Polycystic ovary syndrome.
Polycystic ovary syndrome (PCOS) is the most common female endocrinopathy, affecting 5-10% of the female population. It involves overproduction of ovarian androgens leading to a heterogeneous range of symptoms including hirsutism, acne, anovulation and infertility. Hyperinsulinaemia, exacerbated by obesity, is often a key feature. Treatment depends on the presenting symptoms, which may often be ameliorated by weight loss where relevant. Anti-androgen preparations are used for hyperandrogenic symptoms, and clomiphene citrate (CC) is the first-line treatment for anovulation and infertility. Aromatase inhibitors are being investigated as an alternative to CC. Failure to conceive with CC can be treated in a number of ways, including the addition of insulin-lowering agents (mainly metformin), low-dose gonadotrophin therapy or surgically by laparoscopic ovarian drilling. Although the exact aetiology of PCOS is not known, the therapeutic alternatives provide reasonably successful symptomatic treatment.
Homburg
Roy
R
VU University Medical Centre, Amsterdam, The Netherlands. r.homburg@vumc.nl
D000152:Acne Vulgaris / Q000188:drug therapy; D000726:Androgen Antagonists / Q000627:therapeutic use; D047072:Aromatase Inhibitors / Q000627:therapeutic use; D002996:Clomiphene / Q000627:therapeutic use; D005260:Female; D005300:Fertility Agents, Female / Q000627:therapeutic use; D006065:Gonadotropins, Pituitary / Q000627:therapeutic use; D006628:Hirsutism / Q000188:drug therapy; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy; D007333:Insulin Resistance; D008687:Metformin / Q000627:therapeutic use; D011085:Polycystic Ovary Syndrome / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D015431:Weight Loss