Expert Reviews in Molecular Medicine: http://www.expertreviews.org/
DOI: 10.1017/S1462399408000598; 30 January 2008
Evanthia Diamanti-Kandarakis (2008) Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications. Expert Rev. Mol. Med. Vol. 10, e3, DOI: 10.1017/S1462399408000598

Polycystic ovarian syndrome: pathophysiology, molecular aspects and clinical implications

Evanthia Diamanti-Kandarakis ^a1

^a1 University of Athens Medical School, Mikras Asias 75, Goudi 115-27, Athens, Greece. Tel: +30 210 8133318; Fax: +30 210 8130031; E-mail: akandara@otenet.gr

Polycystic ovarian syndrome (PCOS) is universally recognised as the commonest endocrinopathy of women. The definition and the aetiological hypotheses of PCOS are continuously evolving to accommodate expanding knowledge on the syndrome, which is now known to be more complex than purely a reproductive disorder. Increased androgen synthesis, disrupted folliculogenesis and insulin resistance lie at the pathophysiological core of PCOS. An intriguing concept involves the perpetuation of a vicious circle with endocrine/reproductive and metabolic components. An unfavourable metabolic environment may unmask genetic traits of ovarian dysfunction, and the unfolding endocrine derangement could further aggravate the metabolic disarray. This article reviews the molecular mechanisms known to underlie the ovarian and metabolic abnormalities characterising PCOS. The putative interdependence between reproductive and metabolic aspects of PCOS, and therapeutic implications for the management of PCOS, are also discussed.

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