Diagnosis and Management of PCOS

Continued from Previous post..What is PCOS

Diagnosis

According to Endocrine Society guidelines, diagnosis of PCOS is made by presence of clinical ± biochemical hyperandrogenism in the presence of persistent menstrual irregularity.

Laboratory investigations

To rule out hyperandrogenism – DHEAS, Testosterone
To rule out hyperinsulinemia – Oral Glucose Tolerance Test
To rule out other causes- 17(OH)Progesterone, Thyroid profile, serum Prolactin
Pelvic ultrasound –Recommended for diagnosis only after 8 years from the age of onset of menarche.

Management Of PCOS

Timely diagnosis and intervention is important to prevent both over and under treatment. The Pediatrician should be sensitised enough to not miss PCOD and a Pediatric Endocrinologist should be actively involved in management once PCOD is suspected

Lifestyle interventions including diet, less sedentary behaviour, exercise and behavioural strategies are most important
Pharmacologic interventions – Combined OCPs, Metformin, Anti-androgens
Local therapy– for Cosmetic reasons which include hair removal for hirsutism by ways like bleaching, chemical epilation, plucking, waxing, shaving, electrolysis and LASER hair removal.

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