Chapter 28 POLYCYSTIC OVARY SYNDROME
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Women with PCOS often have irregular menses, obesity, infertility, and hirsutism.
Diagnostic criteria from the 2003 meeting of the European Society of Human Reproduction and Embryology/American Society for Reproductive Medicine (ESHRE/ASRM) stressed that PCOS could be diagnosed only if other causes of hyperandrogenism were ruled out; such causes include androgen-secreting tumors, Cushing syndrome, and congenital adrenal hyperplasia. In addition, two of three criteria must be present to make the diagnosis: oligo-ovulation or anovulation, signs of hyperandrogenism, and ultrasound evidence of polycystic ovaries. These newer criteria include atypical manifestations of PCOS.
PCOS is a worrisome disease because of the potential complications. Women with PCOS are at higher risk for infertility, first-trimester miscarriages, endometrial hyperplasia (with chronic anovulation), type 2 diabetes mellitus, dyslipidemia, and cardiovascular disease. These complications can be treated and prevented; therefore, it is important to diagnose PCOS.
Medications That May Cause Symptoms That Mimic Polycystic Ovary Syndrome
Anabolic steroids (may cause hirsutism, acne, and amenorrhea)
Danazol (may cause amenorrhea and hirsutism)
Diazoxide (may cause hirsutism)
Glucocorticoids (may cause hirsutism)
Oral contraceptives (may cause amenorrhea)
Phenytoin (may cause hirsutism)
Progestins (may cause amenorrhea, hirsutism, and acne)
Causes of Polycystic Ovary Syndrome
The cause of polycystic ovary syndrome is not completely understood. It involves the dysregulation of complex hormone cycles that leads to luteinizing hormone excess, androgen excess, insulin resistance, and chronic anovulation. There is a probable genetic predisposition to PCOS that is affected by environmental factors, especially obesity.
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