Polycystic ovary syndrome

Etiology, pathogenesis and diagnosis

Mark O. Goodarzi, Daniel A. Dumesic, Gregorio Chazenbalk, Ricardo Azziz

Research output: Contribution to journalReview article

591 Citations (Scopus)

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in women of reproductive age, with a prevalence of up to 10%. Various diagnostic criteria have been proposed, generally centered around the features of hyperandrogenism and/or hyperandrogenemia, oligo-ovulation and polycystic ovarian morphology. Insulin resistance is present in a majority of cases, with compensatory hyperinsulinemia contributing to hyperandrogenism via stimulation of ovarian androgen secretion and inhibition of hepatic sex hormone-binding globulin production. Adipose tissue dysfunction has been implicated as a contributor to the insulin resistance observed in PCOS. Environmental and genetic factors also have a role in the development of PCOS. The syndrome is associated with numerous morbidities, including infertility, obstetrical complications, type 2 diabetes mellitus, cardiovascular disease, and mood and eating disorders. Despite these morbidities, PCOS may be common in our society owing to evolutionary advantages of the syndrome in ancient times, including smaller family sizes, reduced exposure to childbirth-related mortality, increased muscle mass and greater capacity to store energy. The diagnosis of PCOS hinges on establishing key features while ruling out other hyperandrogenic or oligo-ovulatory disorders. Treatment is focused on the goals of ameliorating hyperandrogenic symptoms, inducing ovulation and preventing cardiometabolic complications.

Original languageEnglish (US)
Pages (from-to)219-231
Number of pages13
JournalNature Reviews Endocrinology
Volume7
Issue number4
DOIs
StatePublished - Apr 1 2011

Fingerprint

Polycystic Ovary Syndrome
Hyperandrogenism
Ovulation
Insulin Resistance
Morbidity
Sex Hormone-Binding Globulin
Ovulation Induction
Hyperinsulinism
Diabetes Complications
Mood Disorders
Type 2 Diabetes Mellitus
Infertility
Androgens
Adipose Tissue
Cardiovascular Diseases
Parturition
Muscles
Mortality
Liver

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism

Cite this

Goodarzi, M. O., Dumesic, D. A., Chazenbalk, G., & Azziz, R. (2011). Polycystic ovary syndrome: Etiology, pathogenesis and diagnosis. Nature Reviews Endocrinology, 7(4), 219-231. https://doi.org/10.1038/nrendo.2010.217

Polycystic ovary syndrome : Etiology, pathogenesis and diagnosis. / Goodarzi, Mark O.; Dumesic, Daniel A.; Chazenbalk, Gregorio; Azziz, Ricardo.

In: Nature Reviews Endocrinology, Vol. 7, No. 4, 01.04.2011, p. 219-231.

Research output: Contribution to journalReview article

Goodarzi, MO, Dumesic, DA, Chazenbalk, G & Azziz, R 2011, 'Polycystic ovary syndrome: Etiology, pathogenesis and diagnosis', Nature Reviews Endocrinology, vol. 7, no. 4, pp. 219-231. https://doi.org/10.1038/nrendo.2010.217
Goodarzi, Mark O. ; Dumesic, Daniel A. ; Chazenbalk, Gregorio ; Azziz, Ricardo. / Polycystic ovary syndrome : Etiology, pathogenesis and diagnosis. In: Nature Reviews Endocrinology. 2011 ; Vol. 7, No. 4. pp. 219-231.
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