Received April 30, 2002
Accepted May 12, 2002

Polycystic ovarian syndrome has been hampered by varying diagnostic cri teria, and ignorance of the etiology of the syndrome PCOS women are uniquely insulin resistant and obesity aggravates this underlying predisposition to insulin resistance. Diagnostic criteria which focus on hyperandrogenism and or menstrual irregularity are more Iikely to identify insulin resistant women, than such cri teria as abnormal gonadotropin secretion or ovarian morphology. The lack of a c1ear etiologic mechanism to the syndrome has led to a multitude of symptom - oriented treatments with few therapies improving all aspects of' the endocrine syndrome of PCOS.