Materiały źródłowe

• #1 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  Polycystic ovary syndrome is the most common endocrinopathy among reproductive-aged women in the United States, affecting approximately 7% of female patients. […] Guidelines from the Endocrine Society recommend using the Rotterdam criteria for diagnosis, which mandate the presence of two of the following three findings: hyperandrogenism, ovulatory dysfunction, and polycystic ovaries, plus the exclusion of other diagnoses that could result in hyperandrogenism or ovulatory dysfunction. […] The Endocrine Society advises clinicians to diagnose PCOS using the 2003 Rotterdam criteria, although recommendations differ across guidelines. According to the Rotterdam criteria, diagnosis requires the presence of at least two of the following three findings: hyperandrogenism, ovulatory dysfunction, and polycystic ovaries.

• #2 Polycystic Ovarian Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459251/

  Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder among females of reproductive age worldwide. PCOS is based on the presence of diagnostic criteria. This course explores the complexities surrounding PCOS, including the current diagnostic challenges and multifactorial pathophysiology, exploring the role of insulin resistance and hormonal abnormalities. Delayed diagnosis can contribute to complications, making timely lifestyle interventions crucial for symptom management and improving quality of life. Moreover, as a chronic metabolic disorder, PCOS requires a detailed and individualized approach to management, focusing on both reproductive and metabolic health. […] PCOS is widely accepted among specialty society guidelines that the diagnosis of PCOS must be based on the presence of at least 2 of the following 3 criteria: chronic anovulation, hyperandrogenism (clinical or biological), and polycystic ovaries. PCOS is a diagnosis of exclusion, and disorders that mimic clinical features of PCOS must be excluded. Delays in diagnosis can lead to the progression of comorbidities, making it more difficult to implement lifestyle intervention, which is critical for the improvement of features of PCOS and quality of life.

• #3

  https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome

  Polycystic ovary syndrome is diagnosed by the presence of at least two out of the following: […] Blood tests can be used to identify characteristic changes in hormone levels, although these changes are not universal. […] When making a diagnosis, doctors also take into account that irregular periods and ovulation can be a normal part of puberty or menopause, having polycystic ovaries may run in families, and women with a family history of PCOS or type 2 diabetes are at higher risk of PCOS.

• #4 Home Test Kit for PCOS (Polycystic Ovary Syndrome) – LetsGetChecked USA

  https://www.letsgetchecked.com/home-pcos-test/?srsltid=AfmBOooyRclDqM8kSLGn05bRTSzK5ejaBY7yC4Q9w5d2q_BZfKpndlO5

  It’s estimated that up to 75% of women with PCOS remain undiagnosed when visiting their doctor. […] Please talk to your healthcare provider about any concerns or symptoms. Remember that additional testing with your provider, such as an ultrasound, will be required after you receive your results, as it is not possible to diagnose PCOS on a blood test alone. […] No hormone test on its own can provide a diagnosis of PCOS, so further follow-up with a healthcare provider will be required after receiving your results. Follow-up may include further tests and/or an ultrasound. […] This test alone cannot diagnose PCOS. There are several elements healthcare providers consider when diagnosing PCOS including test results, symptoms, and potentially ultrasounds scans and further tests. This test is a great first step towards diagnosis. If your results are abnormal, our clinical team can explain your results to you, answer your questions and guide you to your next steps. Taking this test can empower you to have an informed conversation with your healthcare provider to better enable their diagnosis. We provide a downloadable lab report for you to share with your healthcare provider.

