Talk:Polycystic ovary syndrome

References: with notes

Ehrmann DA. Polycystic ovary syndrome.[Review] [144 refs] New England Journal of Medicine. 352(12):1223-36, 2005 Mar 24. UI: 15788499 Several factors contribute to difficulties in the diagnosis of the polycystic ovary syndrome. Presenting signs and symptoms are heterogeneous and vary over time; in addition, a precise and uniform definition of the syndrome has been lacking. An international consensus group [3] recently proposed that the syndrome can be diagnosed after the exclusion of other medical conditions that cause irregular menstrual cycles and androgen excess (Figure 1 and Table 1) and the determination that at least two of the following are present: oligoovulation or anovulation (usually manifested as oligomenorrhea or amenorrhea), elevated levels of circulating androgens (hyperandrogenemia) or clinical manifestations of androgen excess (hyperandrogenism), and polycystic ovaries as defined by ultrasonography. [4] Women with the polycystic ovary syndrome almost always have some aberration in gonadotropin secretion as compared with women who have normal menstrual cycles. [8] However, since gonadotropin concentrations vary over the menstrual cycle and are released in a pulsatile fashion into the circulation, a single measurement of luteinizing hormone and follicle-stimulating hormone provides little diagnostic sensitivity. Thus, in routine clinical practice, abnormal gonadotropin levels (an elevated level of luteinizing hormone or an elevated ratio of luteinizing hormone to follicle-stimulating hormone) need not be documented to diagnose the polycystic ovary syndrome.

Chronic anovulation most often manifests as oligomenorrhea (fewer than nine menses per year) or amenorrhea. Anovulatory cycles may lead to dysfunctional uterine bleeding and decreased fertility. Cutaneous manifestations of hyperandrogenemia in the polycystic ovary syndrome include hirsutism, acne, and%2