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.)
Last date updated on February, 2021