• #5 What Is Polycystic Ovary Syndrome (PCOS)? Symptoms, Causes, Diagnosis, and Treatment

  https://www.everydayhealth.com/pcos/

  Polycystic ovary syndrome (PCOS) is a common condition that happens when the ovaries produce high levels of androgens, or male hormones. […] A doctor will make a PCOS diagnosis if you meet at least two of three criteria: […] Theres no single test to diagnose PCOS. A doctor will evaluate your signs and symptoms and may conduct any of the following tests to rule out other conditions that present similarly: […] To diagnose PCOS, a doctor may do a physical exam, pelvic exam, pelvic ultrasound, or blood tests. You need to meet at least two of the following criteria to receive a diagnosis: irregular periods, high androgen levels, and ovaries that are larger than typical (polycystic ovaries). […] PCOS is considered a chronic condition. While some women with PCOS may find that their menstrual cycle becomes more regular as they approach menopause, others may continue to experience PCOS symptoms in addition to menopause symptoms. […] PCOS is fairly common, affecting up to 13 percent of women ages 15 to 49 around the world. […] The World Health Organization reports that up to 70 percent of PCOS cases worldwide are undiagnosed.

• #6 Diagnosis and management of polycystic ovarian syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10833093/

  Polycystic ovarian syndrome (PCOS) is a chronic disorder associated with infertility; miscarriage; adverse pregnancy outcomes; and cardiovascular, metabolic, psychological and neoplastic risks. […] Diagnosis of PCOS can be made based on the presence of any 2 of menstrual irregularities, clinical or biochemical hyperandrogenism or polycystic ovarian morphology on transvaginal ultrasonography. […] The Rotterdam criteria are the most widely accepted criteria for diagnosis of PCOS. Polycystic ovarian syndrome is diagnosed when 2 out of 3 of the following criteria are met and other diagnoses are excluded: Irregular cycles (if 3 yr post-menarche, 35 d apart or 21 d apart; 8 menstrual cycles per year; or 90 d for any 1 menstrual cycle), Clinical hyperandrogenism (acne, hirsutism, alopecia) or biochemical hyperandrogenism, Polycystic ovarian morphology on transvaginal ultrasonography or high antimllerian hormone.

• #7 Diagnostic evaluation of polycystic ovary syndrome (PCOS) in adolescents – UpToDate

  https://www.uptodate.com/contents/diagnostic-evaluation-of-polycystic-ovary-syndrome-pcos-in-adolescents

  Diagnostic evaluation of polycystic ovary syndrome (PCOS) in adolescents […] Polycystic ovary syndrome (PCOS) is the most common cause of infertility in women, frequently becomes manifest during adolescence, and is primarily characterized by ovulatory dysfunction and androgen excess (hyperandrogenism). […] The diagnosis of PCOS has lifelong implications with increased risk for metabolic syndrome, type 2 diabetes mellitus, and possibly cardiovascular disease and endometrial carcinoma. […] PCOS should be considered in any adolescent female presenting with a chief complaint of hirsutism, treatment-resistant acne, menstrual irregularity, acanthosis nigricans, and/or obesity. […] The diagnostic evaluation of an adolescent with suspected PCOS is described here. […] International consensus diagnostic criteria for polycystic ovary syndrome in adolescents.

• #8 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  Polycystic ovary syndrome is the most common endocrinopathy among reproductive-aged women in the United States, affecting approximately 7% of female patients. […] Guidelines from the Endocrine Society recommend using the Rotterdam criteria for diagnosis, which mandate the presence of two of the following three findings: hyperandrogenism, ovulatory dysfunction, and polycystic ovaries, plus the exclusion of other diagnoses that could result in hyperandrogenism or ovulatory dysfunction. […] The Endocrine Society advises clinicians to diagnose PCOS using the 2003 Rotterdam criteria, although recommendations differ across guidelines. According to the Rotterdam criteria, diagnosis requires the presence of at least two of the following three findings: hyperandrogenism, ovulatory dysfunction, and polycystic ovaries.

