ABSTRACT
Many believe polycystic ovary syndrome (PCOS) to be a condition of our time. Certainly PCOS is the most common endocrine disturbance to affect women and it appears that its prevalence is on the increase. There is considerable heterogeneity of symptoms and signs among women with PCOS, and for an individual these may change over time. The extreme end of the spectrum, once known as the Stein-Leventhal syndrome, encompasses the combination of hyperandrogenism (hirsutism, acne, alopecia and elevated serum testosterone concentrations), severe menstrual disturbance (amenorrhea or oligomenorrhea) and obesity. We now appreciate that polycystic ovaries may exist without clinical signs of the syndrome. PCOS is familial, and various aspects of the syndrome may be differentially inherited. There are a number of interlinking factors that affect expression of PCOS. A gain in weight is associated with a worsening of symptoms while weight loss will ameliorate the endocrine and metabolic profile and symptomatology. Normal ovarian function relies upon the selection of a follicle, which responds to an appropriate signal (follicle stimulating hormone) in order to grow, become ‘dominant’ and ovulate. This mechanism is disturbed in women with PCOS, resulting in multiple small cysts, most of which contain potentially viable oocytes but within dysfunctional follicles.
