Polycystic Ovary Syndrome: An Overview

Mac Pannill, MPAS, PA-C

Disclosures

Topics in Advanced Practice Nursing eJournal. 2002;2(3) 

In This Article

Abstract and Introduction

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy that affects women. PCOS is also a leading cause of infertility. Women with PCOS may present with obesity, amenorrhea, oligomenorrhea, infertility, or androgenic features. Those with PCOS are also at increased risk for both diabetes and diabetic complications and cardiovascular disease, with a risk of a myocardial infarction 7 times the normal. We know that if patients with PCOS are screened for these diseases, many long-term complications can be prevented.

Introduction

PCOS affects 5% to 10% of women in their reproductive years and is the most common endocrinopathy affecting women.[1,2,3] Stein and Leventhal[4] first described PCOS in 1935. Our understanding of the pathophysiology of PCOS has dramatically changed since then; now, there is particular emphasis on its relationship with insulin resistance. PCOS is a chronic hyperandrogenic state that has many significant short-term and long-term implications for patients such as oligomenorrhea, amenorrhea, infertility, diabetes mellitus, cardiovascular disease, increased risk of endometrial cancer, and excessive body hair (hirsutism).

PCOS is characterized by the following: (1) a menstrual cycle that ranges from > 35 days or < 8 cycles/year to complete absence of menses (amenorrhea); (2) evidence of androgen excess, such as acne, hirsutism, alopecia, acanthosis nigricans, or increased androgen levels on laboratory testing; (3) all other causes of hyperandrogenism and anovulation have been excluded.[1] It is not essential that a woman have polycystic ovaries to have this syndrome. Therefore, polycystic ovaries, observed on ultrasound, are a sign of PCOS and not by themselves diagnostic of the disease. Polycystic ovaries are seen 67% to 86% of the time in patients who have PCOS.[1,3,5,6]

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