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Polycystic Ovarian Syndrome (PCOS) Symptoms and Diagnosis

Peacock with PCOS
Picmonic
PCOS is a disorder leading to infertility and amenorrhea in many women. Other symptoms patients experience include hirsutism, acne and many are obese. Diagnostics exams in PCOS show an LH:FSH of 3:1, while imaging shows enlarged, cystic ovaries which may show a "string of pearls."
8 KEY FACTS
SYMPTOMS
Most Common Cause of Infertility in Women
#1 Foam-finger Infertile-Female-plant

Patients with PCOS have abnormal hormone levels, which disrupts cyclic ovulation. This disorder is the most common cause of infertility in women.

Amenorrhea
Amen-tampon

Typically, women present with amenorrhea after developing this disease, which is one of the most common initial complaints.

Acne
Acne

Due to excess androgens, these patients often develop acne.

Hirsutism
Bearded-lady

As these patients have increased androgens, hirsutism occurs. These patients can end up with male pattern facial hair development.

Obesity
Obese-person

A large percentage of PCOS patients are obese. Obesity is believed to be one of the many factors which leads to development of this disorder.

DIAGNOSIS
Enlarged, Cystic Ovaries
Enlarged Sisters in Ovary

Patients with this disorder, when imaged, show enlarged cystic ovaries bilaterally. The syndrome acquired its most widely used name due to the common sign on ultrasound examination of multiple ovarian cysts. These "cysts" are actually immature follicles, not cysts.

LH:FSH Ratio of 3:1
(3) Tree Luges to (1) Wand Fish

Serum hormone studies show an LH:FSH ratio of greater than 3:1. Patients have large increases in LH while FSH levels stay normal or may slightly decrease.

"String of Pearls" on Ultrasound
String of Pearls

The follicles have developed from primordial follicles, but the development has stopped ("arrested") at an early antral stage due to the disturbed ovarian function. The follicles may be oriented along the ovarian periphery, appearing as a 'string of pearls' on ultrasound examination.

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