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Polycystic ovary syndrome and abnormal glucose tolerance

Helena J Teede and Bronwyn G A Stuckey
Med J Aust 2007; 187 (6): . || doi: 10.5694/j.1326-5377.2007.tb01271.x
Published online: 17 September 2007

Potentially serious metabolic sequelae make diagnosis and intervention imperatives

Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality of women of reproductive age. The diagnosis is based on the presence of two of three criteria — ovulatory disturbance, hyperandrogenism, and polycystic ovaries on ultrasound. However, in most women, insulin resistance is central to the pathogenesis of the syndrome, with hyperinsulinaemia driving both androgen production and androgen bioavailability as the key diagnostic feature.1-3 In PCOS, insulin resistance not only contributes to symptoms, but also has serious sequelae including infertility, impaired glucose tolerance, a fourfold to sevenfold increase in diabetes and a potentially increased risk of cardiovascular disease.3


  • 1 Southern Health, Melbourne, VIC.
  • 2 The Jean Hailes Foundation for Women’s Health, Monash Institute of Health Services Research, Monash University, Melbourne, VIC.
  • 3 Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA.
  • 4 Keogh Institute for Medical Research, Perth, WA.
  • 5 School of Medicine and Pharmacology, University of Western Australia, Perth, WA.



  • 1. Diamanti-Kandarakis E, Papavassiliou AG. Molecular mechanisms of insulin resistance in polycystic ovary syndrome. Trends Mol Med 2006; 12: 324-332.
  • 2. Azziz R, Carmina E, Dewailly D, et al. Criteria for defining polycystic ovary syndrome as a predominantly hyperandrogenic syndrome: an Androgen Excess Society Guideline. J Clin Endocrinol Metab 2006; 91: 4237-4245.
  • 3. Teede H, Zoungas S, Hutchison S, Meyer C. Insulin resistance, metabolic syndrome, diabetes and cardiovascular disease in polycystic ovary syndrome. Endocrine 2006; 30: 45-53.
  • 4. Azziz R, Marin C, Hoq L, et al. Health care-related economic burden of the polycystic ovary syndrome during the reproductive life span. J Clin Endocrinol Metab 2005; 90: 4650-4658.
  • 5. Dabadghao P, Roberts BJ, Wang J, et al. Glucose tolerance abnormalities in Australian women with polycystic ovary syndrome. Med J Aust 2007; 187: 328-331. <MJA full text>
  • 6. Twigg SM, Kamp MC, Davis TM, et al. Prediabetes: a position statement from the Australian Diabetes Society and Australian Diabetes Educators Association. Med J Aust 2007; 186: 461-465. <MJA full text>
  • 7. Norman RJ, Davies MJ, Lord J, Moran LJ. The role of lifestyle modifications in polycystic ovary syndrome. Trends Endocrinol Metab 2002; 13: 251-257.
  • 8. Clark AM, Thornley B, Tomlinson L, Galletly C. Weight loss in obese infertile women results in improvement in reproductive outcome for all forms of fertility treatment. Hum Reprod 1998; 13: 1502-1505.
  • 9. Knowler W, Barrett-Connor E, Fowler S, et al. Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 2002; 346: 393-403.
  • 10. Lord JM, Flight I, Norman R. Metformin in polycystic ovary syndrome: systematic review and meta-analysis. BMJ 2003; 327: 951-956.
  • 11. Meyer C, McGrath B, Teede HJ.The effects of medical therapy on insulin resistance and the cardiovascular system in polycystic ovarian syndrome. Diabetes Care 2007; 30: 471-478.
  • 12. Palomba S, Orio F, Falbo A, et al. Prospective parallel randomized, double-blind, double-dummy controlled clinical trial comparing clomiphene citrate and metformin as the first-line treatment for ovulation induction in nonobese anovulatory women with polycystic ovary syndrome. J Clin Endocrinol Metab 2005; 90: 4068-4074.
  • 13. Cussons AJ, Stuckey BGA, Walsh JP, et al. Polycystic ovarian syndrome: marked differences between endocrinologists and gynaecologists in diagnosis and management. Clin Endocrinol (Oxf) 2005; 62: 289-295.

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