Polycystic ovarian syndrome. A challenge for occupational health nursing.

Polycystic ovarian syndrome is a complex problem affecting as many as 10% of a company's female work force. The condition commonly presents with symptoms of oligomenorrhea or amenorrhea, central obesity, and hirsutism. Stein (1935) first postulated the condition as cystic ovaries resulting from continuous LH stimulation. A current hypothesis is that PCOS may be two conditions--one resulting from LH and a second the result of a hyperinsulinemia. Weight loss and exercise, often difficult to maintain, can often return a woman to normal ovulatory cycles. First line pharmocotherapy includes OCs with desogestral as the progestin component. Antiandrogens such as spironolactone can be added to increase the antiandrogen effect. The occupational health nurse may be the only health care provider with whom the employee comes into contact who is able to see the impact of the syndrome over time, thus allowing the opportunity to counsel employees about long term risk reducing behaviors.