Polycystic Ovary Syndrome: Comprehensive Overview

The document from August 1, 2018, provides a comprehensive overview of Polycystic Ovary Syndrome (PCOS), a common endocrine-metabolic disorder in reproductive-aged women with a prevalence of 5-20%. It describes PCOS as a complex polygenic, multifactorial disorder with increased risks for conditions like glucose intolerance, type 2 diabetes, metabolic syndrome, cardiovascular events, subfertility, and mood disorders. The diagnosis of PCOS involves confirming hyperandrogenism and oligo-anovulation through history, physical examination, hormonal testing, and ovarian ultrasonography, while excluding other disorders. Treatment is tailored to the patient's phenotype and goals, including suppressing androgen secretion and action, improving metabolic status, and enhancing fertility. The document also discusses the clinical presentation of PCOS, which can include hirsutism, acne, and alopecia, and the need for better education and vigilance among clinicians. It touches on the genetics and evolutionary aspects of PCOS, its pathophysiology involving insulin resistance and hyperinsulinemia, and the importance of screening for metabolic comorbidities. Therapeutic strategies include the use of combination oral contraceptives, antiandrogens, metformin, and fertility treatments. The document does not provide specific numbers from studies to assess the strength of the evidence.