ENDOCRINE ASPECTS OF POLYCYSTIC OVARY SYNDROME
Klara Pulić, Sanja Klobučar Majanović
Polycystic ovary syndrome, the most common endocrine disorder among women of reproductive age, is a result of interaction between ovarian genetic traits and many congenital and environmental factors. The most common postnatal contributor is obesity, but the fundamental disorder is in the intraovarian regulation of steroidogenesis, often accompanied by selective insulin resistance. The syndrome is clinically characterized by oligo-amenorrhea, menstrual dysfunction, infertility, hyperandrogenism, as well as the frequent presence of associated risk factors for cardiovascular disease and diabetes, including obesity, glucose intolerance and dyslipidemia. It is very important to identify and monitor the main features of metabolic syndrome and the risk for complications. Weight loss can restore ovulatory cycles and improve metabolic risk, so it is the first-line intervention for most women, but sometimes oral contraceptives and antiandrogens have to be added. In patients with insulin resistance and associated hyperinsulinemia insulin-sensitizing agents like metformin and thiazolidinediones have important role in its treatment.