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Stein and Leventhal: first report of seven amenorrheic women with smooth, enlarged ovaries, who ovulated following wedge polycystic ovary syndrome, hirsutism, PCO resection, polycistic, AIDS The advent of radioimmunoassay Obesity: seen in at least 50% of women with polycystic ovary syndrome (PCO). Upper body obesity is frequently characteristic Oligomenorrhea or amenorrhea Hirsutism 1. Not always present 2. Hirsutism is a function of both target tissue response and hyperandrogenism Premenarchal onset of symptoms Infertility
Biochemical Features
Increased free testosterone: if not present, the diagnosis is suspect; the most reliable biochemical indicator of the disorder
Decreased sex hormone-binding globulin polycystic ovary syndrome, hirsutism (SHBG): a consequence of both elevated androgen secretion and obesity
Increased luteinizing hormone (LH): not always present, and may vary from time to time
Normal follicle-stimulating hormone (FSH)
Prolactin occasionally elevated
Dehydroepiandrosterone sulfate often elevated: no longer viewed as evidence of intrinsic adrenal dysfunction
Insulin resistance
Seen even in lean subjects
Subsequent risk for type II diabetes mellitus may be increased
Pathogenesis
The role of hyperinsulinism: data indicating ability of insulin to stimulate ovarian androgen production is very suggestive
Treatment