Polycystic ovarian syndrome is characterized by irregular or absent menstrual periods and elevated serum testosterone and androstenedione.These patients complain of abnormal bleeding, infertility, obesity, excess hair growth, hair loss, and acne.Polycystic ovarian syndrome seems to have a genetic component in which those who are affected often have male and female relatives with type II diabetes, obesity, elevated blood triglycerides, or high blood pressure.They may also have female relatives with infertility, hirsutism, or menstrual problems.For women in the reproductive age range, polycystic ovarian syndrome is a serious common cause of infertility because of the endocrine abnormalities that accompany elevated insulin levels.As women with polycystic ovarian syndrome may be at greater risk for other medical conditions, testing is essential.They should be tested for blood lipids, diabetes, and blood clotting factors that promote abnormal clotting.Metformin, at doses of 500 mg to 850 mg three times per day, is shown to reverse these endocrine abnormalities.In women with polycystic ovarian syndrome, metformin reduced systolic blood pressure, hyperinsulinemia, and insulin resistance, and facilitated menstrual regulation and pregnancy.