Polycystic ovary syndrome as a form of functional ovarian hyperandrogenism due to dysregulation of androgen secretion.

Abstract

I. History and Terminology: From Stein-Leventhal toFunctional Ovarian Hyperandrogenism (FOH) IN 1935, Stein and Leventhal (1) reported the association of polycystic ovaries in women with amenorrhea, hirsutism, and obesity. Morphological and histological studies of the ovaries from these patients revealed a thickened tunica albuginea, hyperplasia of the theca interna and cortical stroma, and multiple subcapsular follicles that were in various stages of atresia (1). Subsequently, the heterogeneity of both the ovarian histology and clinical findings in women with polycystic ovaries was recognized and led to the establishment of the term polycystic ovary syndrome (PCOS) (2, 3). Indeed, patients with the severest cases may have hyperthecosis, a form in which there are no cysts (2,4,5), and those with milder ovarian dysfunction tend to have normal ovarian morphology (6). Later, increased concentrations of serum LH or an increase in the ratio of LH to FSH were shown to be characteristic (7) and became common dia...