Polycistyc ovary syndrome

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Published: 2017-03-10
DOI: https://doi.org/10.51987/Rev.Hosp.Ital.B.Aires.v37i1.842
Keywords:
polycystic ovary syndrome, hyperandrogenism, obesity, diabetes, infertility, combined oral contraceptive, metformin

Main Article Content

Irina Winnykamien
Servicio de Endocrinología, Metabolismo y Medicina Nuclear. Hospital Italiano de Buenos Aires
Albano Dalibón
Servicio de Endocrinología, Metabolismo y Medicina Nuclear. Hospital Italiano de Buenos Aires
Pablo Knoblovits
Servicio de Endocrinología, Metabolismo y Medicina Nuclear. Hospital Italiano de Buenos Aires

Abstract

Polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women, the main cause of hyperandrogenism (HA). It is a complex, multifactorial polygenic disorder with environmental influences. Although there have been proposed different criteria for diagnosis, using the most comprehensive (Criteria Rotterdam) with the presence of 2 of 3 of the following is preferred: 1) HA clinical or biochemical, 2) oligo-anovulation chronic (OA), 3) polycystic ovaries by ultrasound, excluding other etiologies. It is frequently associated with metabolic comorbidities (obesity, type 2 diabetes, dyslipidemia, sleep apnea, etc.) and reproductive disorders (endometrial hyperplasia and infertility), especially in the classical phenotypes, with HA and OA. The treatment will be oriented to the clinical characteristics of each patient and reproductive desire. Weight loss in those who are overweight and / or obesity can restore menstrual cycles and decrease metabolic risk and represents the first line of treatment. Oral contraceptives (OC) are the pharmacological treatment of choice as it attenuates the manifestations of HA and offer endometrial protection. In patients seeking pregnancy with oligo-anovulation, clomiphene citrate would be used at first instance. Metformin may be used in those with impaired glucose tolerance or type 2 diabetes and also as a second-line treatment to restore cycles and induce ovulation

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Vol. 37 No. 1 (2017): Revista del Hospital Italiano de Buenos Aires

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Review
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This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

How to Cite

1.
Winnykamien I, Dalibón A, Knoblovits P. Polycistyc ovary syndrome. Rev Hosp Ital B.Aires [Internet]. 2017 Mar. 10 [cited 2026 Apr. 27];37(1):10-2. Available from: https://ojs.hospitalitaliano.org.ar/index.php/revistahi/article/view/842

References

McCartney C, Marshall J. Polycystic Ovary Syndrome. N Engl J Med. 2016;375(1):54-64. DOI: https://doi.org/10.1056/NEJMcp1514916

Dumesic D, Oberfield S, Stener-Victorin E, et al. Scientific statement on the diagnostic criteria, epidemiology, pathophysiology, and molecular genetics of polycystic ovary syndrome. Endocr Rev. 2015;36(5):487-525. DOI: https://doi.org/10.1210/er.2015-1018

Zegher F, Ibañez L. Prenatal growth restraint followed by catch-up of weight: a hyperinsulinemic pathway to polycystic ovary syndrome. Fertil Steril. 2006;86(Suppl.1):4-5. DOI: https://doi.org/10.1016/j.fertnstert.2006.03.013

Stracquadanio M, Ciotta L. Low birth-weight is a PCOS risk factor for Southern-Italian women. Gynecol Endocrinol. 2017 Feb 21:1-5. DOI: https://doi.org/10.1080/09513590.2017.1283487

Sir-Petermann T. et al. Maternal serum androgens in pregnant women with polycystic ovarian syndrome: possible implications in prenatal androgenization. Hum Reprod. 2002;17:2573-2579. DOI: https://doi.org/10.1093/humrep/17.10.2573

Crisosto N, Sir-Petermann T, et al. Anti-Müllerian hormone levels in peripubertal daughters of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2007;92:2739-2743. DOI: https://doi.org/10.1210/jc.2007-0267

