Ultrasound-Guided Insights: New Review on Diagnosing and Managing PCOS

Polycystic ovarian syndrome (PCOS) is a prevalent condition affecting approximately 10% of women in their reproductive years, with many cases going undiagnosed or identified late. Characterized by irregular periods, high androgen levels, and polycystic ovarian changes on ultrasound, PCOS significantly impacts reproductive and metabolic health. Key symptoms include menstrual irregularities, hirsutism, acne, and weight challenges. Hyperinsulinemia and hyperandrogenism, exacerbated by body fat distribution, are central to its pathophysiology, though the exact mechanisms remain unclear. Diagnosis follows the Rotterdam criteria, requiring the exclusion of other conditions such as thyroid dysfunction or Cushing syndrome. Effective management targets distressing symptoms like irregular cycles, acne, or excessive weight, with lifestyle modifications playing a critical role. A weight loss of 5-10% can alleviate symptoms, while hormonal therapies, such as combined hormonal contraception (CHC), regulate periods and reduce androgen levels. Non-hormonal options like metformin and inositol improve insulin sensitivity and cycle regularity, particularly in women with higher BMIs. Anti-androgen therapies address hyperandrogenic symptoms like hirsutism, often combined with cosmetic interventions for established hair growth. Women with PCOS face challenges in conception, typically taking longer to achieve pregnancy but experiencing comparable success rates with assisted reproductive technologies. During pregnancy, they are at higher risk for complications like gestational diabetes, hypertension, and preterm delivery. Long-term, PCOS increases the risk of obesity-related conditions, endometrial cancer, depression, anxiety, and obstructive sleep apnea, underscoring the need for annual health evaluations. Greater awareness and early intervention are critical to managing this condition effectively and mitigating its far-reaching impacts.

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