POLYCYSTIC-OVARY-SYNDROME - A MULTIDISCIPLINARY CHALLENGE

The polycystic ovary syndrome (PCOS) is a multifaceted disease. PCOS i s the most frequent cause of hyperandrogenism and anovulation. The ful l-blown syndrome, as defined prior to the 1970s, is only one aspect of the spectrum of ovarian hyperandrogenism. There are both genetic and environmental components in the pathophysiology of this disorder. Hype rinsulinism secondary to insulin resistance is one such factor, The re lationship between hyperinsulinism and PCOS may be more important in a temporal than in a quantitative fashion. For example, puberty may be an ''insulin-sensitive window'' in which subsequent ovarian function i s permanently altered. Hyperinsulinemic PCOS can be an early clinical manifestation of a genetic background that conveys suspectibility to c ardiovascular and metabolic complications later in life. This concept has major consequences in terms of disease prevention and public healt h.