Polycystic Ovary Syndrome (PCOS). This post will cover the points you need to know for your board exams as well as for teaching residents on the daily rounds. Please don't use the information here to treat your patients.
Presents usually with various combinations of obesity, insulin resistance, oligomenorrhea, acne and hirsutism. Pelvic ultrasound usually shows polycystic ovaries. Usually, a clinical diagnosis and lab finding are not always typical but might have elevated LH/FSH ration and increased testosterone.
Mainstay of treatment is weight loss to decrease insulin resistance and hence decrease the androgenic effect of insulin on the ovaries. If pregnancy is not desired start treatment with Oral contraceptive pills. If no response, then use antiandrogen like spironolactone. If pregnancy is desired, then start with metformin. Spironolactone shouldn't be prescribed if pregnancy is desired due to antiandrogen effects on the male fetus.
For more information about PCOS, you can try this book about Polycystic Ovary Syndrome.
The information in this post is not for patients and shouldn't be used in treating patients. Please refer to your doctor for medical advice.