Generally said to affect 5-15% of women of reproductive age (1), PCOS may in fact affect up to 20% of women if the 2003 Rotterdam criteria is used (2,3).
Polycystic ovarian syndrome (PCOS) is generally defined as polycystic ovaries together with one or more characteristic features (hirsutism, acne, male-pattern baldness, amenorrhoea or oligomenorrhoea, or raised serum concentrations of testosterone and/or luteinising hormone) (4).
In polycystic ovarian syndrome the associated metabolic abnormalities (abnormal serum lipid concentrations and insulin resistance) also put some women at an increased risk of developing diabetes mellitus (4).
NICHD (1990) Diagnostic Criteria for PCOS is: |
Clinical Hyperandrogenism (Ferriman-Gallwey Score >8) or Biochemical Hyperandrogenism (Elevated Total/Free Testosterone) AND |
Oligomenorrhea (Less Than 6-9 Menses per Year) or Oligo-Ovulation AND |
Polycystic Ovaries on Ultrasound (>= 12 Antral Follicles in One Ovary or Ovarian Volume >= 10 cm3) |
Rotterdam (2003) Diagnostic criteria for PCOS - two out of three of: |
Clinical Hyperandrogenism (Ferriman-Gallwey Score >8) or Biochemical Hyperandrogenism (Elevated Total/Free Testosterone) OR |
Oligomenorrhea (Less Than 6-9 Menses per Year) or Oligo-Ovulation OR |
Polycystic Ovaries on Ultrasound (>= 12 Antral Follicles in One Ovary or Ovarian Volume >= 10 cm3) |
AE-PCOS Society (2009) Diagnostic Criteria for PCOS is: |
Clinical Hyperandrogenism (Ferriman-Gallwey Score >8) or Biochemical Hyperandrogenism (Elevated Total/Free Testosterone) PLUS Either of: |
Oligomenorrhea (Less Than 6-9 Menses per Year) or Oligo-Ovulation OR |
Polycystic Ovaries on Ultrasound (>= 12 Antral Follicles in One Ovary or Ovarian Volume >= 10 cm3) |
Thyroid dysfunction, congenital adrenal hyperplasia, hyperprolactinaemia, androgen-secreting tumours and Cushing’s syndrome must to be excluded before making a diagnosis of PCOS (4).
Although the primary aetiology of PCOS is unknown
Suggested differential diagnoses and screening tests (4)
Ovulatory dysfunction can still occur with regular cycles and if anovulation needs to be confirmed serum progesterone levels can be measured (12).
If irregular menstrual cycles are present a diagnosis of PCOS should be considered (2)
References:
Annotations allow you to add information to this page that would be handy to have on hand during a consultation. E.g. a website or number. This information will always show when you visit this page.