Sir-Petermann T, Maliqueo M, Codner E, et al. Early metabolic derangements in daughters of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2007;92:4637-4642. DOI: https://doi.org/10.1210/jc.2007-1036

Recabarren SE, Smith R, Rios R, et al. 2008. Metabolic profile in sons of women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2008;93:1820-1826. DOI: https://doi.org/10.1210/jc.2007-2256

Sir-Petermann T, et al. Metabolic and reproductive features before and during Puberty in Daughters of Women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2009;94(6):1923-30. DOI: https://doi.org/10.1210/jc.2008-2836

Qin KN and Rosenfield RL. Role of cytochrome P450c17 in polycystic ovary syndrome. Mol Cell Endocrinol. 1998 Oct 25;145(1-2):111-21. DOI: https://doi.org/10.1016/S0303-7207(98)00177-4

Medeiros SF, Barbosa JS, Yamamoto MM. Comparison of steroidogenic pathways among normoandrogenic and hyperandrogenic polycystic ovary syndrome patients and normal cycling women. J Obstet Gynaecol Res. 2015;41(2):254-63. DOI: https://doi.org/10.1111/jog.12524

Yildiz BO and Azziz R. The adrenal and polycystic ovary syndrome. Rev Endocr Metab Disord. 2007;8(4):331-42. DOI: https://doi.org/10.1007/s11154-007-9054-0

Diamanti-Kandarakis E, Dunaif A. Insulin resistance and the polycystic ovary syndrome revisited: an update on mechanisms and implications. Endocr Rev. 2012;33(6):981-1030. DOI: https://doi.org/10.1210/er.2011-1034

Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obs Gynecol. 1935;29:181-91. DOI: https://doi.org/10.1016/S0002-9378(15)30642-6

Zawadzki JK, Dunaif A. Diagnosis criteria for polycystic ovary syndrome; toward a rational approach. Boston: Blackwell Scientific; 1992.

The Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. DOI: https://doi.org/10.1016/j.fertnstert.2003.10.004

Carmina E, Chu M, Lobo R, et al. Phenotypic variation in hyperandrogenic women influences the findings of abnormal metabolic and cardiovascular risk parameters. J Clin Endocrinol Metab. 2005;90(5):2545-9. DOI: https://doi.org/10.1210/jc.2004-2279

Azziz R, Carmina E, Diamanti-Kandarakis E, et al. Positions statement: criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society guideline. J Clin Endocrinol Metab. 2006;91(11):4237-45. DOI: https://doi.org/10.1210/jc.2006-0178

National Institues of Health, Evidence-based Methodology Workshop on Polycystic Ovary Syndrome December 3-5, 2012. Executive Summary. Available from: https://prevention.nih.gov/docs/programs/pcos/FinalReport.pdf.

Legro R, Arslanian S, Ehrmann D, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2013;98(12):4565-92. DOI: https://doi.org/10.1210/jc.2013-2350

Goodman N, Legro R, Carmina E, et al. American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and Pcos Society Disease State Clinical Review: Guide To the Best Practices in the Evaluation and Treatment of Polycystic Ovary Syndrome - Part 1. Endocr Pract. 2015;21(11):1291-300. DOI: https://doi.org/10.4158/EP15748.DSC

Conway G, Dewailly Diamanti-Kandarakis E, et al. The polycystic ovary syndrome: a position statement from the European Society of Endocrinology. Eur J Endocrinol. 2014;171(4):P1-29. DOI: https://doi.org/10.1530/EJE-14-0253

Moghetti P, Tosi F, Bonora E, et al. Divergences in insulin resistance between the different phenotypes of the polycystic ovary syndrome. J Clin Endocrinol Metab. 2013;98(4):E628-37 DOI: https://doi.org/10.1210/jc.2012-3908

Bart C, Fauser M, Tarlatzis B et al. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012;97(1):28-38. DOI: https://doi.org/10.1016/j.fertnstert.2011.09.024

Lizneva D, Suturina D, Azziz R et al. Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril. 2016;106(1):6-15. DOI: https://doi.org/10.1016/j.fertnstert.2016.05.003