Polycystic ovary syndrome (PCOS): The Daily PANCE Blueprint

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Polycystic ovary syndrome (PCOS): The Daily PANCE Blueprint

A 24-year-old woman presents with irregular menstrual cycles, hirsutism, and recent weight gain. She has been trying to conceive for the past year without success. Her medical history is notable for type 2 diabetes mellitus. On examination, her BMI is calculated to be 32 kg/m^2. Laboratory tests reveal elevated serum testosterone levels. An ultrasound of the pelvis shows enlarged ovaries with multiple peripheral cysts. She is diagnosed with polycystic ovary syndrome (PCOS). Which of the following is the most appropriate first-line treatment for this patient's PCOS, particularly with her desire to conceive?

A. Metformin
B. Oral contraceptive pills
C. Clomiphene citrate
D. Spironolactone
E. Letrozole

Answer and topic summary

The answer is E. Letrozole

Letrozole, an aromatase inhibitor, has been shown to be effective in inducing ovulation in women with PCOS, especially those who are seeking to conceive. It works by decreasing estrogen levels, which in turn stimulates the release of follicle-stimulating hormone (FSH) and promotes ovulation. Recent studies have suggested that letrozole may be more effective than clomiphene citrate for ovulation induction in patients with PCOS, making it an appropriate first-line treatment for women with PCOS who wish to become pregnant.

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Covered under ⇒ PANCE Blueprint Reproductive System ⇒ Ovarian Disorders (PEARLS) ⇒ Polycystic ovarian syndrome (PCOS)