Polycystic ovary syndrome

When patients develop symptoms associated with their polycystic ovaries, they are said to have polycystic ovary syndrome. Of the 20% of women who have PCO only one in three will have symptoms - PCOS. In addition to abnormal menstrual cycles and infertility, some women may be troubled by skin problems, notably acne and greasy skin or unwanted hair production (hirsutism). PCOS was first described by Stein and Leventhal in 1935 and the condition is therefore also known as Stein-Leventhal syndrome.

Many women with PCOS find it difficult to understand why they have developed symptoms, such as irregular and infrequent periods (oligomenorrhoea), after many years of normal cycles. Usually, the key factor to account for the change is an increase in weight. In association with PCO there may be an increased level of insulin which encourages the body to lay down excessive amounts of fat tissue leading to obesity. This excess fat tissue aggravates the hormonal imbalance. A spiral may be set up as the hormone problems increase fat production and the excess fat has a further adverse effect on the hormone balance.  

Part of the difficulty in understanding polycystic ovary syndrome (PCOS) and interpreting the dense literature surrounding it has been that there was no universally accepted clinical definition.⁽⁰³⁰¹⁾

There has been a recent consensus on the diagnosis of polycystic ovary syndrome⁽⁰⁴⁰¹⁾

PCOS is defined as the presence of any two of the following three criteria:

1 polycystic ovaries (either 12 or more follicles measuring 2-9 mm in diameter, or increased ovarian volume (> 10 cm3).

2 oligomenorrheoa / anovulation 

3 clinical or biochemical evidence of hyperandrogenism

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