School of Medicine


MDSG topics

Disorders of menstrual cycling / oligo-amenorrhoea in association with Polycystic ovaries


                                                                                                                                                        Key

                                                                                                                                      [R] = Review

                                                                                                                                      [P] = Protocol

Medical Therapies

  • Antiandrogens
    [R] Antidepressants for polycystic ovary syndrome
    [R] Cabergoline for preventing ovarian hyperstimulation syndrome
    [R] Chinese herbal medicine for subfertile women with polycystic ovarian syndrome
    [R] Lifestyle changes in women with polycystic ovary syndrome
    [R] Statins for women with polycystic ovary syndrome not actively trying to conceive 
  • Gonadotrophin releasing hormones
  • Oral contraceptive pill
  • Progestogens
  • Retinoids
  • Insulin-sensitising drugs
    [R] Insulin-sensitising drugs (metformin, rosiglitazone, pioglitazone, D-chiro-inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility
    [R] Insulin-sensitising drugs versus the combined oral contraceptive pill for hirsutism, acne and risk of diabetes, cardiovascular disease, and endometrial cancer in polycystic ovary syndrome
    [R] Long versus short course treatment with metformin and clomiphene citrate for ovulation induction in women with PCOS

Surgery

  • Wedge biopsy [R] Ovarian surgery for symptom relief in women with polycystic ovary syndrome
  • Ovarian drilling  [R] Ultrasound-guided transvaginal ovarian needle drilling for clomiphene-resistant polycystic ovarian syndrome in subfertile women

Elevated prolactin levels

Medical therapies

  • Bromocriptine
  • Cabergoline

Surgery

Weight-related amenorrhoea

Medical therapies

  • Antidepressants
  • Hormone replacement therapy
  • Oral contraceptive pill

Functional ovarian cysts

Medical therapies

  • Gonadotrophin releasing hormones
  • Oral contraceptive pill
  • Other homones

Surgery

  • Drainage

Irregular menstrual bleeding (oligo-amenorrhoea, amenorrhoea)

  • [R] progestogens versus oestrogens and progestogens for irregular uterine bleeding associated with anovulation

Other endocrine disorders (e.g. congenital adrenal hyperplasia)

[R] Aromatase inhibitors for uterine fibroids

[V] Dopamine-agonists for women with prolactinoma

[R] Progestogens or progestogen-releasing intrauterine systems for uterine fibroids

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