Beyond the Label: A Patient-Centred Approach to Polycystic Ovary Syndrome

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. Importantly, it is not one disease with a single pathophysiology but is instead a heterogeneous syndrome with several underlying biological mechanisms. Careful diagnosis requires attention to the key symptom of androgen excess as well as the exclusion of similar disorders including hyperprolactinemia, late-onset congenital adrenal hyperplasia, and hypothalamic amenorrhea. A patient-centred approach to treatment requires further assessment of underlying drivers and mechanisms including neuroendocrine disturbance, insulin resistance, and adrenal hyperresponsiveness.