Polycystic ovary syndrome: update on diagnosis and treatment

Am J Med. 2014 Oct;127(10):912-9. doi: 10.1016/j.amjmed.2014.04.017. Epub 2014 May 21.


Polycystic ovary syndrome is now a well-recognized condition affecting 6%-25% of reproductive-aged women, depending on the definition. Over the past 3 decades, research has launched it from relative medical obscurity to a condition increasingly recognized as common in internal medicine practices. It affects multiple systems, and requires a comprehensive perspective on health care for effective treatment. Metabolic derangements and associated complications include insulin resistance and diabetes, hyperlipidemia, hypertension, fatty liver, metabolic syndrome, and sleep apnea. Reproductive complications include oligo-/amenorrhea, sub-fertility, endometrial hyperplasia, and cancer. Associated psychosocial concerns include depression and disordered eating. Additionally, cosmetic issues include hirsutism, androgenic alopecia, and acne. This review organizes this multi-system approach around the mnemonic "MY PCOS" and discusses evaluation and treatment options for the reproductive, cosmetic, and metabolic complications of this condition.

Keywords: Hirsutism; Insulin resistance; Irregular menses; Oligomenorrhea; PCOS; Polycystic ovary syndrome; Treatment.

Publication types

  • Review

MeSH terms

  • Anovulation / complications
  • Anovulation / etiology*
  • Contraceptives, Oral, Hormonal / therapeutic use*
  • Depression / etiology
  • Diet
  • Exercise
  • Female
  • Health Behavior
  • Hirsutism / etiology
  • Humans
  • Hyperandrogenism / complications
  • Hyperandrogenism / etiology*
  • Hypertension / etiology
  • Insulin Resistance
  • Menstruation Disturbances / etiology
  • Metabolic Diseases / etiology
  • Polycystic Ovary Syndrome / diagnosis*
  • Polycystic Ovary Syndrome / physiopathology
  • Polycystic Ovary Syndrome / therapy*
  • Sleep Apnea Syndromes / etiology
  • Weight Loss


  • Contraceptives, Oral, Hormonal