Ahmed Y, Akhtar A S M, Reshi F Q, Anjum Q, Halt H A.
Polycystic Ovarian Syndrome: a new perspective.
J Pak Med Assoc Jan ;53(2):72-7.

Polycystic ovarian syndrome (PCOS) is sometimes called Stein-Leventhal Syndrome. It is the most common ovarian disorder with typical features of obesity, anovulation, hyperandrogenism, hirsutism and infertility. Despite extensive research, the etiology and the mechanisms underlying PCOS are largely unknown, but there is considerable evidence suggesting that insulin plays the basic pathologic role along with a genetic component to the syndrome. It is not purely an ovarian disease but an extremely heterogeneous clinical syndrome that should be recognized as a systemic endocrine and metabolic disorder. The metabolic derangements may predispose women with PCOS to a range of diseases such as type 2 diabetes mellitus, dyslipidemia, endometrial cancer and coronary artery syndrome. Functional adrenal hyperandrogenism, glucocorticoid-suppressible ACTH-dependant 17-ketosteroid excess is found in approximately one half of hyperandrogenic women and patients with functional ovarian hyperandrogenism. In 1980, it was first reported that patients with PCOS had high insulin levels suggesting that they were insulin resistant. Hyperinsulinemia is probably the result of both increased insulin secretion and decrease in insulin clearance. Though laboratory examinations may be performed, they are mainly for excluding disorders of hormone production, enzyme deficiencies and other metabolic disorders

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