02-02-2007.

Debe sospecharse este síndrome, si hay: a)alteraciones mestruales, b)criterios clínicos y de laboratorio de hiperandrogenismo, c)presencia de quistes en ovario.

Hallar cosas aisladas, no es suficiente (quistes, hiperandrogenismo.

Tenga en cuenta que:

DHEAS, es normal en 50% de las pacientes con el sindrome.
LH/FSH, es normal en 50% de las pacientes con el sindrome

El examen más recomendado, es testosterona libre y total, a no ser que signos clínicos hagan muy sospechoso el hiperandrogenismo.

Ya se están descubriendo los genes responsables.

TREATMENT
Treatment of PCOS focuses on the symptoms that occur in each individual. Risk reduction for diabetes and heart disease is important. A number of treatments are available:

• Weight loss and exercise can help to manage diabetes and high blood pressure and reduce risk of development of cardiovascular disease and stroke. Weight loss and exercise are also crucial to prevent type 2 diabetes. Medications may be prescribed to control blood pressure.
  
• Stopping smoking reduces risk of cardiac disease.
  
• Treating type 2 diabetes may involve oral medications and insulin if diet and exercise do not control elevated blood sugar levels.
  
• Oral contraceptives (birth control pills) regulate menstrual periods and suppress androgen (the hormone that causes excess body and facial hair growth in women).
  
• Metformin, an oral medication often used in treating type 2 diabetes, improves insulin resistance even if diabetes is not yet present, decreases androgen, and improves ovulation.
  
• Spironolactone is a diuretic that decreases androgen and treats acne and hirsutism.
  
• Mechanical methods (plucking, shaving, depilatory products) help to manage excessive hair growth. Laser treatments and prescription creams may also be prescribed for women with hirsutism.
  
  Ref:
  
  Polycystic Ovary Syndrome
  Janet M. Torpy, Cassio Lynm, and Richard M. Glass
  JAMA. 2007;297:554.
  
  Jairo Mesa Cock