• #9 Current Guidelines for Diagnosing PCOS

  https://www.mdpi.com/2075-4418/13/6/1113

  The Rotterdam criteria continues to be the most widely used and accepted criteria for PCOS and were once again unanimously supported in the 2018 International Evidence-Based Guideline for the Assessment and Management of PCOS. […] It is recommended to use the modified Rotterdam criteria, in which PCOS may be diagnosed if any two of the following are present: (1) clinical or biochemical hyperandrogenism, (2) evidence of oligo-anovulation, (3) polycystic appearing-ovarian morphology on ultrasound, with exclusion of other relevant disorders. […] Diagnosis of PCOS should not be given lightly. Receiving a diagnosis of this syndrome is associated with significant psychological distress, reduced well-being, depression, and fears about future health and fertility. From the patient’s perspective, the vast majority receiving a diagnosis feel that they either receive no information about the diagnosis or receive inadequate information. Furthermore, diagnosis can be delayed by two or more years for approximately a quarter of women with PCOS.

• #10 Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023) – practice guidance | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-from-the-2023-international-evidence-based-guideline-for-the-assessment-and-management-of-polycystic-ovary-syndrome/

  The guideline provides 77 evidence-based and 54 consensus recommendations, with 123 practice points underpinned by a technical report on evidence synthesis and GRADE detailed considerations. […] Key recommendations and updates include that PCOS should be diagnosed using the 2018 International Evidence-based Guideline criteria, which built on the consensus based 2003 Rotterdam criteria. […] This requires the presence of two of the following: i) clinical / biochemical hyperandrogenism; ii) ovulatory dysfunction; and iii) polycystic ovaries on ultrasound; and here in 2023, alternatively anti-Mullerian hormone (AMH) can now be used instead of ultrasound, with the exclusion of other aetiologies. […] Importantly, where irregular menstrual cycles and hyperandrogenism are present, diagnosis is simplified and ultrasound or AMH are not required for diagnosis.

• #11 Diagnosis and management of polycystic ovarian syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10833093/

  Polycystic ovarian syndrome (PCOS) is a chronic disorder associated with infertility; miscarriage; adverse pregnancy outcomes; and cardiovascular, metabolic, psychological and neoplastic risks. […] Diagnosis of PCOS can be made based on the presence of any 2 of menstrual irregularities, clinical or biochemical hyperandrogenism or polycystic ovarian morphology on transvaginal ultrasonography. […] The Rotterdam criteria are the most widely accepted criteria for diagnosis of PCOS. Polycystic ovarian syndrome is diagnosed when 2 out of 3 of the following criteria are met and other diagnoses are excluded: Irregular cycles (if 3 yr post-menarche, 35 d apart or 21 d apart; 8 menstrual cycles per year; or 90 d for any 1 menstrual cycle), Clinical hyperandrogenism (acne, hirsutism, alopecia) or biochemical hyperandrogenism, Polycystic ovarian morphology on transvaginal ultrasonography or high antimllerian hormone.

• #12 Polycystic Ovarian Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459251/

  Most society guidelines have accepted that PCOS may be diagnosed if 2 out of the 3 following clinical criteria are present: chronic oligo-anovulation, clinical or biological hyperandrogenism, and PCOM in the absence of any other pathology, which are part of the Rotterdam Criteria. The National Institute of Health criteria also require clinical or biochemical hyperandrogenism and oligo or anovulation; however, the Rotterdam Criteria are the most commonly used. […] Newer criteria from the International Evidence-Based Guideline for the Assessment and Management of PCOS 2023 recommend that an adult diagnosis of PCOS requires the presence of 2 out of the following 3 criteria, as well as the exclusion of differential diagnoses with similar clinical features: clinical or biochemical hyperandrogenism, ovulatory dysfunction, findings of polycystic ovaries on ultrasound or elevated AMH levels.

• #13 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  Diagnosis can generally be accomplished with a careful history, physical examination, and basic laboratory testing, without the need for ultrasonography or other imaging. […] The goal of further evaluation of suspected PCOS is twofold: to exclude other treatable conditions that can mimic PCOS and to detect and treat long-term metabolic complications. […] The differential diagnosis of PCOS is broad and includes both endocrinologic and malignant etiologies. […] For any woman with suspected PCOS, the Endocrine Society recommends excluding pregnancy, thyroid dysfunction, hyperprolactinemia, and nonclassical congenital adrenal hyperplasia. […] The Endocrine Society recommends clomiphene or letrozole (Femara) for ovulation induction. Recent studies suggest that letrozole is associated with higher live-birth rates and ovulation rates compared with clomiphene in patients with PCOS.

