Polycystic ovarian syndrome

Polycystic ovarian syndrome (PCOS), the most common endocrine disorder in women of reproductive age, is a process with polygenic and epigenetic origins. An adverse intrauterine environment, premature adrenarche, or childhood obesity may precede the typical presentation of chronic anovulation, hyperandrogenism, or abnormal uterine bleeding (AUB). As a diagnosis of exclusion, other causes of hyperandrogenism and AUB must be ruled out before a diagnosis of PCOS is made. Metabolic dysfunction, including insulin resistance, obesity, and dyslipidemia, are often seen in association with PCOS and increase the risk of early cardiovascular disease. Hormonal contraception, insulin sensitizers, antiandrogens, and lifestyle modifications have roles in improving the symptoms of PCOS and are reviewed in this article.