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.