SÍNDROME DE OVARIOS POLIQUÍSTICOS: CONCEPTOS ACTUALES

Emmy Arrue; Dayra Ávila; Juan Raúl Brin

Enviado octubre 18, 2024

Publicado 2026-04-06

Artículos de Investigación

Vol. 18 Núm. 2 (2005): Revista Médico Científica

SÍNDROME DE OVARIOS POLIQUÍSTICOS: CONCEPTOS ACTUALES

Emmy Arrue⁺⁻
Dayra Ávila⁺⁻
Juan Raúl Brin⁺⁻

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DOI: ND

Publicado: 2026-04-06

Derechos de autor 2024 Revista médico científica

Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-CompartirIgual 4.0.

Resumen

El síndrome del ovario poliquístico es la causa de anovulación e hirsutismo más frecuente y la endocrinopatía más común de la población adolescente. Afecta entre 5-10% de mujeres en edad reproductiva. Su diagnóstico requiere la presencia de dos de los siguientes: anovulación crónica con irregularidades menstruales de por lo menos seis meses, hiperandrogenismo clínico y ovarios de apariencia poliquística al ultrasonido. Clásicamente se piensa en el síndrome de ovarios poliquísticos como la triada de oligo/amenorrea, hirsutismo y obesidad. La causa es desconocida; las pacientes con este síndrome cursan con disfunción de múltiples ejes endocrinos. Puede existir resistencia a la insulina, hiperinsulinemia, dislipidemia y niveles séricos elevados del inhibidor de la activación de plasminógeno.

En cuanto al tratamiento, las modificaciones al estilo de vida, tales como restricción de calorías y ejercicio físico, mejoran la sensibilidad a la insulina y los síntomas en mujeres con síndrome de ovarios poliquísticos. Los anticonceptivos orales son fármacos de primera línea, aunque también se emplean hipoglicemiantes orales y drogas antiandrogénicas .

