Polycystic ovaries

Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting women of reproductive age. Characterized by a combination of symptoms and physical findings, its etiology is multifactorial, involving genetic, hormonal, metabolic, and environmental factors.

Overview

PCOS is marked by a combination of signs and symptoms of androgen excess and ovarian dysfunction. The most common clinical features include irregular menstrual cycles, hirsutism (excessive hair growth), acne, and obesity. Polycystic ovaries, identified through ultrasound, are a hallmark of the condition, though not all women with PCOS have polycystic ovaries.

Diagnosis

The diagnosis of PCOS is primarily clinical, based on the Rotterdam criteria, which require two of the following three criteria to be met: oligo- or anovulation, clinical or biochemical signs of hyperandrogenism, and polycystic ovaries on ultrasound. Exclusion of other endocrinopathies, such as thyroid disorders and hyperprolactinemia, is also necessary for a definitive diagnosis.

Pathophysiology

The pathophysiology of PCOS involves insulin resistance, hyperinsulinemia, and dysregulation of gonadotropin release, leading to increased androgens production by the ovaries. This hormonal imbalance disrupts the normal ovarian cycle, leading to the development of multiple small cysts on the ovaries and the clinical manifestations of PCOS.

Management

Management of PCOS focuses on symptom relief and prevention of long-term complications, such as type 2 diabetes, cardiovascular disease, and endometrial cancer. Lifestyle modifications, including diet, exercise, and weight loss, are first-line treatments. Pharmacological treatments may include oral contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth and acne, and metformin to improve insulin sensitivity.

Epidemiology

PCOS is a common disorder, affecting approximately 10% of women of reproductive age. However, its prevalence varies worldwide and is influenced by diagnostic criteria and population characteristics.

Complications

Women with PCOS are at increased risk for several medical conditions, including metabolic syndrome, infertility, gestational diabetes, and psychological disorders such as depression and anxiety.

Conclusion

PCOS is a multifaceted disorder requiring a comprehensive approach to diagnosis and management. Early recognition and treatment are crucial to reduce the risk of long-term complications.