Toward a new approach: primary and preventive care of the woman with polycystic ovarian syndrome.

Polycystic ovarian syndrome (PCOS), characterized by chronic anovulation and hyperandrogenism, affects approximately 5%-10% of reproductive-age women. The reproductive consequences of this syndrome, such as menstrual irregularities and infertility, are well understood and managed by obstetrician/gynecologists. However, less is known about the metabolic consequences of PCOS. As primary physicians for women, we are obligated to promote disease prevention. This can be done by recognizing the significant impact that the metabolic consequences of PCOS have on long-term health while continuing to recognize and treat the reproductive abnormalities. This article reviews the metabolic consequences of PCOS, discusses the use of insulin-sensitizing agents in PCOS, and discusses the role of the obstetrician/gynecologist in the primary and preventive care of women with PCOS.