Polycystic ovary syndrome is a clinical syndrome characterized by mild obesity, irregular menses or lack of menstruation, and signs of androgen excess (eg, facial hair and acne). In most patients, the ovaries contain multiple cysts.

Causes: This syndrome involves anovulation or ovulatory dysfunction and androgen excess of unknown origin. However, some evidence suggests that patients have a functional abnormality of cytochrome P450c17 affecting 17-hydroxylase (the rate-limiting enzyme in androgen production); as a result, androgen production increases.

Signs and symptoms:

Typical symptoms include mild obesity, slight hirsutism, and irregular menses or lack of menstruation. Body hair may grow in a male pattern (eg, on the upper lip and chin, around the nipples, and along the linea alba of the lower abdomen). Some women have other signs of virilization, such as acne and temporal balding. Areas of thickened, darkened skin (acanthosis nigricans) may appear in the axillae, on the nape of the neck, in skinfolds, and on knuckles and/or elbows; the cause is high insulin levels due to insulin resistance.

Diagnosis:

  • Clinical criteria
  • Serum testosterone, follicle-stimulating hormone, prolactin, and thyroid-stimulating hormone levels
  • Pelvic ultrasonography