Polycystic ovaries are characterised by the presence of many small cysts (fluid filled swellings) around the surface of the ovaries. The cysts are quite small ranging from 2 to 8 mm (Figure 7.1). Polycystic ovaries are usually larger than normal ovaries and their central substance is generally more dense. Over recent years, with the advent of ultrasound examination, we have learned that about one woman in five has polycystic ovaries. At ultrasound examination, the ovaries appear larger and more dense and the cysts look like a necklace around the periphery of the ovaries. Hormone replacement therapy involves administration of oestrogen and there is some evidence that it may have a part to play in the management of hirsutism when the pill is not acceptable. Cyproterone acetate is an anti-androgen; it competes at the receptor sites (hormones) with androgens and reduces their effects. Dianette (Schering) is a special combined oral contraceptive pill that contains 2mg cyproterone acetate. Yasmin is a combined oral contraceptive pill with drosperinone as the progestogen. While many synthetic progestogens are derived from the male hormone, testosterone, drosperinone is derived from spironolactone and this most closely resembles and acts like the hormone progesterone made by your body.