POLYCYSTIC-OVARY-SYNDROME

The cardinal clinical features of polycystic ovary syndrome (PCOS) are hirsutism and menstrual irregularity from anovulation. Obesity occurs in one half of these women, some of whom also have diabetes. Underlyi ng biochemical abnormalities in PCOS include luteinizing hormone (LH) hypersecretion, hyperandrogenism, acyclic estrogen production, decreas ed sex hormone-binding globulin (SHBG) capacity, and hyperinsulinemia from insulin resistance, all of which contribute to increased ovarian androgen production. The hyperinsulinemia found in PCOS women accompan ies upper body obesity, occurs independently of obesity alone, and pot entiates ovarian hyperandrogenism by enhancing LH secretion, potentiat ing 17-hydroxylase and, to a lesser extent, 17,20-lyase activity, and suppressing SHBG capacity. All women with suspected hyperandrogenic an ovulation should undergo an evaluation to rule out other endocrinopath ies, such as virilizing tumors, adult-onset congenital adrenal hyperpl asia.