Polycystic ovary syndrome


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Polycystic ovary syndrome


Adrenal gland disorders

Congenital adrenal hyperplasia

Primary adrenal insufficiency

Waterhouse-Friderichsen syndrome


Adrenal cortical carcinoma

Cushing syndrome

Conn syndrome

Thyroid gland disorders

Thyroglossal duct cyst


Graves disease

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Parathyroid gland disorders





Pancreatic disorders

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Pituitary adenoma






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Sheehan syndrome


Constitutional growth delay

Diabetes insipidus

Syndrome of inappropriate antidiuretic hormone secretion (SIADH)

Gonadal dysfunction

Precocious puberty

Delayed puberty

Premature ovarian failure

Polycystic ovary syndrome

Androgen insensitivity syndrome

Kallmann syndrome

5-alpha-reductase deficiency

Polyglandular syndromes

Autoimmune polyglandular syndrome type 1 (NORD)

Endocrine tumors

Multiple endocrine neoplasia

Pancreatic neuroendocrine neoplasms

Zollinger-Ellison syndrome

Carcinoid syndrome



Opsoclonus myoclonus syndrome (NORD)

Endocrine system pathology review

Adrenal insufficiency: Pathology review

Adrenal masses: Pathology review

Hyperthyroidism: Pathology review

Hypothyroidism: Pathology review

Thyroid nodules and thyroid cancer: Pathology review

Parathyroid disorders and calcium imbalance: Pathology review

Diabetes mellitus: Pathology review

Cushing syndrome and Cushing disease: Pathology review

Pituitary tumors: Pathology review

Hypopituitarism: Pathology review

Diabetes insipidus and SIADH: Pathology review

Multiple endocrine neoplasia: Pathology review

Neuroendocrine tumors of the gastrointestinal system: Pathology review


Polycystic ovary syndrome


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USMLE® Step 1 questions

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High Yield Notes

9 pages


Polycystic ovary syndrome

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USMLE® Step 1 style questions USMLE

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A 30-year-old woman presents to the clinic to establish care. She is starting a new job as a receptionist and wants to "take care of her irregular periods.” Her menarche was at age 14 and she has been having irregular periods since then. Review of systems is significant for deepening of voice. Past medical history is unremarkable. She only takes over the counter multivitamins. Vitals are within normal limits. BMI is 32 kg/m2. Physical examination shows papulo-pustular acne on the face and a receding hairline. Pelvic examination reveals normal external genitalia and a mobile and nontender uterus with no adnexal masses. This patient is at increased risk of developing which of the following?  

External References

First Aid








Polycystic ovarian syndrome (PCOS)

anovulation p. 669

antiandrogens p. 681

clomiphene p. 680

endometrial hyperplasia p. 665

ovarian neoplasm risk p. 670


Content Reviewers

Yifan Xiao, MD


Simone Taylor

Sam Gillespie, BSc

In polycystic ovary syndrome, “poly” means many, and “cystic” refers to cysts.

So you might think that having many ovarian cysts is a crucial part of polycystic ovary syndrome.

But while some people with polycystic ovarian syndrome do have ovarian cysts, ovarian cysts are no longer a necessary characteristic of the condition.

Instead, polycystic ovary syndrome is a dysfunction in the hypothalamic-pituitary-ovarian axis, which are the hormones that regulate the menstrual cycle.

A normal menstrual cycle can be divided into two phases: the follicular phase, which takes place before ovulation, and the luteal phase, which takes place after ovulation.

During the follicular phase, the hypothalamus secretes gonadotropin-releasing hormone, or GnRH.

GnRH makes the anterior pituitary gland secrete two other hormones, called gonadotropins, in roughly equal amounts, which it releases in pulses.

One of these gonadotropins is the luteinizing hormone, or LH.

The other is the follicle-stimulating hormone, or FSH.

LH and FSH travel to the follicles in the ovaries.

The follicles are small clusters of theca and granulosa cells that protect the developing oocyte, or egg.

The theca cells develop LH receptors which allow them to bind LH, and in response they secrete a hormone called androstenedione.

Granulosa cells develop FSH receptors, which allow them to bind to FSH and produce an enzyme called aromatase, which converts the androstenedione into 17β-estradiol - a member of the estrogen family.


Polycystic ovary syndrome or just PCOS, refers to a set of symptoms due to excessive androgen production in women. Signs and symptoms of PCOS include irregular or no menstrual periods, heavy periods, excess body and facial hair, acne, pelvic pain, trouble getting pregnant, and patches of thick, darker, velvety skin. Associated conditions include type 2 diabetes, obesity, obstructive sleep apnea, heart disease, mood disorders, and endometrial cancer. Management for PCOS may involve lifestyle modifications such as diet and exercise, hormone therapy, and medications.


  1. "Robbins Basic Pathology" Elsevier (2017)
  2. "Harrison's Principles of Internal Medicine, Twentieth Edition (Vol.1 & Vol.2)" McGraw-Hill Education / Medical (2018)
  3. "Pathophysiology of Disease: An Introduction to Clinical Medicine 7/E (ENHANCED EBOOK)" McGraw Hill Professional (2014)
  4. "CURRENT Medical Diagnosis and Treatment 2020" McGraw-Hill Education / Medical (2019)
  5. "Harrison's Endocrinology, 4E" McGraw-Hill Education / Medical (2016)
  6. "Genetic, hormonal and metabolic aspects of PCOS: an update" Reproductive Biology and Endocrinology (2016)
  7. "Androgens in Polycystic Ovary Syndrome: The Role of Exercise and Diet" Seminars in Reproductive Medicine (2009)

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