Premature progesterone rise as a trigger of polycystic ovarian syndrome
Article In Press
Dmitri I. Dozortsev, M.D., Ph.D., Antonio Pellicer, M.D., Michael P. Diamond, M.D.
Originally described as Stein-Leventhal syndrome, polycystic ovarian syndrome (PCOS) is a very common condition in women of reproductive age, characterized by hyperandrogenism, insulin resistance, the presence of multiple ovarian cysts, and irregular menstrual cycles with accompanying infertility. There is currently a consensus that genetic and epigenetic factors as well as intrauterine environment create a predisposition to PCOS (1). However, there is no agreement on whether the ovarian cysts are the cause or the result of the hyperandrogenism and insulin resistance or even whether the cysts should be used as a part of diagnostic criteria (1). We believe that a recent change in understanding the role of progesterone (P) in ovulation lends credence to the idea that ovarian cysts are the cause of other PCOS presentations and may hold a key to solving the PCOS conundrum.