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Stein-Leventhal Syndrome, more commonly known as Polycystic Ovary Syndrome (PCOS), is a complex endocrine disorder affecting women of reproductive age. Characterized by a combination of symptoms and biochemical markers, PCOS is associated with irregular menstrual cycles, hyperandrogenism, and polycystic ovaries. Its etiology remains multifactorial, involving genetic, environmental, and lifestyle factors.
Symptoms and Diagnosis
The clinical presentation of PCOS can vary significantly from one individual to another. Common symptoms include:
- Oligomenorrhea or amenorrhea - irregular or absent menstrual periods
- Signs of hyperandrogenism - including hirsutism (excessive hair growth), acne, and alopecia
- Polycystic ovaries visible on ultrasound
Diagnosis of PCOS follows the Rotterdam criteria, which require two of the following three to be present: oligo- or anovulation, clinical or biochemical signs of hyperandrogenism, and polycystic ovaries on ultrasound.
Pathophysiology
The pathophysiology of PCOS is complex and not fully understood. It involves an imbalance in the secretion and action of several hormones, including increased insulin levels and resistance, elevated levels of androgens, and disrupted regulation of the gonadotropins LH (luteinizing hormone) and FSH (follicle-stimulating hormone). These hormonal imbalances lead to the symptoms and complications associated with PCOS.
Complications
Women with PCOS are at an increased risk of several health conditions, including:
Management
Management of PCOS focuses on symptom relief and prevention of complications. Treatment options include:
- Lifestyle changes - such as weight loss, diet, and exercise
- Medications - including hormonal contraceptives to regulate menstrual cycles, anti-androgens to reduce hair growth, and metformin to improve insulin sensitivity
- Fertility treatments - for those desiring pregnancy
Epidemiology
PCOS is one of the most common endocrine disorders among women of reproductive age, affecting approximately 10% of women worldwide. However, due to its heterogeneous nature and varying diagnostic criteria, the prevalence may vary.
See Also
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Contributors: Prab R. Tumpati, MD