Discussion: What would be the most important questions to ask while taking the history of a patient with polycystic ovary syndrome (PCOS)?
Discussion: What would be the most important questions to ask while taking the history of a patient with polycystic ovary syndrome (PCOS)?
Discussion
Polycystic ovarian syndrome (PCOS) is the most prevalent female hormonal disorder. It presents with two or more of the following: hyperandrogenism, irregular menstrual periods, and polycystic ovaries (Witchel et al., 2019). Important questions to ask while taking the history of a patient with PCOS are:
- Do you have a regular or irregular menstrual cycle? Patients with PCOS have chronic anovulation, which presents with irregular menstruation.
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- What is the length of your menstrual cycle? A cycle length of above 35 days would suggest chronic anovulation. However, a cycle length of 32 to 35/36 days would need to be assessed for ovulatory dysfunction (Witchel et al., 2019).
- Do you have coarse, dark, terminal hairs that grow in a male pattern: To assess for hirsutism, which is a characteristic of hyperandrogenism.
- Do you experience severe acne, bitemporal hair loss, or loss of the frontal hairline? The question seeks to assess signs of hyperandrogenism, which presents with alopecia and acne (Witchel et al., 2019).
- Have you experienced challenges with fertility like taking longer to conceive or having fewer children than you wished? Infertility is a common symptom of PCOS and is associated with chronic anovulation.
- Have you ever experienced diabetes or glucose intolerance symptoms, such as increased urine production, excessive hunger, or acute thirst? Insulin resistance and diabetes have been highly associated with PCOS. About one to two-thirds of women with PCOS have an abnormal level of insulin resistance (Rocha et al., 2019).
- How have the symptoms of PCOS affected your self-esteem? PCOS is associated with a disturbed body image due to symptoms of hirsutism, acne, and alopecia, which negatively affect a woman’s self-esteem (Witchel et al., 2019).
- How often do you experience changes in mood, such as depressive or anxiety symptoms? The question will help screen for depressive and anxiety disorders, common in patients with PCOS (Rocha et al., 2019).
- Do you have family members with a history of menstrual abnormalities, infertility, diabetes, obesity, or hirsutism? PCOS is genetically linked to some degree through autosomal dominant genes (Rocha et al., 2019).
References
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Rocha, A. L., Oliveira, F. R., Azevedo, R. C., Silva, V. A., Peres, T. M., Candido, A. L., Gomes, K. B., & Reis, F. M. (2019). Recent advances in the understanding and management of polycystic ovary syndrome. F1000Research, 8, F1000 Faculty Rev-565. https://doi.org/10.12688/f1000research.15318.1
Witchel, S. F., Oberfield, S. E., & Peña, A. S. (2019). Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls. Journal of the Endocrine Society, 3(8), 1545–1573. https://doi.org/10.1210/js.2019-00078
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