Polycystic ovary syndrome in every day practice

Main Article Content

A.M. Urbanovych


Polycystic ovary syndrome (PCOS) is a systemic pathology in which not only the function of the ovaries are violated but of all parts of the endocrine system. PCOS occurs in women of any age, from puberty to menopause, with the involvement of almost all organs and systems of the body. PCOS is identified in 6–19 % of women of reproductive age. More than half of all cases of endocrine infertility (50–75 %) and nearly 20–22 % of the causes of infertile marriage generally occur at PCOS. Hyperandrogenism, menstrual and/or ovulatory dysfunction and polycystic ovarian morphology are the main clinical signs of PCOS. Women with this diagnosis have a significantly higher risk of developing cardiovascular diseases, diabetes mellitus, malignant neoplasms of the small pelvis, mastopathy and breast cancer. Glandular and extraglandular hyperandrogenism, insulin resistance, pituitary dysfunction, genetic violations and disorders in the production of adipose tissue hormones have a significant role in the pathogenesis of the syndrome. The main objective of diagnosis is to determine the severity of clinical manifestations, the source and pathogenesis of overproduction of androgens, influence on the reproductive function, assessment of metabolic and cardiovascular risks. Differential diagnosis is aimed at the exclusion of thyroid diseases, hyperprolactinemia and non-classic congenital adrenal dysfunction. Today, more and more attention is paid to the integrated approach to the treatment of disorders occurring in patients with PCOS, taking into account their age, reproductive plans and the state of the endocrine profile. It is important not only to restore fertility and achieve cosmetic effects, but also to prevent late metabolic disorders.

Article Details

How to Cite
Urbanovych, A. “Polycystic Ovary Syndrome in Every Day Practice”. INTERNATIONAL JOURNAL OF ENDOCRINOLOGY (Ukraine), vol. 14, no. 1, Mar. 2018, pp. 40-45, doi:10.22141/2224-0721.14.1.2018.127090.
Literature Review


Milewicz A, editor. Endokrynologia kliniczna. Wroclaw: Polskie Towarzystwo Endokrynologiczne, 2012. 1224 p. (in Polish).

Dubossarska ZM, Dubossarska YuA, Duka IuM, Nagorniuk VT, authors; Dubossarskaia ZM, editor. Teoriia i praktika endokrinnoi ginekologii [Theory and practice of endocrine gynecology]. Dnipropetrovsk: Lira, 2010. 459 p. (in Russian).

Bachelot A. Polycystic ovarian syndrome: clinical and biological diagnosis. Ann Biol Clin (Paris). 2016 Dec 1;74(6):661-667. doi: 10.1684/abc.2016.1184.

Dunaif A. Insulin resistance and the polycystic ovary syndrome: mechanism and implications for pathogenesis. Endocr Rev. 1997 Dec;18(6):774-800. doi: 10.1210/edrv.18.6.0318.

Urbanovych AM. Hormones of adipose tissue and theirclinical significance. Endokrynologia. 2013;18(1):69-72. (in Ukrainian).

Tatarchuk TF, Voronenko NYu, Kapshuk IM. State of adipose tissue at polycystic ovary syndrome. Health of woman. 2013;10:35-38. (in Ukrainian).

Urbanovych AM. The role of leptin in the pathogenesis of diseases associated wiht insulin resistance. Experimental and clinical physiology. 2010;1:57-62. (in Ukrainian)

Mankovsky B, Urbanovych A. The Content of Blood Leptin and Activity of Systemic Inflammatory Response in Patients with Type 2 Diabetes Mellitus depending on Weight and Length of the Process. Int J Physiol Pathophysiol Pharmacol. 2015;6(3):213-219. doi: 10.1615/IntJPhysPathophys.v6.i3.50.

Franks S, McCarthy MI, Hardy K. Development of polycystic ovary syndrome: involvement of genetic and environmental factors. Int J Androl. 2006 Feb;29(1):278-85; discussion 286-90. doi: 10.1111/j.1365-2605.2005.00623.x.