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Franks S. Medical progress: polycystic ovary syndrome. N Engl J Med. 1995;333:853-61.
Ehrmann DA. Medical progress: polycystic ovary syndrome. N Engl J Med. 2005;352:1223-36.
Pfeifer S. Polycystic ovary syndrome. J Pediatr Adolesc Gynecol. 2003;16:259-63.
Aguirre A, Benvenuto G, Urrutia MT. Calidad de vida en mujeres con síndrome de ovario poliquístico. Rev Chil Obstet Ginecol. 2005;70(2):103-7.
Avvad CK, Holeuwerger R, Silva VCG, Bordalo MAN, Breitenbach MMD. Menstrual irregularity in the first postmenarchal years: an early clinical sign of polycystic ovary syndrome in adolescence. Gynecol Endocrinol. 2001;15:170.
Trent ME, Rich M, Austin B, Gordon C. Fertility concerns and sexual behavior in adolescent girls with polycystic ovary syndrome: implications for quality of life. J Pediatr Adolesc Gynecol. 2003;16:33-37.
Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19-25.
Rodrigues A, Japur AC, Salata G, Carbol M, dos Reis RM. Insulin resistance in adolescents with menstrual irregularities. J Pediatr Adolesc Gynecol. 2005;18:269-74.
Driscoll DA. Polycystic ovary syndrome in adolescence. Semin Reprod Med. 2003;21:301.
Archer J, Chang RJ. Hirsutism and acne in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2004;18(5):737-54.
Timpatanapong P, Rojanasakul A. Hormonal profiles and prevalence of polycystic ovary syndrome in women with acne. J Dermatol. 1997;24(4):223.
Pérez J, Méndez MJ, Fuhrer J, Márquez J, Cumsille M, Fuhrer J. Síndrome de ovario poliquístico. Presentación clínica, bioquímica y ultrasonográfica. Rev Chil Obstet Ginecol. 2003;68(6):471-6.
Homburg R. What is polycystic ovarian syndrome? Hum Reprod. 2002;17(10):2495-9.
Dramusic V, Goh VHH, Rajan U, Wong YC, Ratnam SS. Clinical, endocrinologic and ultrasound features of polycystic ovary syndrome in Singaporean adolescents. J Pediatr Adolesc Gynecol. 1997;10:125.
Silverman K, Alderman EM. Polycystic ovarian syndrome [monografía en Internet]. Omaha: eMedicine.com, Inc; 2005 [citado 23 de octubre de 2005]. Disponible en: http://www.emedicine.com/ped/topic2155.htm
Balen A. The pathophysiology of polycystic ovary syndrome: trying to understand PCOS and its endocrinology. Best Pract Res Clin Obstet Gynaecol. 2004 Oct;18(5):685-706.
Zhou R, Bird IM, Dumesic DA, Abbott DH. Adrenal hyperandrogenism is induced by fetal androgen excess in a rhesus monkey model of polycystic ovary syndrome. J Clin Endocrinol Metab. 2005 Sep 20 [Epub ahead of print].
Acien P, Quereda F, Matallin P, Villarroya E, Lopez-Fernandez JA, Acien M, Mauri M, Alfayate R. Insulin, androgens, and obesity in women with and without polycystic ovary syndrome: a heterogeneous group of disorders. Fertil Steril. 1999 Jul;72(1):32-40.
Premoli AC, Sanlana LF, Ferriani RA, Moura MD, De Sa MF, Reis RM. Growth hormone secretion and insulin-like growth factor-1 are related to hyperandrogenism in nonobese patients with polycystic ovary syndrome. Fertil Steril. 2005 Jun;83(6):1852-5.
Dilek S, Ertunc O, Tok EC, Erdal EM, Aktas A. Association of Gly972Arg variant of insulin receptor substrate-1 with metabolic features in women with polycystic ovary syndrome. Fertil Steril. 2005 Aug;84(2):407-12.
Ibanez L, Valls C, Cabre S, De Zegher F. Flutamide-metformin plus ethinylestradiol-drospirenone for lipolysis and antiatherogenesis in young women with ovarian hyperandrogenism: the key role of early, low-dose flutamide. J Clin Endocrinol Metab. 2004 Sep;89(9):4716-20.
Khan MI, Klachko DM. Polycystic ovarian syndrome [monografía en Internet]. Omaha: eMedicine.com, Inc; 2005. [citado 23 de octubre de 2005]. Disponible en: http://www.emedicine.com/med/topic2173.htm
Azziz R. The time has come to simplify the evaluation of the hirsute patient. Fertil Steril. 2000;74:870.
Michelmore KF, Balen AH, Dunger DB, Vessey MP. Polycystic ovaries and associated clinical and biochemical features in young women. Clin Endocrinol (Oxf). 1999 Dec;51(6):779-86.
Oppenheimer E, Linder B, Dimartino-Nardi J. Decreased insulin sensitivity in prepubertal girls with premature adrenarche and acanthosis nigricans. J Clin Endocrinol Metab. 1995;80(2):614.
Franks S. Polycystic ovary syndrome. Arch Dis Child. 1997;77:89.
Legro RS, Kunselman AR, Dodson WC, et al. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999;84:165.
Knowler W, Barrett E, Fowler S, Hamman RF, Lachin J, Walker E, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393.
Ehrmann DA, Barnes RB, Rosenfield RL, et al. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999;22:141.
Huber-Buchholz MM, Carey DGP, Norman RJ. Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J Clin Endocrinol Metab. 1999;84:1470.
Morin-Papunen L, Vauhkonen I, Koivunen R, Ruokonen A, Martikainen H, Tapanainen J. Endocrine and metabolic effects of metformin vs ethinyl estradiol-cyproterone acetate in obese women with polycystic ovary syndrome: randomized study. J Clin Endocrinol Metab. 2000;85:3161-8.
Orio F, Palombo S, Falbo A, Manguso F, Russo T, Cascella T, et al. Prospective parallel randomized double-blinded double-dummy controlled clinical trial comparing clomiphene citrate and metformin as the first line treatment for ovulation induction in non-obese anovulatory women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90(7):4068-74.
Batukan C, Baysal B. Metformin improves ovulation and pregnancy rates in patients with polycystic ovary syndrome. Arch Gynecol Obstet. 2001 Aug;265(3):124-7.
Arias M, Reid I, Acuña M, Muster H. Terapia con metformina y embarazo en pacientes con síndrome de ovario poliquístico. Rev Chil Obstet Ginecol. 2004;69(4):290-3.
Ashraf M, Khurana ML, Eunice M, Gulati M, Dwivedi SN, Ammini A. Comparison of efficacy of spironolactone with metformin in the management of polycystic ovary syndrome: an open-labeled study. J Clin Endocrinol Metab. 2004;89(6):2756-62.
Dereli O, Dereli T, Bayraktar F, Ozgen AG, Yilmaz C. Endocrine and metabolic effects of rosiglitazone in non-obese women with polycystic ovary disease. Endocr J. 2005;52(3):299-308.
Mitkov M, Pehlivanov B, Terzieva D. Combined use of metformin and ethinyl estradiol-cyproterone acetate in polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2005 Feb 1;118(2):209-13.
Tartagni M, Schonauer MM, Cicinelli E, Petruzzelli F, De Pergola G, De Salvia MA, et al. Intermittent low-dose finasteride is as effective as daily administration for the treatment of hirsute women. Fertil Steril. 2004 Sep;82(3):752-5.

