The Pathophysiology of Polycystic Ovary Syndrome

The 2003 document on polycystic ovary syndrome (PCOS) describes it as a complex disorder affecting 6-10% of women of reproductive age, with symptoms like menstrual irregularities, hirsutism, acne, alopecia, and infertility. It is characterized by elevated levels of androgens and insulin resistance, which is a common feature in both obese and nonobese women with PCOS. The document suggests that disordered insulin action is central to PCOS and may lead to increased androgen production. Interventions that improve insulin sensitivity, such as weight loss and medications like metformin, have been shown to ameliorate symptoms of PCOS. However, the document notes limitations in the studies regarding metformin's efficacy and safety. It also discusses the unclear relationship between PCOS, cardiovascular disease, and diabetes, acknowledging that while PCOS is linked to cardiovascular risk factors, there is no proven excess mortality from circulatory disease. The document concludes that while insulin resistance is significant in PCOS, other genetic factors may also play a role in the syndrome.