Managing polycystic ovary syndrome | |
Polycystic ovary syndrome. Gabor T Kovacs (editor). Cambridge: Cambridge University Press, 2000 (217 pp). ISBN: 0 521 66073 4. |
At first glance,
Polycystic ovary syndrome might seem like a book for the subspecialist gynaecologist or reproductive endocrinologist only. However, one does not need to delve very far into the book to appreciate that in fact polycystic ovary syndrome (PCOS) is perhaps the most common of all endocrine disorders, a major cause of infertility in women and an important metabolic disturbance. It not only presents often to the general practitioner, with its diverse manifestations of acne, hirsutism, obesity, amenorrhoea or infertility, but it is most often the general practitioner or general gynaecologist who is responsible for ongoing management of the condition, even when a sub-specialist is initially involved. The syndrome has important implications for later health — diabetes, cardiovascular disease, hypertension, complications of pregnancy and endometrial cancer have all been associated with PCOS. It is now recognised as a familial condition and long-term monitoring of patients and relatives may be in order. It is therefore of great interest to a wide range of medical practitioners. It is therefore fortunate that this book is extremely readable, well presented, and not at all daunting for the generalist, while also providing enough detail for the specialist. Professor Gabor Kovacs, of Monash University, has had an interest in PCOS for 25 years; he has gathered material from more than 30 experts in the field, and organised chapters so that history, clinical presentations, lifestyle issues and management are easily accessible to those seeking an overview of the subject. The treatment of acne and hirsutism and the value of programs for modest but sustained weight loss are dealt with succinctly. There are well-researched and annotated accounts of the genetic basis of PCOS, as so far elucidated, ultrasound diagnosis, current concepts of laparoscopic treatment, ovulation induction and the use of IVF. A short but exciting chapter looks at developments in assisted-reproduction techniques and their possible future application to women with PCOS. References are comprehensive but not intrusive and the style is fluent throughout. Kovacs has made a valuable contribution to generalist and specialist understanding of this complex syndrome. Caroline de Costa
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