• #14 Polycystic Ovary Syndrome (PCOS) | Clinical Focus | Quest Diagnostics Polycystic Ovary Syndrome (PCOS)Polycystic Ovary Syndrome (PCOS)

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_PCOS/polycystic-ovary-syndrome-pcos

  This Clinical Focus provides information on tests available for the differential diagnosis of polycystic ovary syndrome (PCOS) and the identification of common comorbidities. […] An estimated 75% of individuals with PCOS remain undiagnosed because of the variability in presentation and differences in published clinical diagnostic criteria. […] No single criterion or test can be used to diagnose PCOS—diagnosis is primarily based on the exclusion of diseases with similar symptoms. […] The 2003 Rotterdam criteria are the most-used approach for diagnosis of PCOS; the Rotterdam consensus defines PCOS based on the presence of at least 2 of 3 criteria: (1) hyperandrogenism; (2) ovulatory dysfunction; and (3) polycystic ovarian morphology (PCOM). […] Importantly, PCOS can only be diagnosed once other disorders have been excluded.

• #15 Polycystic ovary syndrome (PCOS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443

  During a pelvic exam, a doctor inserts one or two gloved fingers inside the vagina. Pressing down on the abdomen at the same time, the doctor can check the uterus, ovaries and other organs. […] There’s no single test to specifically diagnose polycystic ovary syndrome (PCOS). Your health care provider is likely to start with a discussion of your symptoms, medications and any other medical conditions. Your provider also may ask about your menstrual periods and any weight changes. A physical exam includes checking for signs of excess hair growth, insulin resistance and acne. […] Your health care provider might then recommend: […] Blood tests can measure hormone levels. This testing can exclude possible causes of menstrual problems or androgen excess that mimic PCOS. […] An ultrasound can check the appearance of your ovaries and the thickness of the lining of your uterus.

• #16 Polycystic Ovary Syndrome Q&A with Dr. Jessica Chan | Cedars-Sinai

  https://www.cedars-sinai.org/blog/polycystic-ovary-syndrome.html

  While there’s no single test for polycystic ovarian syndrome diagnosis (PCOS), a physical exam, ultrasound, and blood tests can help make a diagnosis. […] There’s no single test for it, but a physical exam, ultrasound, and blood tests can help diagnose PCOS. […] You need to meet 2 of these 3 „official” criteria to be diagnosed: […] Your doctor will use an ultrasound to check for cysts. […] Treatments vary depending on the particular phase of your reproductive life and can include lifestyle changes or medications to help control symptoms. […] It’s important to get those symptoms caused by male hormones under control because even though they’re cosmetic, they can impact your quality of life. […] PCOS can make getting pregnant difficult, so we give fertility medications to help. […] At all stages of PCOS, we worry about possible future development of heart disease, including high blood pressure, high cholesterol, and stroke, along with type 2 diabetes. […] A reproductive endocrinologist can help.

• #17 Polycystic ovary syndrome (PCOS) – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pcos/diagnosis-treatment/drc-20353443

  During a pelvic exam, a doctor inserts one or two gloved fingers inside the vagina. Pressing down on the abdomen at the same time, the doctor can check the uterus, ovaries and other organs. […] There’s no single test to specifically diagnose polycystic ovary syndrome (PCOS). Your health care provider is likely to start with a discussion of your symptoms, medications and any other medical conditions. Your provider also may ask about your menstrual periods and any weight changes. A physical exam includes checking for signs of excess hair growth, insulin resistance and acne. […] Your health care provider might then recommend: […] Blood tests can measure hormone levels. This testing can exclude possible causes of menstrual problems or androgen excess that mimic PCOS. […] An ultrasound can check the appearance of your ovaries and the thickness of the lining of your uterus.

