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Polycystic ovary syndrome: a new direction in treatment
by Warren Kidson MJA 1998; 169: 537-540
Key points from his paper, submitted "For Debate" . But there has been no debate! Kidson is right!
Polycystic ovary syndrome is a diagnosis made in 5%-10% of women;
they may present with oligomenorrhoea or amenorrhoea, anovulation or infertility, hirsutism or acne;
they.have at least seven times the risk of myocardial infarction and ischaemic heart disease; by the age of 40 years up to 40% will have type 2 diabetes or impaired glucose tolerance.
Polycystic ovary syndrome is associated with insulin resistance, with consequent hyperinsulinaemia.
Insulin resistance in polycystic ovary syndrome is not due primarily to obesity (as lean women with polycystic ovary syndrome are insulin resistant) or to hyperandrogenism. (as androgen blockade reduces insulin resistance by only 10%-15%)
Insulin resistance can also be assessed by the serum insulin response to an oral glucose load during an oral glucose tolerance test, peak serum insulin levels above 100 mU/L (718 pmol/L) being highly suggestive of insulin resistance.
For full text of article in MJA click here.