21 Hydroxylase Deficiency
- Decreased Cortisol
- Increased 17 Hydroxyprogesterone
- Decreased Aldosterone
- Hypotension
- Increased Renin
- Hyperkalemia
- Female Pseudohermaphroditism
11 Beta-Hydroxylase Deficiency
- Decreased Cortisol
- Decreased Aldosterone
- Increased Sex Hormones
- Increased 11 Deoxycorticosterone (11 DOC)
- Hypertension
- Masculinization
17 Alpha Hydroxylase Deficiency
- Decreased Cortisol
- Decreased Sex Hormones
- Increased Mineralocorticoids (DOC)
- Hypertension
- Hypokalemia
- XY Externally Phenotypic Female
- No Internal Reproductive Structures Due to Mullerian Inhibitory Factor
- XX Externally Phenotypic Female
- Sexual Infantilism
Polycystic Ovarian Syndrome (PCOS) Mechanism
- Hyperinsulinemia Increases GnRH Pulse Frequency
- Large Increase in LH
- Small Decrease in FSH
- Increased Androgen Production From Theca-Lutein Cells
- Decreased Steroid Hormone-Binding-Globulin (SHBG) Causes Increased Free Testosterone
- Obese Patients Have Increased Estrogen
- Increased Risk of Endometrial Cancer
Polycystic Ovarian Syndrome (PCOS) Symptoms and Diagnosis
- Most Common Cause of Infertility in Women
- Amenorrhea
- Acne
- Hirsutism
- Obesity
- Enlarged, Cystic Ovaries
- LH:FSH Ratio of 3:1
- "String of Pearls" on Ultrasound
Polycystic Ovarian Syndrome (PCOS) Treatment
- Weight Loss
- Oral Contraceptives
- Clomiphene Citrate
- Anti-androgens
- Cyclic Progesterone for Endometrial Protection
- Metformin
Infertility
- No Conception After 1 Year
- Artificial Insemination
- In Vitro Fertilization (IVF)
- Clomiphene Citrate (Clomid)
- Menotropins
- GnRH Agonists
- Treat Underlying Disorders
- Emotional Support
- Multiple Gestations
Fludrocortisone
- Aldosterone Analog
- Addison’s Disease (Primary Adrenal Insufficiency)
- Congenital Adrenal Hyperplasia
- Cushing Syndrome
- Edema
- Congestive Heart Failure Exacerbation
- Hyperpigmentation