Clinical manifestations of polycystic ovary syndrome

Abstract

Polycystic ovary syndrome is the most frequentendocrine disorder. In 1976 Kahn described the relation ofovarian hyperandrogenism and insulin resistance. Bergen in1980 established the association between polycysticovaries, hyperandrogenism and hyperinsulinemia anddescribed that polycystic ovary syndrome was not only acause of infertility and anovulation, but also had an associ-ated metabolic risk.

Polycystic ovary syndrome was redefined by a 2003Holland consensus workshop. This condition is felt tobe present if there are 2 of 3 possible diagnostic criteria: menstrual irregularities, biochemical o clinical signs of androgen excess and the presence of polycystic ovarymorphology.}

The gynecologist frequently makes this diagnosis and has to have an adequate knowledge of the clinical signs and the possible long term risks.

The evidence of a possible association with endometrial cancer and an increased cardiovascular disease risk is incomplete because the variety of definitions of polycysticovary syndrome makes difficult the comparison of the studies.

Dunaif claims that the prevalence of insulin resistance isa function of the studied population and the sensitivity andspecificity of the method used to measure this parameter.

She also mentions that women with polycystic ovarysyndrome are hyperinsulinemic and insulin resistant, inde-pendently of obesity, compared with normal women.

Legro demonstrated that 25 to 30% of the women withpolycystic ovary syndrome have glucose intolerance andthat Diabetes Mellitus occurs in 8% each year. He says thatfasting glucose concentration is not a reliable predictor ofthe prevalence of diabetes in comparison with the 75 gramsglucose tolerance test (American Society of Diabetes). Healso says that the fasting determination is a better screeningmethod, with the same predictive value for development ofmicro vascular complications.