Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a common and heterogeneous disorder of young women, affecting at least 6-8% of subjects in the reproductive age. Diagnosis is based on the presence of variable combinations of at least two out of 3 clinical elements, i.e. hyperandrogenism (clinical and/or biochemical), chronic oligo-anovulation and polycystic ovarian morphology, after exclusion of secondary causes. PCOS is also frequently characterized by obesity and insulin resistance, with an associated risk of metabolic alterations and cardiovascular disease. The presence of both hyperandrogenism and oligo-anovulation identifies in these women the classic phenotype of this syndrome, which is characterized by a worse metabolic profile. Therefore, the detection of hyperandrogenism is of major clinical significance in PCOS subjects. Unfortunately, the assessment of both clinical and biochemical hyperandrogenism usually relies on inaccurate methods. The treatment of these women should be personalized: lifestyle intervention is always recommended in subjects with fat excess, whereas the choice of medications depends on specific needs and characteristics of each patient.