• #18

  https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/diagnosis/

  See your GP if you have any typical symptoms of polycystic ovary syndrome (PCOS). […] Your GP will ask about your symptoms to help rule out other possible causes, and check your blood pressure. […] They’ll also arrange for you to have a number of hormone tests to find out whether the excess hormone production is caused by PCOS or another hormone-related condition. […] You may also need an ultrasound scan, which can show whether you have a high number of follicles in your ovaries (polycystic ovaries). […] A diagnosis of PCOS can usually be made if other rare causes of the same symptoms have been ruled out and you meet at least 2 of the following 3 criteria: you have irregular periods or infrequent periods this indicates that your ovaries do not regularly release eggs (ovulate) […] blood tests showing you have high levels of „male hormones”, such as testosterone (or sometimes just the signs of excess male hormones, even if the blood test is normal)

• #19 Diagnosis and management of polycystic ovarian syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10833093/

  Polycystic ovarian syndrome (PCOS) is a chronic disorder associated with infertility; miscarriage; adverse pregnancy outcomes; and cardiovascular, metabolic, psychological and neoplastic risks. […] Diagnosis of PCOS can be made based on the presence of any 2 of menstrual irregularities, clinical or biochemical hyperandrogenism or polycystic ovarian morphology on transvaginal ultrasonography. […] The Rotterdam criteria are the most widely accepted criteria for diagnosis of PCOS. Polycystic ovarian syndrome is diagnosed when 2 out of 3 of the following criteria are met and other diagnoses are excluded: Irregular cycles (if 3 yr post-menarche, 35 d apart or 21 d apart; 8 menstrual cycles per year; or 90 d for any 1 menstrual cycle), Clinical hyperandrogenism (acne, hirsutism, alopecia) or biochemical hyperandrogenism, Polycystic ovarian morphology on transvaginal ultrasonography or high antimllerian hormone.

• #20 PCOS (Polycystic Ovary Syndrome): Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/8316-polycystic-ovary-syndrome-pcos

  Polycystic ovary syndrome (PCOS) is a hormonal imbalance that occurs when your ovaries create excess hormones. If you have PCOS, your ovaries produce unusually high levels of hormones called androgens. This causes your reproductive hormones to become imbalanced. As a result, people with PCOS often have irregular menstrual cycles, missed periods and unpredictable ovulation. […] PCOS is one of the most common causes of female infertility. It can also increase your risk of other health conditions. Your healthcare provider can treat PCOS based on your symptoms and if you wish to become pregnant. […] In most cases, your healthcare provider can diagnose PCOS after an examination and discussing your symptoms. They may order blood tests or perform an ultrasound to help with the diagnosis. […] Typically, healthcare providers diagnose PCOS if you have at least two of the three symptoms: Irregular or missed periods. Some people with PCOS have very heavy bleeding when they do have a period. Signs of excess androgens such as acne or excessive hair growth. Or a blood test confirming high androgen levels. Enlarged ovaries or polycystic appearance of ovaries on ultrasound. Many people dont develop cysts.

• #21 Polycystic Ovarian Syndrome: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/256806-overview

  Women with polycystic ovarian syndrome (PCOS) have abnormalities in the metabolism of androgens and estrogen and in the control of androgen production. PCOS can result from abnormal function of the hypothalamic-pituitary-ovarian (HPO) axis. A woman is diagnosed with polycystic ovaries (as opposed to PCOS) if she has 20 or more follicles in at least 1 ovary. […] The major features of PCOS include menstrual dysfunction, anovulation, and signs of hyperandrogenism. Other signs and symptoms of PCOS may include the following: Hirsutism, Infertility, Obesity and metabolic syndrome, Diabetes, Obstructive sleep apnea. […] On examination, findings in women with PCOS may include the following: Virilizing signs, Acanthosis nigricans, Hypertension, Enlarged ovaries: May or may not be present; evaluate for an ovarian mass.