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[1] Franks S. Medical progress: polycystic ovary syndrome. N Engl J Med. 1995;333:853-61.

[2] Ehrmann DA. Medical progress: polycystic ovary syndrome. N Engl J Med. 2005;352:1223-36.

[3] Pfeifer S. Polycystic ovary syndrome. J Pediatr Adolesc Gynecol. 2003;16:259-63.

[4] Aguirre A, Benvenuto G, Urrutia MT. Calidad de vida en mujeres con síndrome de ovario poliquístico. Rev Chil Obstet Ginecol. 2005;70(2):103-7.

[5] Avvad CK, Holeuwerger R, Silva VCG, Bordalo MAN, Breitenbach MMD. Menstrual irregularity in the first postmenarchal years: an early clinical sign of polycystic ovary syndrome in adolescence. Gynecol Endocrinol. 2001;15:170.

[6] Trent ME, Rich M, Austin B, Gordon C. Fertility concerns and sexual behavior in adolescent girls with polycystic ovary syndrome: implications for quality of life. J Pediatr Adolesc Gynecol. 2003;16:33-37.

[7] Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81:19-25.

[8] Rodrigues A, Japur AC, Salata G, Carbol M, dos Reis RM. Insulin resistance in adolescents with menstrual irregularities. J Pediatr Adolesc Gynecol. 2005;18:269-74.

[9] Driscoll DA. Polycystic ovary syndrome in adolescence. Semin Reprod Med. 2003;21:301.

[10] Archer J, Chang RJ. Hirsutism and acne in polycystic ovary syndrome. Best Pract Res Clin Obstet Gynaecol. 2004;18(5):737-54.

[11] Timpatanapong P, Rojanasakul A. Hormonal profiles and prevalence of polycystic ovary syndrome in women with acne. J Dermatol. 1997;24(4):223.

[12] Pérez J, Méndez MJ, Fuhrer J, Márquez J, Cumsille M, Fuhrer J. Síndrome de ovario poliquístico. Presentación clínica, bioquímica y ultrasonográfica. Rev Chil Obstet Ginecol. 2003;68(6):471-6.

[13] Homburg R. What is polycystic ovarian syndrome? Hum Reprod. 2002;17(10):2495-9.

[14] Dramusic V, Goh VHH, Rajan U, Wong YC, Ratnam SS. Clinical, endocrinologic and ultrasound features of polycystic ovary syndrome in Singaporean adolescents. J Pediatr Adolesc Gynecol. 1997;10:125.

[15] Silverman K, Alderman EM. Polycystic ovarian syndrome [monografía en Internet]. Omaha: eMedicine.com, Inc; 2005 [citado 23 de octubre de 2005]. Disponible en: http://www.emedicine.com/ped/topic2155.htm

[16] Balen A. The pathophysiology of polycystic ovary syndrome: trying to understand PCOS and its endocrinology. Best Pract Res Clin Obstet Gynaecol. 2004 Oct;18(5):685-706.

[17] Zhou R, Bird IM, Dumesic DA, Abbott DH. Adrenal hyperandrogenism is induced by fetal androgen excess in a rhesus monkey model of polycystic ovary syndrome. J Clin Endocrinol Metab. 2005 Sep 20 [Epub ahead of print].

[18] Acien P, Quereda F, Matallin P, Villarroya E, Lopez-Fernandez JA, Acien M, Mauri M, Alfayate R. Insulin, androgens, and obesity in women with and without polycystic ovary syndrome: a heterogeneous group of disorders. Fertil Steril. 1999 Jul;72(1):32-40.

[19] Premoli AC, Sanlana LF, Ferriani RA, Moura MD, De Sa MF, Reis RM. Growth hormone secretion and insulin-like growth factor-1 are related to hyperandrogenism in nonobese patients with polycystic ovary syndrome. Fertil Steril. 2005 Jun;83(6):1852-5.

