Abstract

Polycystic ovary syndrome (PCOS) was first described by Stein and Leventhal in 1935. PCOS is the most prevalent endocrinopathy with genetic predisposition, affecting 5% to 10% of premenopausal women. PCOS is a condition of unexplained hyperandrogenic anovulation that most likely represents a heterogeneous disorder. The aetiology of the condition is unknown. There is some evidence of autosomal transmission related to strong familial clustering. Recent findings suggest that the principal underlying disorder is one of insulin  resistance, with the resultant hyperinsulinaemia stimulating excess ovarian androgen production. Associated with prevalent insulin resistance, these women exhibit a characteristic dyslipidaemia and a predisposition to non – insulin dependent diabetes and cardiovascular disease in later life. The treatment of PCOS is largely symptom based and empirical. It includes lifestyle modification, use of cyclical progestagens and antiandrogens. Ovulation induction by drug therapy and ovarian drilling are used to treat subfertility in women with PCOS. Therapeutic approaches to PCOS remain an ongoing source of debate. Insulin sensitizing agents may bring new hope in therapy and it seems that primary treatment should focus on metabolic sequelae.