Endocrinopathies and other disorders inducing a polycystic ovary syndrome phenotype

Amongst the commonest endocrine symptoms encountered in premenopausal women are those related to excessive androgen secretion or action, along with menstrual irregularity. The vast majority of women presenting with such symptoms will be found to have the polycystic ovary syndrome (PCOS), a disorder characterized by specific clinical, endocrine and ultrasonographic features. PCOS is regarded as a state of 'functional hyperandrogenism', as no distinct source of autonomous androgen secretion is identified and is commonly associated with insulin resistance. This later feature may also be related to some long-term sequelae of the syndrome that are associated with metabolic abnormalities and excessive cardiovascular morbidity. Although PCOS in the short-term is regarded as a 'benign' disease, a proportion of patients may harbor other underlying disorders that can be life-threatening, requiring prompt diagnosis and treatment. Adrenal and ovarian androgen-secreting tumors, adrenal and ovarian steroidogenic deficiencies along with other medical or endocrine conditions, particularly in the presence of insulin resistance, can exhibit similar clinical, endocrine and/or ultrasonographic features to PCOS. Their early identification is based on the presence of distinct features and a high index of suspicion.