Polycystic ovary syndrome (PCOS) is a complex endocrinologic disorder
resulting in chronic anovulation. The clinical appearance of PCOS
was originally described by Stein and Leventhal in 1905 (often
called the Stein Leventhal syndrome) and classically has involved
obesity (overweight), amenorrhea (absence of menstrual flow) and
hirsutism (excess hair growth with a male pattern) associated
with the finding of enlarged ovaries that have many follicular
cysts seemingly arrested in development.
There are "atypical" presentations for PCOS. About 30%
of PCOS patients are not hirsute, probably as a result of decreased
peripheral metabolism of the androgens to the more active form
(dihydrotestosterone) that is associated with hirsutism. Also,
about 50% of PCOS patients are not obese and some are quite slender.
Many women with PCOS have a mild elevation of insulin and associated
insulin resistance. Obese women have a greater disorder of insulin
than thin women. There is a syndrome called HAIR-AN syndrome which
involves hyperandrogenic insulin resistance and acanthosis nigricans.
Acanthosis nigricans is a an irregular velvety dark discoloration
of the skin especially in regions of skin folds or creases. It
seems to be especially difficult to stimulate ovulation in women
with HAIR-AN syndrome.
|
