Data gathering

  • Red flags
  • Others – infrequent periods, acne, hair growth, mood, weight, problems getting pregnant
  • Examine – BMI, acne, hirsutism, pelvic exam


Clinical management

  • Investigations
    • Bloods – LH (raised), FSH (normal), testosterone (total and free), SHBG (low), HbA1c, lipids, TFTs
    • Pelvic USS
  • Explanation
    • cysts on ovaries result in imbalance of hormones – affects periods, fertility, hormones, skin
  • Treatment
    • Lifestyle
      • weight loss, diet, exercise, smoking cessation
    • Acne
      • as per usual acne treatment (+ consider Dianette)
    • Periods
      • If 3 or fewer periods per year, induce a bleed every 3 months using the COCP and scan for endometrial thickness
    • Hirsutism
      • hair removal, laser treatment, eflornithine
    • Fertility
      • refer to gynae to consider clomiphene
  • Follow-up / Safety net
    • Patient information leafleft
    • If weight loss/fertility/hirsutism ongoing problem, consider gynae and dietician referral