Screening for and Treatment of Polycystic Ovary Syndrome in Teenagers
Exerpt:
Although the first description of polycystic ovary syndrome (PCOS) is generally credited to Stein and Leventhal in 1935,
it may have been observed as early as 1721, when Italian scientist Antonio Vallisneri observed "young married peasant women, moderately obese and infertile, with two larger than normal ovaries, bumpy and shiny, whitish, just like pigeon eggs" (1). This depiction sounds similar to the subfertility and obesity commonly found in PCOS. It was not until 1921 that Achard and Thiers noticed a relationship between hyperandrogenism and insulin resistance in their study of the "bearded diabetic woman" (2). This relationship is present in PCOS in what might be called the "hirsute hyperinsulinemic woman." In 1935, Stein and Leventhal made the connection between amenorrhea and polycystic ovaries. In addition, they noticed the occurrence of "masculinizing changes" in many patients with polycystic ovaries, including hirsutism and acne (3). Several, though not all, of their original case studies involved women who were overweight. In all seven of their case reports, attempts to treat ovulatory dysfunction with estrogenic hormone failed, and wedge resection was employed. Surgery for PCOS is uncommon now, but all of Stein and Leventhal’s patients gained normal menstruation, and two become pregnant. Still, much has changed in the way we understand and treat PCOS.
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