Which endocrine disorder causes chronic anovulation, irregular menses, hirsutism, infertility and obesity?

• A. PCOS
• B. Cushing syndrome
• C. Hypogonadism
• D. Hyperprolactinemia

Answer: (A)

Polycystic ovary syndrome presents with a combination of chronic anovulation, irregular or absent menses, androgen excess such as hirsutism, infertility, and commonly obesity. The underlying pattern involves increased ovarian androgen production (theca cells stimulated by LH), leading to hyperandrogenism and disrupted follicle maturation, which causes anovulation and irregular cycles. Insulin resistance is also common in PCOS and worsens androgen effects by increasing insulin levels and lowering sex hormone–binding globulin, which raises free testosterone. This mix of menstrual dysfunction, signs of androgen excess, and metabolic features like obesity fits PCOS more than the other conditions listed, which have different primary patterns of symptoms (for example, hypogonadism lowers ovulatory function without androgen excess, and hyperprolactinemia mainly causes galactorrhea and amenorrhea rather than persistent hirsutism).