:
* Multiple small follicles on the ovaries (10 or more) (one form of [[ovarian cyst]]). Sonographically they may look like a string of pearls.
* Enlarged ovaries, generally 1.5 to 3 times larger than normal(volume >20mls), resulting from multiple peripherally located small follicles and echogenic ovarian stroma.
* Thickened, smooth, pearl-white outer surface of ovary on [[laparoscopic_surgery|laparoscopic]] examination.
* The ratio of LH ([[Luteinizing hormone]]) to FSH ([[Follicle stimulating hormone]]) is greater than 1:1, as tested on Day 3 of the menstrual cycle.
* High levels of [[testosterone]].
* Low levels of [[sex hormone binding globulin]].
* [[Hyperinsulinemia]].
 
It is important to know that PCOS can present in any age. Many can be diagnosed as young children, some might not present until after menopause. It is [[vital]] to find a PCOS knowledgeable doctor to catch this disorder as many miss the diagnosis - sometimes for years.
 
===Vital Signs===
===Vital Signs===
During the physical exam the doctor will want to measure your [[blood pressure]].
Patients with polycystic ovary syndrome may have elevated [[blood pressure]], with a systolic [[blood pressure]] of 130 mm Hg or higher and a [[diastolic blood pressure]] of 85 mm Hg or higher.
 
===Skin===
===Skin===
He or she also will check out the areas of increased hair growth, so try to allow the natural hair growth for a few days before the visit.
* [[Hyperpigmentation]] of the skin at the nape of the neck, axillae, area beneath the breasts, and exposed areas.
 
* Excessive body hair in a male distribution pattern
* [[Acne]]
===Abdomen===
===Abdomen===
Your doctor will also want to check your waist size. He might want to do a '''pelvic exam''' to see if your ovaries are enlarged or swollen by the increased number of small cysts.
Patients with polycystic ovarian syndrome (PCOS) have [[abdominal obesity]].


==References==
==References==

Latest revision as of 17:51, 1 November 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]

Overview

Patients with polycystic ovary syndrome usually appear obese. The physical examination findings of PCOS include signs of androgen excess, insulin resistance, and the presence of unopposed estrogen.

Physical Examination

The physical examination findings of PCOS include signs of androgen excess, insulin resistance, and the presence of unopposed estrogen.[1][2][3]

General appearance

Patients with PCOS may appear obese and tired.[4]

Vital Signs

Patients with polycystic ovary syndrome may have elevated blood pressure, with a systolic blood pressure of 130 mm Hg or higher and a diastolic blood pressure of 85 mm Hg or higher.

Skin

  • Hyperpigmentation of the skin at the nape of the neck, axillae, area beneath the breasts, and exposed areas.
  • Excessive body hair in a male distribution pattern
  • Acne

Abdomen

Patients with polycystic ovarian syndrome (PCOS) have abdominal obesity.

References

  1. Rosenfield RL (1997). "Current concepts of polycystic ovary syndrome". Baillieres Clin Obstet Gynaecol. 11 (2): 307–33. PMID 9536213.
  2. Goudas VT, Dumesic DA (1997). "Polycystic ovary syndrome". Endocrinol. Metab. Clin. North Am. 26 (4): 893–912. PMID 9429864.
  3. Rosenfield RL (2008). "What every physician should know about polycystic ovary syndrome". Dermatol Ther. 21 (5): 354–61. doi:10.1111/j.1529-8019.2008.00217.x. PMID 18844713.
  4. Buggs C, Rosenfield RL (2005). "Polycystic ovary syndrome in adolescence". Endocrinol. Metab. Clin. North Am. 34 (3): 677–705, x. doi:10.1016/j.ecl.2005.04.005. PMC 3477606. PMID 16085166.


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