Polycystic ovary syndrome and metabolic disorders: A review of the literature

Polycystic ovarian syndrome (PCOS) is one of the most common female endocrinopathies and is a leading cause of infertility. The syndrome derives its name from the pathological appearance of the ovary in women with menstrual irregularities and hyperandrogenism. Its symptoms appear as early as adolescence in the form of amenorrhea, hirsutism and obesity. The majority of patients are overweight, obese or of normal weight, but metabolically obese. The prevalence of PCOS is on the increase and is associated with a significantly higher risk of various metabolic disorders including cardiovascular disease (CVD), Type2 diabetes (T2DM), gestational diabetes, hypercholesterolemia and different types of cancer, including endometrial and possibly ovarian cancer, especially if associated with hyperinsulinaemia. In contrast, in women with PCOS who have normal insulin levels, it is likely that genetics, inflammation, oxidative stress and possible interaction with environmental factors are present that link these women to metabolic disorders. The mechanism of PCOS is not well understood and this review aims to provide a detailed description of the mechanism underlying the development of PCOS and associated metabolic disorders with a full description of all possible scenarios associating PCOS to metabolic disorders, as well as an epidemiological overview regarding the relationship between these metabolic disorders and PCOS.