Polycystic ovary syndrome

Abstract

PCOS is a common condition that incorporates oligoanovulation and evidence of hyperandrogenism. Recent consensus guidelines have now included polycystic ovarian morphology as a diagnostic criterion. Androgen excess and insulin resistance are currently recognised to be responsible for much of the phenotypic presentation, though insulin resistance is far from universally present. The approach to managing these patients involves addressing the patient's dominant symptom as well as the metabolic consequences of the disease. Lifestyle modification has benefits that are synergistic with pharmacological therapies that improve hyperandrogenism and improve insulin sensitivity thus assisting in regulating menstrual cycles and increasing fertility and preventing potential adverse metabolic and cardiovascular consequences. Measurement of insulin levels for diagnosis, prognosis and monitoring are mythical, as is the notion that metformin is the panacea for obese women with this disorder.