PCOS - An Updated Overview and Current Trends in Ultrasound Imaging

Abstract

Dev Prakash Singh Rathour1 , Shubham Singh2

BACKGROUND Poly-Cystic Ovary Syndrome (PCOS) is a widespread complex endocrine disorder of women in the reproductive age group. It may present as mild menstrual disorder which affects metabolic functions severely. PCOS results in chronic anovulation. There is abnormal production of oestrogen and androgens due to imbalance of LH and FSH. LH/FSH ratio is elevated. Women with PCOS are prone to insulin resistance, type II diabetes mellitus, obesity and infertility, psychological disorder like depression, cardiovascular diseases, and endometrial and ovarian cancer. Presenting symptoms may be acne and hirsutism. To define PCOS, there has to be two of the three following features- menstrual irregularity, clinical and biochemical evidence of androgen excess and multiple cysts in the ovary. PCOS is manifestation of various interrelated mechanisms; it may not be known which if any, is primary. Probably PCOS is common end result of different mechanisms and pathologies. There may be pituitary dysfunction resulting in high serum LH and high serum prolactin. Menstrual cycles may be anovulatory presenting as oligomenorrhea, secondary amenorrhea, cystic ovaries and infertility. Patients are prone to obesity which leads hyperglycaemia and elevated oestrogen and sometimes insulin resistance leading to type II diabetes mellitus, dyslipidaemia and hypertension. However, despite significant progress in understanding the pathophysiology and diagnosis of the disorder, over the past 20 years, the disorder remains underdiagnosed and misunderstood. The diagnostic criteria are indefinite with numerous intricacies, PCOS remains a challenging area of research. The aim of this article is to review the present status and formulate an interesting clinically relevant research direction with emphasis on ultrasound imaging in diagnosis of polycystic ovary with stress on various aspects of 3D, colour & power Doppler study that is essential to move the field of PCOS forward.

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