This page has moved. Click here to view.



Polycystic ovary syndrome is a heterogeneous disorder characterized by obesity, oily skin, acne, hirsutism, and frequently oligomenorrhea or amenorrhea and infertility. Other symptoms of PCOS include increased libido, clitoromegaly, and masculinization, including deepening of voice, increase in muscle mass, a male body polycystic ovary syndrome, policystic, polysistic, overy, sindrome habitus, and often oligoovulation or anovulation. This phenotypic variability probably represents the fact that PCOS encompasses different disorders that have similar manifestations. The confusion is further compounded by the lack of any consistent definition by which this condition is diagnosed. An elevated ratio of LH to FSH of 3:1 or higher has frequently been used for laboratory confirmation of PCOS. More recently, with the advent of newer assays, cortex of the ovary.

For those individuals who present with infertility due to oligoovulation or anovulation, medical therapy with the use of clomiphene citrate or gonadotropins or both often can induce ovulation. Individuals with PCOS tend to

Most women with PCOS, however, are not trying to conceive. Rather, they present to the physician because they frequently experience hirsutism and virilization. Hirsutism is a demoralizing condition that afflicts women


Treatment of women with PCOS who do not desire pregnancy depends on their underlying goals. In those individuals who wish to reduce hair growth, a variety of agents are available. However, patients should be counseled that medical therapy requires a minimum of 3-6 months to achieve a reduction in hirsutism. Usually, these medical therapies only affect hirsutism by diminishing new terminal hair growth and do little

Probably the most common treatment of PCOS in the United States is a combination oral contraceptive. These agents work in several ways, including the suppression of LH-dependent androgen production, estrogen stimulation of sex hormone-binding globulin production (which reduces free-testosterone levels),

Recently, GnRH analogues have been used to suppress gonadotropin levels with subsequent reduction in LH-dependent androgen production from thecal cells. With such therapy, it is often helpful to monitor the degree to which androgens have been reduced so as to titrate the GnRH analogue dose. Further efficacy may be achieved by add-back therapy given with GnRH analogues. Add-back therapy may allow the use of

Spironolactone is an aldosterone antagonist diuretic that is frequently used in combination with oral

Another agent used to treat PCOS is cyproterone acetate alone or in combination with an estrogen. Cyproterone acetate is a potent progestational agent that both inhibits gonadotropin secretion and binds to

In individuals with elevated androgen levels unresponsive to medical therapy, consideration can be given to performing bilateral salpingo-oophorectomy, either with our without hysterectomy. This should be considered