Polycystic ovary syndrome

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting women of reproductive age. Characterized by a variety of symptoms and biochemical abnormalities, PCOS is primarily noted for its impact on ovarian function and metabolic processes.

Overview

PCOS is one of the most common hormonal disorders among women of reproductive age, with a prevalence estimated to be between 6% to 12% depending on the population studied and the diagnostic criteria used. The disorder is characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries, with the presence of numerous small cysts within the ovary.

Symptoms

The symptoms of PCOS can vary significantly from one individual to another but commonly include:

• Irregular menstrual cycles or absence of menstruation (amenorrhea)
• Signs of hyperandrogenism, such as hirsutism (excessive hair growth), acne, and alopecia (hair loss)
• Obesity or difficulty losing weight
• Infertility due to irregular or absent ovulation

Pathophysiology

The pathophysiology of PCOS involves multiple systems, including the endocrine and metabolic systems. Insulin resistance is a central feature, contributing to both the hyperandrogenism and the metabolic disturbances seen in PCOS. Elevated levels of insulin can stimulate the ovaries to produce excess androgens (male hormones), which can interfere with the development of the ovarian follicles and thus disrupt normal ovulation.

Diagnosis

Diagnosis of PCOS is typically based on the criteria outlined in the Rotterdam consensus, which requires two out of three of the following for a diagnosis:

• Polycystic ovaries visible on ultrasound
• Signs of hyperandrogenism, either clinical or biochemical
• Ovulatory dysfunction

Treatment

Treatment of PCOS is tailored to the symptoms and reproductive goals of the individual. Common treatments include:

• Lifestyle modifications, such as diet and exercise, which can help manage weight and reduce insulin resistance
• Oral contraceptives to regulate menstrual cycles and reduce androgen levels
• Metformin, a medication that improves insulin sensitivity and can aid in weight management and ovulatory regulation
• Clomiphene citrate and other fertility medications for women seeking pregnancy

Prognosis

While PCOS is a chronic condition, the prognosis is generally good with appropriate management. Treatment can alleviate symptoms, reduce the risk of complications such as type 2 diabetes and cardiovascular disease, and improve quality of life.

Epidemiology

PCOS affects approximately 6-12% of women globally, making it the most common endocrine disorder among women of reproductive age. The prevalence can vary based on the diagnostic criteria used and the population studied.

See also

• Endocrine system
• Menstrual cycle
• Insulin resistance