Period irregularities and infertility

      Most patients in whom polycystic ovaries syndrome is ultimately diagnosed initially present with amenorrhoea, irregular menses or infertility. Although most patients present in their 20s or 30s, polycystic ovarian disease can affect females of any age, from menarche to menopause. Findings in almost 75% of patients meet the imaging studies like USG,CT,MRI criteria for polycystic ovary syndrome. Primary amenorrhoea is a well known but uncommon presentation.

      Although infertility is the most common presentation, polycystic ovaries syndrome may be associated with obesity and insulin resistance, among other symptoms. A number of patients are identified only when they present with unrelated complaints. These patients may believe that the symptoms associated with the syndrome are not of sufficient clinical significance to warrant medical attention.

      A second population of patients presents with systemic signs of androgen excess, namely, hirsuitism, acne, or male-pattern baldness. In approximately one half of the patients, sonograms show polycystic ovaries.

      Additionally, a significant number of patients with unrelated complaints are incidentally found to have polycystic ovaries. Further detailed clinical evaluation reveals that approximately one half of the patients in this group have typical signs and symptoms of the syndrome (ie, hirsutism, acne, infertility) and that one-quarter have related symptoms such as obesity, irregular menses, or insulin resistance. The remaining one-quarter of the patients may not have any clinically evident abnormality.