Stein-Leventhal syndrome

Complex of symptoms associated with certain functional disturbances of the ovaries. During menstruation it is usual for an ovum to ripen in one of the ovaries (in a follicle, a vesicle filled with fluid). At ovulation the ovum is released, involving hormones from the pituitary gland and hypothalamus. In Stein-Leventhal syndrome this hormonal function is not regulated, and the ovaries are continuously stimulated. The follicles never ripen but are halted at various stages of development, with the result that the ovaries are enlarged and surrounded by a rigid capsule; laparoscopy reveals various follicular cysts. Outward symptoms of this syndrome are slight, brief menstruation (oligomenorrhoea) and even complete lack of menstruation4’ (amenorrhoea). First menstruation starts at the usual age. Some women affected complain of heavy, lengthy menstruation; such women are often thickset and have a masculine pattern of hair distribution (hirsutism). Infertility occurs through lack of ovulation. Treatment is aimed at producing ovulation, which can be done by removing a third to a half of the ovaries, a so-called wedge resection, which results in menstruation in 80-90 per cent of cases. Menstruation becomes regular, and 60-80 per cent of women can become pregnant. Another possible therapy is by hormones to stimulate ovulation.