Stein-Leventhal Syndrome

Characterized by amenorrhea, infertility, hirsutism, and enlarged polycystic ovaries.

Polycystic Ovary Syndrome (PCOS); Sclerocystic Disease of the Ovaries.

Stein and Leventhal first described this entity in 1935.

Most authors agree that it is present in 3 to 7% of women worldwide. Approximately 75% of women with irregular menses and/or infertility may have polycystic ovaries. Based on ultrasonographic studies, 50% of women with regular menstrual cycles had polycystic ovaries.

Unknown. Believed to be autosomal dominant.

In Stein-Leventhal syndrome patients, the preovulatory follicle in the ovary does not develop. As a result, multiple subcapsular follicles develop. This creates an androgenic ovary, which is usually anovulatory.

The National Institutes of Health has defined PCOS as a state of hyperandrogenism and chronic anovulation in the absence of other causes, for example, congenital adrenal hyperplasia, hyperprolactinemia, and Cushing syndrome. The diagnosis is made on clinical grounds, in addition to the presence of bilateral polycystic ovaries in 90% of patients. Increased plasma levels of luteinizing hormone but normal or reduced levels of follicle-stimulating hormone. Other biochemical tests are done to exclude other causes.

Stein-Leventhal Syndrome is a condition that is usually diagnosed after the expected onset of menstruation. Symptoms can include amenorrhea or menstrual irregularity, hirsutism in androgen-dependent regions (face, chest, lower abdomen), upper body obesity (in 50% of patients), and infertility in patients of childbearing age. Associated with the obesity, patients frequently have insulin resistance resulting in adult-onset diabetes. Treatment may include progestins, oral contraceptives, antiandrogens (including spironolactone), weight reduction, ovulation-inducing medication, and surgery (laparoscopic ovarian cautery or laser vaporization).

Fasting blood sugar in older patients (particularly obese patients). Ensure other conditions have been excluded, for example, Cushing Syndrome.

Consider implications of obesity and glucose intolerance, if present.

There are no known implications with this condition.