Jędrzejuk D, Laczmański L, Kuliczkowska J, et al. Selected CNR1 polymorphisms and hyperandrogenism as well as fat mass and fat distribution in women with polycystic ovary syndrome. Gynecol Endocrinol. 2015 Jan;31(1):36-9. doi: 10.3109/09513590.2014.946899.

Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Consensus on women’s health aspects of polycystic ovary syndrome (PCOS). Hum Reprod. 2012 Jan;27(1):14-24. doi: 10.1093/humrep/der396.

Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obster Gynecol. 1935;29(2):181-191. doi: 10.1016/S0002-9378(15)30642-6.

Zawadski JK, Dunaif A. Diagnostic criteria for polycystic ovary syndrome: towards a rational approach. In: Dunaif A, Givens JR, Haseltine FP, Merriam GR, editors. Polycystic Ovary Syndrome. Boston: Blackwell Scientific Publications; 1992. pp. 377-384.

Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to Polycystic Ovary Syndrome (PCOS). Hum Reprod. 2004 Jan;19(1):41-47. PMID: 14688154.

Fauser BC, Tarlatzis BC, Rebar RW, at al. Consensus on women's health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group. Fertil Steril. 2012 Jan;97(1):28-38.e25. doi: 10.1016/j.fertnstert.2011.09.024.

Kamins'kyj VV, Tatarchuk TF, Dubossarska YuO. National consensus on the management of patients with hyperandrogenism. Reproductive Endocrinology. 2016;4(30):19-31. doi: 10.18370/2309-4117.2016.30.19-31. (in Ukrainian).

World Health Organization. Global Database on Body Mass Index. BMI classification. Available from: http://apps.who.int/bmi/index.jsp?introPage=intro_3.html.

Bode D, Seehusen DA, Baird D. Hirsutism in women. Am Fam Physician. 2012 Feb 15;85(4):373-80. PMID: 22335316.

Сonway G, Dewailly D, Diamanti-Kandarakis E, et al. The polycystic ovary syndrome: a position statement from the European Society of Endocrinology. Eur J Endocrinol. 2014 Oct;171(4):P1-29. doi: 10.1530/EJE-14-0253.

Levy JC, Matthews DR, Hermans MP. Correct homeostasis model assessment (HOMA) evaluation uses the computer program. Diabetes Care. 1998 Dec;21(12):2191-2. PMID: 9839117.

Department of Reproductive Health, World Health Organization. Medical eligibility criteria for contraceptive use. 5th ed. Geneva: WHO Press; 2015. 269 p.

Urbanovych AM. Effect of metformin therapy on the levels of certain adipose tissue hormones and mediators of nonspecific generalized inflammation in patients with newly diagnosed type 2 diabetes. Mìžnarodnij endokrinologìčnij žurnal. 2015;4(68):34-38. doi: 10.22141/2224-0721.4.68.2015.75009. (in Ukrainian).

Legro RS, Arslanian SA, Ehrman DA, et al. Diagnosis and treatment of polycystic ovary syndrome: an Endocrine Society clinical practice guidelines. J Clin Endocrinol Metab. 2013 Dec;98(12):4565-92. doi: 10.1210/jc.2013-2350.

Gambineri A, Patton L, Vaccina A, et al. Treatment with flutamide, metformin, and their combination added to a hypocaloric diet in overweight-obese women with polycystic ovary syndrome: a randomized, 12-month, placebo-controlled study. J Clin Endocrinol Metab. 2006 Oct;91(10):3970-80. doi: 10.1210/jc.2005-2250.

Thessaloniki ESRE/ASRM-Sponsored PCOS Consensus Workshop Group. Consensus on infertility treatment related to polycystic ovary syndrome. Hum Reprod. 2008 Mar;23(3):462-77. doi: 10.1093/humrep/dem426.