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[The ovary and insulin resistance]
J Belaisch1, J P Allart, C Nahmanovici
1jean.belaisch@wanadoo.fr
Gynecologie, Obstetrique & Fertilite
|December 6, 2001
Summary
Polycystic ovary syndrome (PCOS) involves insulin resistance and excess LH, leading to androgen production. Diagnosis uses ultrasounds, and management requires endocrinological supervision due to metabolic complications.
Area of Science:
- Reproductive Endocrinology
- Metabolic Disorders
Background:
- Polycystic ovary syndrome (PCOS) is linked to insulin resistance and abnormal ovarian stimulation by luteinizing hormone (LH).
- Excess androgen production by the ovarian stroma is a key symptom.
- Diagnosis often relies on ultrasound, revealing increased ovarian volume and stromal vascularity.
Purpose of the Study:
- To review the multifaceted nature of PCOS, including its causes, diagnosis, and management.
- To highlight the metabolic complications and the need for endocrinological supervision.
- To discuss recent findings on PCOS across all life stages and its hereditary aspects.
Main Methods:
- Literature review focusing on the pathophysiology, diagnosis, and treatment of PCOS.
- Analysis of current research on ovarian hyperstimulation syndrome and metabolic complications.
- Examination of recent studies on the extended age range and hereditary nature of PCOS.
Main Results:
- PCOS pathogenesis involves both insulin resistance and LH excess, often in combination.
- Ultrasound findings include increased ovarian volume and stromal vascularity.
- Increased frequency of ovarian hyperstimulation syndrome and significant metabolic complications necessitate medical supervision.
Conclusions:
- PCOS affects individuals across their lifespan, from intrauterine life to post-menopause, and has a hereditary component.
- Surgical and laparoscopic ovulation induction methods show promise in clomiphene-resistant cases.
- Metformin administration has demonstrated benefits in managing PCOS.