Understanding and managing Polycystic Ovarian Syndrome (PCOS) 
by Sam Thatcher, M.D., Ph.D.

Polycystic ovarian syndrome (PCOS) is a complex hormonal disturbance that affects the entire body and has numerous implications for general health. For far too long, PCOS has been in the “closet,” underestimated both in prevalence and importance. Now, with a better understanding of the spectrum of the disorder and armed with new treatment options, PCOS is starting to receive the attention it deserves. Interest, research and most importantly, recognition are increasing in a number of medical disciplines including gynecology, reproductive medicine, internal medicine, endocrinology, dermatology, genetics, pediatrics, radiology, and family medicine. Still, it is quite possible that we are still at the tip of the iceberg as we look at the consequences of PCOS on long-term health and disease.

It has been said that PCOS is the most common hormonal disturbance of premenopausal women and certainly it is a leading cause of infertility. Depending on how the disorder is defined, from five to 30 percent of all women have some characteristic of PCOS.

There are three broad reasons why PCOS patients seek medical care: Menstrual cycle disturbance and infertility; problems of appearance and self esteem arising from obesity and excessive hair growth, and metabolic derangements, including abnormalities in blood fat (lipid) levels, insulin/glucose (sugar), and elevated blood pressure (hypertension).

Often gynecologists, the health care provider to whom many women turn for help, have concerned themselves with only the first of these concerns and have been relatively insensitive to the latter two. Generalists have often failed to make, or understand, the relationship of the different faces of PCOS. A more holistic approach to PCOS is certainly warranted and can have a significant effect in altering quality of life.

• History & Terminology
• Making the Diagnosis of PCOS
  • Clinical findings
  • Laboratory Testing
  • Ultrasound
• Pregnancy & PCOS Therapy & PCOS
  • Weight Loss
  • Progestins
  • Oral Contraceptives
  • Corticosteroids
  • Anti-Androgens
  • GnRH Analogs
  • Fertility Therapy
  • Surgical Therapy
  • Comesis
  • Insulin-Altering Agents
• Causes of PCOS
  • PCOS & Insulin Resistance
  • It’s in the genes

Editor’s note: Sam Thatcher, M.D., Ph.D. director of the Center for Applied Reproductive Science in Johnson City, TN, is the author of PCOS: The Hidden Epidemic, published by Perspectives Press. In addition to serving on INCIID’s Advisory Board, Dr. Thatcher co-moderates INCIID’s PCOS Forum, and contributes Thatcher’s Thoughts as a regular column. For additional information about PCOS please see the PCOS FAQ.