Polycystic Ovary Syndrome:
A Multisystem Endocrine Disorder
Polycystic Ovary Syndrome (PCOS) is a common, heterogeneous endocrine disorder affecting approximately 6–12% of reproductive-aged women, with clinical features that extend beyond the reproductive system. It is characterized by a combination of hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology on ultrasound.
The presentation and severity of symptoms vary widely, requiring a nuanced and individualized diagnostic and therapeutic approach.
The pathophysiology of PCOS is complex and multifactorial, involving insulin resistance, hormonal imbalance, and hypothalamic-pituitary-ovarian axis dysregulation. Common clinical manifestations include irregular menstrual cycles, hirsutism, acne, anovulatory infertility, and metabolic disturbances such as insulin resistance, dyslipidemia, and increased risk for type 2 diabetes and cardiovascular disease. A diagnosis is typically made using the Rotterdam criteria, which require two out of three hallmark features, after exclusion of other etiologies.
Management is tailored to the patient’s primary concerns—whether they be cycle regulation, fertility, metabolic health, or dermatologic symptoms. First-line treatment often includes lifestyle modification focused on weight management, which can significantly improve both metabolic and reproductive outcomes. Pharmacologic options may include combined oral contraceptives for hormonal regulation, metformin to address insulin resistance, and ovulation induction agents such as letrozole or clomiphene for those pursuing pregnancy.
PCOS is a chronic condition with long-term health implications, necessitating an ongoing, multidisciplinary approach involving gynecology, endocrinology, nutrition, and mental health support.
Early diagnosis and proactive management can significantly improve both quality of life and long-term outcomes.