Polycystic ovary syndrome (PCOS) is a heterogeneous and complex disorder that has both adverse reproductive and metabolic implications for affected women. However, there is generally poor understanding of its etiology. Varying expert-based diagnostic criteria utilize some combination of oligo-ovulation, hyperandrogenism, and the presence of polycystic ovaries. Criteria that require hyperandrogenism tend to identify a more severe reproductive and metabolic phenotype. The phenotype can vary by race and ethnicity, is difficult to define in the perimenarchal and perimenopausal period, and is exacerbated by obesity. The pathophysiology involves abnormal gonadotropin secretion from a reduced hypothalamic feedback response to circulating sex steroids, altered ovarian morphology and functional changes, and disordered insulin action in a variety of target tissues. PCOS clusters in families and both female and male relatives can show stigmata of the syndrome, including metabolic abnormalities. Genome-wide association studies have identified a number of candidate regions, although their role in contributing to PCOS is still largely unknown.
Scientific Statements educate basic scientists, clinical scientists, and clinicians on the scientific basis of disease and on how this knowledge can be applied in clinical practice. These publications provide an evidence-based overview of basic and clinical science topics and identify areas that require additional research. Topics are selected on the basis of their emerging scientific impact on disease and their clinical relevance to the general population. Scientific Statements are developed by a multidisciplinary Task Force of experts with representation from several committees within the Endocrine Society.