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Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications

Published online by Cambridge University Press:  30 January 2008

Evanthia Diamanti-Kandarakis
Affiliation:
University of Athens Medical School, Mikras Asias 75, Goudi 115-27, Athens, Greece. Tel: +30 210 8133318; Fax: +30 210 8130031; E-mail: akandara@otenet.gr

Abstract

Polycystic ovarian syndrome (PCOS) is universally recognised as the commonest endocrinopathy of women. The definition and the aetiological hypotheses of PCOS are continuously evolving to accommodate expanding knowledge on the syndrome, which is now known to be more complex than purely a reproductive disorder. Increased androgen synthesis, disrupted folliculogenesis and insulin resistance lie at the pathophysiological core of PCOS. An intriguing concept involves the perpetuation of a vicious circle with endocrine/reproductive and metabolic components. An unfavourable metabolic environment may unmask genetic traits of ovarian dysfunction, and the unfolding endocrine derangement could further aggravate the metabolic disarray. This article reviews the molecular mechanisms known to underlie the ovarian and metabolic abnormalities characterising PCOS. The putative interdependence between reproductive and metabolic aspects of PCOS, and therapeutic implications for the management of PCOS, are also discussed.

Type
Review Article
Copyright
Copyright © Cambridge University Press 2008

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References

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Further reading, resources and contacts

The Androgen Excess Society Site offers information on every aspect of androgen excess disorders, such as the polycystic ovary syndrome, nonclassic adrenal hyperplasia, idiopathic hirsutism and premature adrenarche, based on original clinical and basic research:

Diamanti-Kandarakis, E. and Papavassiliou, A.G. (2006) Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med 12, 324-32CrossRefGoogle ScholarPubMed
Diamanti-Kandarakis, E. et al. (2007) Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab 18, 280-285CrossRefGoogle ScholarPubMed
Pasquali, R. (2006) Obesity and androgens: fact and perspectives. Fertil Steril 85, 1319-1340CrossRefGoogle Scholar
Diamanti-Kandarakis, E. and Papavassiliou, A.G. (2006) Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med 12, 324-32CrossRefGoogle ScholarPubMed
Diamanti-Kandarakis, E. et al. (2007) Pathophysiology and types of dyslipidemia in PCOS. Trends Endocrinol Metab 18, 280-285CrossRefGoogle ScholarPubMed
Pasquali, R. (2006) Obesity and androgens: fact and perspectives. Fertil Steril 85, 1319-1340CrossRefGoogle Scholar