Endocrine Abstracts

: Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women of reproductive age. It’s a heterogeneous functional disorder of unclear etiology. The features of PCOS are disorders of ovulation, androgen excess, polycystic ovaries; it’s associated with presence of associated risk factors for cardiovascular disease (obesity, glucose intolerance, dyslipidemia). The diagnosis of PCOS is made using the Rotterdam 2003 criteria. 23yo female patient was evaluated for oligomenorrhea. At the age of 17, she consulted for the first time her gynecologist because of irregluar menstrual cycles since the menarche (age 14) and excessive hair growth. A diagnosis of PCOS was made and oral contraceptives (OC) were introduced in therapy. After 1.5 yrs, OC were excluded because of undetectable levels of LH and FSH. Without them, the menstrual cycle length was 40–120 days. Examination revealed high BMI 25; normal BP; excessive hair on chin, forearms and lower abdomen; no striae, no acanthosis nigricans, normal thyroid. High levels of insulin, LH, total testosterone, androstendione and low levels of SHBG and progesterone in the luteal phase were found. An oral glucose tolerance test, fasting lipid profile and concentrations of TSH, prolactin, 17OHP were normal. A pelvic ultrasound confirmed polycystic ovaries. The clinical and lab. tests were consistent with PCOS. Therapy with life style changes (weight reduction) and metformin was started (500 mg bid). After 10 months of treatment, she lost 8 kg, menstrual cycles were regular (26–28 days), concentrations of LH, testosterone, progesterone and insulin were normal. The patients with PCOS are treated according to their symptoms, risks and desire for pregnancy. The OCs are the mainstay of pharmacologic therapy for women with PCOS for managing hyperandrogenism and menstrual dysfunction. The case has showed impact of the OC on the pituitary-ovarian suprresion. There are relatively few publications examining the effect of the OC on ovarian function in women and it’s less clear whether the pituitary–ovarian suppression induced by the OCs has any impact on functional ovarian reserve, so we need further evaluation. Although, the use of metformin in the treatment of PCOS is off-label, in this case, metformin had showed as safe and effective. Benefit was made on oligomenorrhea, fertility and obesity.