In this post I link to and excerpt from the outstanding PCOS Article from The Curbsiders’ #198 PCOS: Polycystic Ovary Syndrome with Katherine Sherif MD
MARCH 9, 2020 By MOLLY HEUBLEIN. Here is the Intro:
Polycystic ovary syndrome (PCOS) is more common than we think! Listen as our esteemed guest Dr Katherine Sherif (@katherinesherif) reviews common patient complaints that should trigger PCOS in the differential, its pathophysiology, key physical exam findings, an algorithm for lab evaluation for PCOS diagnosis, and common treatments (OCPs, metformin, spironolactone and more!).
And here is the podcast:
- 00:00 Sponsors – AccessMedicine.com (McGraw-Hill) https://bit.ly/MHCurbsiders; Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/
- 00:35 Intro, disclaimer, guest bio
- 03:00 Guest one-liner, book recommendation; Picks of the Week*: The Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death, by Dr BJ Miller and Shoshana Berger; Overdrive App to download audio books and other media from libraries
- 07:58 AccessMedicine.com (McGraw-Hill) https://bit.ly/MHCurbsiders; Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/
- 09:30 Case of PCOS; Definition; Common presenting complaints
- 14:40 Hirsutism and terminal hair growth
- 17:05 Alopecia
- 20:25 Acne; Hidradenitis suppurativa
- 23:05 Irregular menses; Lab workup; Non-classic congenital adrenal hyperplasia
- 28:38 Hyperandrogenism lab workup (Testosterone, DHEA-S, Anti-Mullerian Hormone, utility of LH and FSH); Quick word on US
- 37:15 Recap of how to diagnose PCOS
- 38:15 Insulin resistance, body habitus in PCOS
- 40:04 Pathophysiology in PCOS (two schools of thought: Hypothalamus vs Insulin)
- 43:27 Dr. Sherif’s spiel to patients newly diagnosed with PCOS
- 46:40 Long term risks in PCOS
- 50:35 Approach to treatment of PCOS (OCPs, metformin, spironolactone, hair removal)
- 60:35 Treatment of alopecia; Lifestyle factors
- 63:55 Take home points and Outro
Here are the excerpts from the show notes of #198 PCOS – Polycystic Ovary Syndrome:
(1) Anti-Müllerian hormone (AMH) in the Diagnosis of Menstrual Disturbance Due to Polycystic Ovarian Syndrome [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Front Endocrinol (Lausanne). 2019 Sep 26;10:656. doi: 10.3389/fendo.2019.00656. eCollection 2019.
(2) Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls [PubMed Abstract] [Full Text HTML] [Full Text PDF]. J Endocr Soc. 2019 Aug 1; 3(8): 1545–1573.
(3) Recent advances in biochemical and molecular analysis of congenital adrenal hyperplasia due to 21-hydroxylase deficiency [PubMed Abstract] [Full Text HTML] [Full Text PDF]. Ann Pediatr Endocrinol Metab. 2016 Mar;21(1):1-6. doi: 10.6065/apem.2016.21.1.1. Epub 2016 Mar 31.