[20] Dilek S, Ertunc O, Tok EC, Erdal EM, Aktas A. Association of Gly972Arg variant of insulin receptor substrate-1 with metabolic features in women with polycystic ovary syndrome. Fertil Steril. 2005 Aug;84(2):407-12.

[21] Ibanez L, Valls C, Cabre S, De Zegher F. Flutamide-metformin plus ethinylestradiol-drospirenone for lipolysis and antiatherogenesis in young women with ovarian hyperandrogenism: the key role of early, low-dose flutamide. J Clin Endocrinol Metab. 2004 Sep;89(9):4716-20.

[22] Khan MI, Klachko DM. Polycystic ovarian syndrome [monografía en Internet]. Omaha: eMedicine.com, Inc; 2005. [citado 23 de octubre de 2005]. Disponible en: http://www.emedicine.com/med/topic2173.htm

[23] Azziz R. The time has come to simplify the evaluation of the hirsute patient. Fertil Steril. 2000;74:870.

[24] Michelmore KF, Balen AH, Dunger DB, Vessey MP. Polycystic ovaries and associated clinical and biochemical features in young women. Clin Endocrinol (Oxf). 1999 Dec;51(6):779-86.

[25] Oppenheimer E, Linder B, Dimartino-Nardi J. Decreased insulin sensitivity in prepubertal girls with premature adrenarche and acanthosis nigricans. J Clin Endocrinol Metab. 1995;80(2):614.

[26] Franks S. Polycystic ovary syndrome. Arch Dis Child. 1997;77:89.

[27] Legro RS, Kunselman AR, Dodson WC, et al. Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women. J Clin Endocrinol Metab. 1999;84:165.

[28] Knowler W, Barrett E, Fowler S, Hamman RF, Lachin J, Walker E, et al. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002;346:393.

[29] Ehrmann DA, Barnes RB, Rosenfield RL, et al. Prevalence of impaired glucose tolerance and diabetes in women with polycystic ovary syndrome. Diabetes Care. 1999;22:141.

[30] Huber-Buchholz MM, Carey DGP, Norman RJ. Restoration of reproductive potential by lifestyle modification in obese polycystic ovary syndrome: role of insulin sensitivity and luteinizing hormone. J Clin Endocrinol Metab. 1999;84:1470.

[31] Morin-Papunen L, Vauhkonen I, Koivunen R, Ruokonen A, Martikainen H, Tapanainen J. Endocrine and metabolic effects of metformin vs ethinyl estradiol-cyproterone acetate in obese women with polycystic ovary syndrome: randomized study. J Clin Endocrinol Metab. 2000;85:3161-8.

[32] Orio F, Palombo S, Falbo A, Manguso F, Russo T, Cascella T, et al. Prospective parallel randomized double-blinded double-dummy controlled clinical trial comparing clomiphene citrate and metformin as the first line treatment for ovulation induction in non-obese anovulatory women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005;90(7):4068-74.

[33] Batukan C, Baysal B. Metformin improves ovulation and pregnancy rates in patients with polycystic ovary syndrome. Arch Gynecol Obstet. 2001 Aug;265(3):124-7.

[34] Arias M, Reid I, Acuña M, Muster H. Terapia con metformina y embarazo en pacientes con síndrome de ovario poliquístico. Rev Chil Obstet Ginecol. 2004;69(4):290-3.

[35] Ashraf M, Khurana ML, Eunice M, Gulati M, Dwivedi SN, Ammini A. Comparison of efficacy of spironolactone with metformin in the management of polycystic ovary syndrome: an open-labeled study. J Clin Endocrinol Metab. 2004;89(6):2756-62.

[36] Dereli O, Dereli T, Bayraktar F, Ozgen AG, Yilmaz C. Endocrine and metabolic effects of rosiglitazone in non-obese women with polycystic ovary disease. Endocr J. 2005;52(3):299-308.

[37] Mitkov M, Pehlivanov B, Terzieva D. Combined use of metformin and ethinyl estradiol-cyproterone acetate in polycystic ovary syndrome. Eur J Obstet Gynecol Reprod Biol. 2005 Feb 1;118(2):209-13.

[38] Tartagni M, Schonauer MM, Cicinelli E, Petruzzelli F, De Pergola G, De Salvia MA, et al. Intermittent low-dose finasteride is as effective as daily administration for the treatment of hirsute women. Fertil Steril. 2004 Sep;82(3):752-5.

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