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    Definition

Polycystic ovary syndrome (PCOS) is a condition characterized by the accumulation of numerous cysts (fluid-filled sacs) on the ovaries associated with high male hormone levels, chronic anovulation (absent ovulation), and other metabolic disturbances. Classic symptoms include excess facial and body hair, acne, obesity, irregular menstrual cycles, and infertility.
Description

PCOS, also called Stein-Leventhal syndrome, is a group of symptoms caused by underlying hormonal and metabolic disturbances that affects about 6% of premenopausal women. PCOS symptoms appear as early as adolescence in the form of amenorrhea (missed periods), obesity, and hirsutism, the abnormal growth of body hair.

A disturbance in normal hormonal signals prevents ovulation in women with PCOS. Throughout the cycle, estrogen levels remain steady, LH levels are high, and FSH and progesterone levels are low. Since eggs are rarely or never released from their follicles, multiple ovarian cysts develop over time.

One of the most important characteristics of PCOS is hyperandrogenism, the excessive production of male hormones (androgens), particularly testosterone, by the ovaries. This accounts for the male hair-growth patterns and acne in women with PCOS. Hyperandrogenism has been linked with insulin resistance, the inability of the body to respond to insulin, and hyperinsulinemia (high blood insulin levels), both of which are common in PCOS.
Causes & symptoms

While the exact cause of PCOS is unknown, it runs in families, so the tendency to develop the syndrome may be inherited. The interaction of hyperinsulinemia and hyperandrogenism is believed to play a role in chronic anovulation in susceptible women.

The numbers and types of PCOS symptoms that appear vary between women. These include:

* Hirsutism. Related to hyperandrogenism, this occurs in 70% of women.
* Obesity. Approximately 40-70% of PCOS patients are overweight.
* Anovulation and menstrual disturbances. Anovulation appears as amenorrhea in 50% of patients, and as heavy uterine bleeding in 30% of patients; however, 20% of PCOS patients menstruate normally.
* Male-pattern hair loss. Some PCOS patients develop bald spots.
* Infertility. Achieving pregnancy is difficult in many women with PCOS.
* Polycystic ovaries. Most, but not all, women with PCOS have multiple cysts on their ovaries.
* Skin discoloration. Some women with PCOS have dark patches on the skin.
* Abnormal blood chemistry. Women with PCOS have high levels of low-density lipoprotein (LDL or "bad") cholesterol and triglycerides, and low levels of high-density lipoprotein (HDL or "good") cholesterol.
* Hyperinsulinemia. Some women with PCOS have high blood insulin levels, particularly if overweight.

Diagnosis

PCOS is diagnosed when the patient visits her doctor for treatment of symptoms such as hirsutism, obesity, menstrual irregularities, or infertility. PCOS patients are treated by a gynecologist, a doctor who treats diseases of the female reproductive organs, or a reproductive endocrinologist, a specialist who treats diseases of the body's endocrine (hormones and glands) system and infertility.