Polycystic ovary syndrome (PCOS) is more common than we think!  Listen as our esteemed guest Dr Katherine Sherif (@katherinesherif) reviews common patient complaints that should trigger PCOS in the differential, its pathophysiology, key physical exam findings, an algorithm for lab evaluation for PCOS diagnosis, and common treatments (OCPs, metformin, spironolactone and more!). Show Notes | Subscribe | Spotify | Swag! | Top Picks | Mailing List | thecurbsiders@gmail.com Credits Written and Produced by: Molly Heublein, MD Cover Art and Infographic: Kate Grant MBChB DipGUMed  Hosts: Matthew Watto MD, FACP; Molly Heublein, MD Editor: Emi Okamoto MD (written materials); Clair Morgan of Nodderly.com (audio) Guest: Katherine Sherif, MD Sponsors AccessMedicine is the acclaimed online medical resource that features Harrison's Principles of Internal Medicine and more trusted content from the best minds in medicine. Visit  AccessMedicine to learn more: http://bit.ly/MHCurbsiders.   Primary Care Physician Opportunity in beautiful Ithaca, NY! Join a well established practice in beautiful upstate New York near the finger lakes and wine country! You'll have flexible hours and the ability to take the time you need with patients! Contact Dr. Ann Costello arcostello@gmail.com to find out more about this incredible opportunity to join the team at Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/.  Time Stamps 00:00 Sponsors - AccessMedicine.com (McGraw-Hill) http://bit.ly/MHCurbsiders; Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/ 00:35 Intro, disclaimer, guest bio 03:00 Guest one-liner, book recommendation; Picks of the Week*: The Beginner’s Guide to the End: Practical Advice for Living Life and Facing Death, by Dr BJ Miller and Shoshana Berger; Overdrive App to download audio books and other media from libraries 07:58 AccessMedicine.com (McGraw-Hill) http://bit.ly/MHCurbsiders; Primary Care Internal Medicine of Ithaca https://www.primarycareinternalmedicineofithaca.com/ 09:30 Case of PCOS; Definition; Common presenting complaints 14:40 Hirsutism and terminal hair growth 17:05 Alopecia 20:25 Acne; Hidradenitis suppurativa 23:05 Irregular menses; Lab workup; Non-classic congenital adrenal hyperplasia 28:38 Hyperandrogenism lab workup (Testosterone, DHEA-S, Anti-Mullerian Hormone, utility of LH and FSH); Quick word on US 37:15 Recap of how to diagnose PCOS 38:15 Insulin resistance, body habitus in PCOS 40:04 Pathophysiology in PCOS (two schools of thought: Hypothalamus vs Insulin) 43:27 Dr. Sherif’s spiel to patients newly diagnosed with PCOS 46:40 Long term risks in PCOS 50:35 Approach to treatment of PCOS (OCPs, metformin, spironolactone, hair removal) 60:35 Treatment of alopecia; Lifestyle factors 63:55 Take home points and Outro *The Curbsiders participates in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising commissions by linking to Amazon. Simply put, if you click on our Amazon.com links and buy something we earn a (very) small commission, yet you don’t pay any extra. Goal Listeners will explain the basic pathophysiology, diagnosis, and management of PCOS. Learning objectives After listening to this episode listeners will…   List the criteria for diagnosis of PCOS. Explain the relationship between PCOS and metabolic risks. Determine first line treatments for PCOS symptoms including oligomenorrhea, hirsutism, acne and alopecia.  Counsel patients on long term risks associated with PCOS and how to mitigate these. Disclosures Dr Sherif reports no relevant financial disclosures. The Curbsiders report no relevant financial disclosures.  Citation Sherif K, Heublein M, Grant K, Okamoto E, Watto MF.  “#198 PCOS: Polycystic Ovary Syndrome with Katherine Sherif MD”. The Curbsiders Internal Medicine Podcast. https://thecurbsiders.com/episode-list. March 9, 2020.