Abstract
Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorder that affects 6-15% of the female population. It is a very complex syndrome that involves the hypothalamus, the pituitary gland, the ovaries, the adrenal gland and the peripheral adipose tissue that together contribute to create a generally imbalance, associated with three characteristic symptoms: oligo-anovulation, hirsutism and infertility. PCOS has been studied over a prolonged period of time and yet is still not fully understood. In 2003, in Rotterdam, the European Society for Human Reproduction and Embryology (ESHRE) together with the American Society for Reproductive Medicine (ASRM), drafted a consensus document that, gathering the conclusions discussed and compared of various experts works, established a worldwide standard diagnostic criteria for the Polycystic ovary syndrome. Since then, other workshops focused on summarizing know-hows on PCOS by identifying gaps in various aspects. Most symptoms of PCOS first appear in adolescence, around the start of menstruation. However, some women do not develop symptoms until early to mid-20's. Although PCOS presents early in life, it persists through and beyond the reproductive years. This manuscript focuses on summarizing the current knowledge on PCOS, underlying features, diagnosis and treatment.
Highlights
Definition and diagnosis Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders [1]
PCOS is, a very complex disorder that involves the hypothalamus, the pituitary gland, the ovaries, the adrenal gland and the peripheral adipose tissue creating an imbalance associated with three characteristic symptoms: oligo-anovulation, hirsutism and infertility [3]
PCOS is mainly diagnosed on the exclusion of androgen excess or ovulatory disorders with clearly defined causes: the 21-hydroxylase deficiency is observed in nonclassic adrenal hyperplasia (NCAH) and affects 1-10% of hirsute women [11]; Cushing's syndrome with hyperandrogenic characteristics [12], adrenal carcinomas, ovarian tumors and other adrenal androgen-secreting tumors present in 1:300-1000 androgenic women; exogenous anabolic drugs, whose prevalence is unknown, but it is generally present only in the minor androgenization [13]
Summary
Definition and diagnosis Polycystic ovary syndrome (PCOS) is one of the most common female endocrine disorders [1]. According to the Rotterdam Consensus criteria polycystic ovary should contain 12 or more follicles of 2-9 mm in diameter This is a useful parameter to distinguish PCO cases from multi ovarian follicular (MFOs), a transitory condition generally associated to delayed puberty, hyperprolactinemia, hypothalamic anovulation, amenorrhea related to weight [10]. Hirsutism Hirsutism is defined as the development of male pattern terminal hair growth in women and affects approximately 5-8% of the population [14,65] It is often associated with androgen excess disorders including non-classic adrenal hyperplasia, androgen secreting tumors, and polycystic ovary syndrome (PCOS) [14,66]. Even if the specific interaction between physical activity and mental health has not been explored in depth in PCOS, preliminary data including a recent clinic-based study of women with PCOS, have evidenced that physically inactive women suffer from higher depression scores than physically active women, and that there is an association between lower physical activity and mild depression [80]
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