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1. Polycystic ovary syndrome (PCOS) is the most common endocrine disturbance in women of reproductive age, affecting an estimated seven percent of all women.

2. No one knows exactly what causes PCOS. Women with PCOS often have a mother or sister with PCOS, but there is not enough evidence to say there is a definite genetic link to the disorder.

3. During the normal ovulatory process, an egg matures in an ovarian follicle, which then ruptures and releases the egg. In women with PCOS, high levels of hormones called androgens halt the follicle's development, leaving a small follicle containing the immature egg. These follicles--whose appearance is sometimes likened to a string of pearls--are the cysts observed via ultrasound in PCOS. Many women with PCOS will have polycystic ovaries, but it is possible to be diagnosed with the syndrome without this sign. Some health care professionals diagnose PCOS based on other symptoms or hormone abnormalities, regardless of ultrasound findings.

4. Many PCOS symptoms are the result of high levels of androgens. These hormones are often called "male hormones" even though they are found in both men and women. Androgens include testosterone, DHT and androstenedione. Other hormones such as dehydroepiandrosterone (DHEA) and DHEA sulfate (DHEAS) can be converted into testosterone or DHT.

5. PCOS is strongly linked to obesity and insulin resistance (a precursor to type 2 diabetes). For women with PCOS who are obese, the treatment plan should incorporate a diet and exercise program. About 45 percent of women with PCOS who are obese have insulin resistance (35 percent) or type 2 diabetes (10 percent).

6. Women with PCOS are at very high risk for developing type 2 diabetes. The syndrome may also increase the risk for heart disease, although long-term, definitive studies have yet to be completed.

7. If you are overweight, losing weight is a major step toward lowering your risk for diabetes and heart disease. Losing weight can help restore regular periods and improve other hormonal imbalances, but weight loss is often an incomplete solution to PCOS.

8. If irregular and/or infrequent menstruation is a problem, birth control pills (typically incorporating estrogen and progestogen) or periodic courses of progestin alone can probably get you on schedule again. During menstruation, the lining of the uterus is shed, providing protection against uterine cancer, so restoring regular periods is essential.

9. PCOS is associated with insulin resistance and diabetes, but not all women who have PCOS are insulin-resistant or diabetic. If you have PCOS, you should also be evaluated for diabetes with both a fasting glucose test and a glucose challenge test with insulin levels. The fasting glucose insulin test is the standard, but that test alone misses about half the women with PCOS who have diabetes or insulin resistance.

10. Occasionally, symptoms are the result of an androgen-producing tumor. If symptoms are severe or progress rapidly, or your testosterone level is above 150 ng/dL or your cortisol level is elevated, your health care professional may want to investigate further.