Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder in premenopausal women, with an estimated 10% of all premenopausal women having it. The name is actually a misnomer because the problem is not ovarian cysts, but rather insulin resistance that leads to hyperinsulinemia (too much insulin). It is hyperinsulinemia that leads to the signs and symptoms of PCOS and therefore needs to be the focus of treating it.