Case history
Case history #1
An 18-year-old woman presents with a chief complaint of hirsutism. She needs to wax her upper lip and chin twice a week. This has been a problem for 4 years. She also has excess hairs on her upper back and lower abdomen. Her periods are irregular, occurring every 2-3 months. Embarrassment about the facial hirsutism has affected her social life, and she is finding she feels depressed much of the time.
Case history #2
A 32-year-old woman presents with a chief complaint of difficulty becoming pregnant. She was prescribed oral contraceptives at the age of 17 years because of irregular periods (4-6 periods per year). She continued with oral contraception until 30 years of age, at which point she and her husband decided they wanted to have a baby. Since ceasing oral contraception, she has gained weight and has only 3 to 5 periods per year. She has actively been trying to conceive, with no results.
Other presentations
The most common presentations are hirsutism and infertility. Women typically present with oligo- or anovulation, manifesting as infrequent, irregular menstrual periods. Polycystic ovary syndrome (PCOS) may also more rarely present with irregular and heavy menstrual bleeding. Some women present with regular menses and hirsutism, and on further investigation are found to have anovulatory cycles. There are no pathognomic features that suggest PCOS. It is largely a diagnosis of exclusion.
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