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Year : 2014  |  Volume : 139  |  Issue : 4  |  Page : 653-654

Polycystic ovary syndrome: Novel insights into causes and therapy

Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India

Date of Web Publication9-Jun-2014

Correspondence Address:
Alka Kriplani
Department of Obstetrics & Gynaecology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029
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Source of Support: None, Conflict of Interest: None

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How to cite this article:
Kriplani A, Kachhawa G. Polycystic ovary syndrome: Novel insights into causes and therapy. Indian J Med Res 2014;139:653-4

How to cite this URL:
Kriplani A, Kachhawa G. Polycystic ovary syndrome: Novel insights into causes and therapy. Indian J Med Res [serial online] 2014 [cited 2021 Apr 23];139:653-4. Available from:

D. Macut, M. Pfeifer, B.O. Yildiz, E. Diamanti-Kandarakis, editors (Karger, Basel, Switzerland) 2013. 176 pages. Price: CHF 169.00 / US$ 199.00

ISBN 978-3-318-0-2238-4

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women and is now recognized as an important metabolic as well as reproductive disorder conferring substantially increased risk for type 2 diabetes and cardiovascular events later in life apart from menstrual problems and infertility. The aetiology of the syndrome remains obscure, and the variability in phenotype expression continues to render the clinical care and research concerning this heterogeneous condition challenging. This book on PCOS has 12 chapters authored by 28 distinguished internationally acclaimed European experts. Each chapter starts with an introduction of the topic followed by detailed evaluation of the recent studies and advanced research and ends with a brief summary of relevant conclusion and future insights into research along with a complete list of references for quick guide.

The expansion of the diagnostic criteria for PCOS has added additional phenotypes to the diagnosis and one of the highlights of the book is the very first chapter on phenotypes and diagnostic approach. The authors present a comprehensive review of the interpretation of diagnostic criteria, which is further complicated in adolescents and perimenopausal population as the pubertal status, changing age and body mass index may affect the interpretation of these findings. At the same time, the authors have evaluated in detail the recent developments in identifying the phenotypic expression resulting in an individualized approach to recognize its phenotypic variability and presented it in a simplified form for the readers.

The most exciting advance in the field is the recognition that PCOS is a highly heritable complex genetic trait. The chapter on genetics uses an integrative approach pertaining to the complex genetic, metabolic, and cardiovascular aspects related to PCOS. Though the literature on the genetics of PCOS is still emerging, the authors have meticulously tried to collect reasonable evidence to hypothesize that at least some of the variants of PCOS have a genetic background.

The long-term health consequences of PCOS are a concern particularly in the background of the current obesity pandemic. The major part of the book is devoted to providing insights into metabolic, endocrine and biochemical derangements as a consequence of or leading to metabolic abnormalities in women with PCOS. Authors, through many of these chapters have tried to provide evidence and simplify the correlation between body mass, insulin resistance and development of DM and cardiovascular risk. The inclusion of chapters on obesity, dyslipidaemia and endothelial markers stresses the need to evaluate and manage these women for these risk factors. The authors have stressed on the point that in simple terms, these women are at a greater risk for insulin resistance, type 2 diabetes, and vascular disease as compared with their non-PCOS counterparts. Thus, women with PCOS require more regular screening for such risks as well as effective and targeted lifestyle advice. The identification, evaluation and management of cardiovascular and metabolic risk factors are discussed in detail, which give an insight to educate these young women for long-term health benefits, apart from treating them for immediate reproductive symptoms. Chapters on insulin sensitizers and oral contraceptive pills provide clear guidelines for an individualized approach of treatment.

The role of vitamin D and its effect on insulin resistance in women with PCOS is emerging and it would have been better to discuss this upcoming topic. Vitamin D deficiency is common (67-85%) in women with PCOS and several studies have demonstrated associations between vitamin D levels and various PCOS symptoms, including insulin resistance, infertility and hirsutism. Though the role of vitamin D in the aetiopathogenesis of PCOS is still largely speculative evidence for the correlation between vitamin D and insulin resistance is emerging and the authors could have discussed this association for the benefit of the readers.

The issue of quality of life and the psychological effect of the disease on young adolescent women is an important issue which could have been discussed. It has been shown in various studies that women with PCOS think differently, especially in regards to their feminity, and there is increased incidence of depressive disorder, social phobia, self-reported hirsutism in adolescents, and infertility. Clinicians should be aware of these psychological symptoms in these young girls and should address these issues so as to provide quality care for these women.

The book is in an easy to read format with 11 figures and 10 tables. Every chapter has been extensively referenced and updated, and covers recent developments in phenotypic variations, underlying pathophysiological mechanisms, obscure diagnostic criteria, hyperinsulinemic insulin resistance; newer management modalities for reproductive aspects and long-term risk of diabetes and cardiovascular events.

Overall, this book is a reference text in the form of a handbook for all clinicians with an interest in reproductive endocrinology, including general practitioners, gynaecologists, paediatricians, cardiologists and endocrinologists.


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