Introduction to Polycystic Ovary Syndrome (PCOS)

Progression of Polycystic Ovary Syndrome

In most cases, the onset of polycystic ovary syndrome (PCOS) occurs during adolescence. Usually the primary symptoms or complaints of adolescent girls relate to acne, hirsutism, or irregular menses (oligomenorrhea or amenorrhea). Adolescents may present with symptoms of hyperandrogenism but not with hyperinsulinemia (excess of insulin in the blood). The issue of weight is usually not as pronounced and problematic during adolescence, though this subgroup tends to have higher than normal waist:hip ratios.

If onset of PCOS is at a later age, the first symptom may be infertility. Many women with PCOS are obese and many are insulin resistant (estimates are at least 50%), regardless of obesity. Metabolic problems (e.g., hyperinsulinemia) usually appear with age, and as a woman ages, her risk for developing metabolic syndrome (i.e., type II diabetes, dyslipidemia, hypertension, and cardiovascular disease) increases. The risks for endometrial hyperplasia, endometrial cancer and breast cancer also increase with age.

Polycystic ovary syndrome afflicts approximately 5-10% of women of reproductive age. It is one of the most frequent causes of infertility in women. According to some estimates, up to 10% of women with amenorrhea and approximately 75% of women with oligomenorrhea may be diagnosed with PCOS.