gynecology and obstetrics
Polycystic Ovary Syndrome (PCOS)
Introduction
Polycystic ovary syndrome is a clinical syndrome typically characterized by anovulation or oligo-ovulation, signs of androgen excess (eg, hirsutism, acne), and multiple ovarian cysts in the ovaries.Insulinresistance and obesity are often present. Diagnosis is by clinical criteria, hormone measurement, and imaging to exclude a virilizing tumor. Treatment is symptomatic. Polycystic ovary syndrome (PCOS) occurs in 5 to 10% of women ( General reference ). In the US, it is the most common cause of infertility. PCOS is usually defined as a clinical syndrome, not by the presence of ovarian cysts. But typically, ovaries contain many 2- to 6-mm follicular cysts and sometimes larger cysts containing atretic cells. Ovaries may be enlarged with smooth, thickened capsules or may be normal in size. This syndrome involves anovulation or ovulatory dysfunction and androgen excess of unclear etiology. However, some evidence suggests that patients have a functional abnormality of cytochrome P450c17 affecting 17-hydroxylase (the rate-limiting enzyme in androgen production); as a result, androgen production increases. Pathogenesis appears to involve environmental and hereditary factors. 