From the Guidelines
The main cause of Polycystic Ovary Syndrome (PCOS) is not a single organ but rather a complex hormonal disorder involving multiple organs, primarily the ovaries, as well as the hypothalamus, pituitary gland, pancreas, and adrenal glands. The ovaries play a central role in PCOS as they develop multiple small follicles (cysts) and produce excess androgens (male hormones) 1. However, the condition also involves the hypothalamus and pituitary gland in the brain, which regulate hormone production, and the pancreas, which produces insulin. In PCOS, insulin resistance is common, causing the pancreas to produce more insulin, which in turn stimulates the ovaries to produce more androgens 1. The adrenal glands may also contribute to excess androgen production. This hormonal imbalance disrupts normal ovulation and leads to the characteristic symptoms of PCOS, including irregular periods, excess hair growth, acne, and fertility issues. Some key points to consider in the diagnosis and management of PCOS include:
- The detection of hyperandrogenism in women with PCOS can be accomplished clinically through assessment of hirsutism, acne or androgenic alopecia, or via biochemical testing of circulating androgen concentrations 1
- Liquid chromatography-tandem mass spectrometry (LC-MS/MS) is considered the reference standard for assessing steroids including androgens, but its use is limited by technical complexity and accessibility 1
- Management typically involves lifestyle modifications (diet and exercise), medications to regulate periods and reduce androgen levels, and insulin-sensitizing drugs like metformin if insulin resistance is present 1. It is essential to note that PCOS is a complex disorder, and its management should be individualized based on the patient's specific needs and circumstances.
From the Research
PCOS Overview
- Polycystic ovary syndrome (PCOS) is a complex endocrinopathy affecting women of childbearing age 2
- The diagnosis of PCOS is primarily clinical, based on the presence of at least two of the three Rotterdam criteria: oligoanovulation, hyperandrogenism, and polycystic ovaries on ultrasonography 2
Causes of PCOS
- The aetiology of PCOS remains largely unknown, but mounting evidence suggests that PCOS might be a complex multigenic disorder with strong epigenetic and environmental influences, including diet and lifestyle factors 3
- PCOS is often associated with insulin resistance, which is a key factor in the development of the syndrome 2, 3
Role of the Ovary in PCOS
- PCOS is characterized by ovarian dysfunction, including oligoanovulation and hyperandrogenism 2, 3
- The ovary is not the sole cause of PCOS, but rather one of the affected organs in the syndrome 2, 3
Other Factors Contributing to PCOS
- Insulin resistance and hyperinsulinemia are key factors in the development of PCOS 4, 5
- Lifestyle factors, such as diet and physical activity, also play a role in the development and management of PCOS 2, 3