Polycystic Ovary Syndrome (PCOS) is a common cause of irregular periods and infertility in women of reproductive age, affecting 5-10% of women. It is associated with increased levels of androgens and insulin resistance. Women with PCOS have an increased risk of health issues like endometrial cancer, diabetes, cardiovascular disease, and metabolic syndrome. Diagnosis involves evaluating symptoms, family history, ultrasound of ovaries, and hormone levels. Treatment focuses on lifestyle changes, oral contraceptives, and medications to improve insulin sensitivity and reduce androgen levels.

1. Polycystic Ovary (Ovarian) Syndrome

10. Polycystic Ovaries

11. * Sonography of polycystic ovary.

12. A: Polycystic ovaries, showing increased size and a smooth white surface reflecting thickening of the capsule. B: Section through polycystic ovary, showing multiple cysts with diameter < 10 mm arranged around the periphery of the ovary. The stroma is increased, and the ovary enlarged. ©The Medical Journal of Australia 2004 www.mja.com.au ISSN: 0025-729X

13. Diagnosis of PCOS

15. Diagnosis of PCOS

16. Diagnosis of PCOS

17. Diagnosis of PCOS

19. Young woman with PCOS showing facial hirsutism (A) and axillary acanthosis nigricans (B). The latter is associated with severe insulin resistance and hyperinsulinaemia and is an occasional finding in PCOS (photographs courtesy Dr John Casey, St Vincent’s Clinic, Sydney, NSW). ©The Medical Journal of Australia 2004 www.mja.com.au ISSN: 0025-729X

21. * Manifestations of polycystic ovary syndrome at different ages ©The Medical Journal of Australia 2004 www.mja.com.au ISSN: 0025-729X

25. Flow diagram for the laboratory evaluation of amenorrhea. Such a scheme must be considered as an adjunct to the clinical evaluation of the patient. CAH -= congenital adrenal hyperplasia; DHEAS = dehydroepiandrosterone sulfate; FSH = follicle-stimulating hormone; HCA = hypothalamic chronic anovulation; PCO = polycystic ovary syndrome; PRL = prolactin; T = testosterone; TSH = thyroid-stimulating hormone. Originally from Rebar RW, The ovaries. In: Smith LH Jr, ed. Cecil textbook of medicine, ed. 18. Philadelphia. WB Saunders, 1992:1367)

33. Randomized, Double-Blind, Placebo-Controlled Trials of Metformin in PCOS

45. Oral Contraceptives and Glucose Tolerance/Insulin Sensitivity in Women With PCOS: Clinical Trials

46. FIG. 1. Case-control studies on myocardial infarctions associated with current use of low-dose oral contraceptives versus no current use. Odds ratios (ORs) are expressed with their 95% confidence interval. OR were adjusted for multiple confounding factors, depending on the study. The combined OR was weighted based on the variance of the ORs in each study.

47. FIG. 2. Case-control studies on ischemic strokes associated with current use of low-dose oral contraceptives versus no current use. Odds ratios (ORs) are expressed with their 95% confidence interval. OR were adjusted for multiple confounding factors, depending on the study. The combined OR was weighted based on the variance of the ORs in each study.

48. The cardinal feature is functional ovarian hyperandrogenism. ©The Medical Journal of Australia 2004 www.mja.com.au ISSN: 0025-729X