Polycystic Ovary Syndrome

Polycystic Ovary Syndrome (PCOS) is the most common endocrinopathy of women of reproductive age and the most common cause of anovulatory infertility in developed countries. Diagnostic criteria, as suggested in the Rotterdam Consensus Statement (2003) include (i) oligo- and/or anovulation, (ii) hyperandrogenemia and/or hyperandrogenism (clinical signs of high androgen levels: hirsutism, acne, alopecia) and (iii) polycystic ovarian morphology on ultrasound examination. Diagnosis is set when at least two of the three features are present, after the exclusion of other androgen excess disorders. The combination of diagnostic criteria results to four distinct clinical phenotypes of PCOS, according to the combination of manifestations. However, despite the consented criteria there is still uncertainty concerning the importance of each syndrome feature and the severity of the metabolic dysfunction every phenotype implies. Obesity is closely related to PCOS and the 38-88% of women with the syndrome are overweight or obese. Insulin resistance is another important pathophysiological feature of the syndrome. The majority of the women with PCOS, independent of their body weight, have a type of insulin resistance which is characteristic of the syndrome. Additionally, obese women with PCOS present a further burden upon their insulin resistance which is attributed to their obesity. PCOS is related with significant metabolic disorders that are probably caused by the characteristic insulin resistance of the syndrome. As a result, the prevalence of diabetes mellitus type 2 is ten-fold higher among young women with PCOS compared to healthy women of similar age. Likewise, 30-50% of obese women with PCOS show impaired glucose tolerance or type 2 diabetes, after the age of 30 years. (Karkanaki A, Kalogiannidis I, Panidis D (2013) Effects of Lifestyle Modification on Pregnancy Success in Obese and Overweight Womenwith PCOS.)

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Last date updated on September, 2024