Polycystic ovary syndrome: It's not just infertility

Recent diagnostic and pharmacologic developments have focused renewed atten tion on polycystic ovary syndrome. Clinical features of the syndrome includ e anovulation, hyperandrogenism and menstrual dysfunction, but several othe r abnormalities, including hyperinsulinemia, luteinizing hormone hypersecre tion, elevated testosterone levels and acyclic estrogen production, have be en documented. Accompanying obesity and lipid abnormalities compound the ri sk of developing diabetes mellitus or cardiovascular disease, and chronic a novulation increases the risk for endometrial cancer. A careful history and physical examination should guide diagnostic testing. Slowly progressive h yperandrogenic symptoms with anovulation of peripubertal onset often repres ent polycystic ovary syndrome. Treatment goals include symptom management a nd the identification and prevention of potential cardiovascular risks. Tre atment should take into account the patient's desire for fertility. Advance s in transvaginal ultrasonography and infertility treatments, including new er medications, have facilitated assisted reproduction in patients with pol ycystic ovary syndrome. Ongoing pharmacologic research focusing on the trea tment of insulin resistance appears promising in reversing the longterm com plications of the syndrome.