Clinical classification of polycystic ovary syndrome

The definition of polycystic ovary syndrome is still subject to debate. Ultrasonographic diagnosis alone does not suffice. Clinical relevance is only reached when additional endocrinological alterations exist such as irregular menstrual cycles, hyperandrogenemia, or a disorder of glucose metabolism. An endocrinological work-up is thus indispensable. The pathophysiological associations are still not completely clarified so that primarily ovarian as well as disturbances of different hormonal systems can be present. It appears that various factors such as an elevation of testosterone or even insulin levels lead to an increase of LH concentrations and thus to hyperandrogenemia. Only when the cause has been determined adequate therapy can be instituted. Special attention should be paid to possible insulin resistance or metabolic syndrome because of the harmful cardiovascular after-effects.