Polycystic Ovary Syndrome (PCOS) - From in Utero to Menopause

Polycystic ovary syndrome (PCOS) usually presents during the reproductive years with hyperandrogenism, oligo-anovulation and/or polycystic ovaries on ultrasonography. The identification of PCOS was largely restricted to these reproductive years earlier. However, with improved understanding of the disease, currently there is data to describe the PCOS phenotype from infancy up to the post menopausal years. The spectrum of presentation of PCOS phenotype changes across the life span of a given individual. Early identification of high risk individuals during childhood and pre-pubertal years will enable the clinician to incorporate therapeutic or lifestyle preventive measures at an earlier age. Intra uterine programming of the foetus exposed to elevated testosterone and gestational hyperglycemia are also being shown to contribute significantly to the phenotypic expression in later years. The data on post menopausal women with PCOS is also increasing. Contrary to what was expected, except for a subgroup of women with persistent hyperandrogenism, available data does not seem to indicate an increase in cardiovascular morbidity or all cause mortality among post menopausal women with previous history suggestive of PCOS.