• #22 Signs of PCOS: A symptoms checklist — Flo

  https://flo.health/pcos/signs-of-pcos-diagnosis

  During the initial assessment, you might be asked about your medical history including information about your menstrual cycle and checked for symptoms, including excessive hair growth or acne. […] The lab tests conducted will be blood tests although there is no definitive blood test for PCOS, there might be signs of PCOS in your blood work, such as raised androgen levels. […] If the assessment, blood tests, and ultrasound show that you have two out of the three main symptoms listed above (with no other obvious explanation), then you are likely to be diagnosed with PCOS. […] There is currently no cure for the condition, meaning it is something that’s lifelong, but be reassured that the symptoms can be managed with a wide range of PCOS treatment options. Your doctor will be able to discuss these with you when you’re ready to have that conversation.

• #23 PCOS | Polycystic Ovary Syndrome | MedlinePlus

  https://medlineplus.gov/polycysticovarysyndrome.html

  Polycystic ovary syndrome (PCOS) is the name for set of symptoms that are related to an imbalance of hormones. PCOS affects the ovaries, as well as many other parts of the body. […] There is no specific test for PCOS. To find out if you have PCOS, your provider: […] Will do a physical exam, which will include looking for the physical signs of PCOS. […] Will ask about your medical history and family health history. […] May do a pelvic exam to check for signs of extra male hormones and to see if your ovaries are enlarged or swollen. […] May order a pelvic ultrasound to look for cysts on your ovaries and check the thickness of your endometrium (the lining of your uterus, or womb). […] May order blood tests, including tests to check your hormone levels.

• #24 Polycystic Ovarian Syndrome: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/256806-overview

  Exclude all other disorders that can result in menstrual irregularity and hyperandrogenism, including adrenal or ovarian tumors, thyroid dysfunction, congenital adrenal hyperplasia, hyperprolactinemia, acromegaly, and Cushing syndrome. […] Baseline screening laboratory studies for women suspected of having PCOS may include the following: Thyroid function tests (eg, TSH, free thyroxine), Serum prolactin level, Total and free testosterone levels, Free androgen index, Serum hCG level, Cosyntropin stimulation test, Serum 17-hydroxyprogesterone (17-OHPG) level, Urinary free cortisol (UFC) and creatinine levels, Low-dose dexamethasone suppression test, Serum insulin-like growth factor (IGF)1 level. […] Other tests used in the evaluation of PCOS include the following: Androstenedione level, FSH and LH levels, GnRH stimulation testing, Glucose level, Insulin level, Lipid panel.

• #25 What Blood Tests are Done for PCOS? – TMB – Travel Health Clinics

  https://www.tmb.ie/blog/blood-tests-pcos

  Polycystic Ovary Syndrome (PCOS) is a common endocrine disorder that affects women of reproductive age. While the diagnosis of PCOS typically involves a comprehensive evaluation of the patients medical history, physical examination, and various diagnostic tests, blood tests play a pivotal role in confirming the condition and guiding appropriate management strategies. […] These tests should ideally be performed around Day 3 of the menstrual cycle for the most accurate results, and it is important to note that any form of hormonal contraception will affect the results. […] Elevated LH levels, often in a specific LH to FSH ratio, are a hallmark of PCOS and contribute to the pathogenesis of the syndrome. […] Elevated levels of testosterone are common in women with PCOS, contributing to symptoms such as hirsutism, acne, and male-pattern baldness.

• #26 Diagnosis and treatment of polycystic ovary syndrome (PCOS) using virtual health | This Changed My Practice (TCMP) by UBC CPD

  https://thischangedmypractice.com/diagnosis-and-treatment-pcos-using-virtual-health/

  In order to make the diagnosis, Rotterdam (2003) recommended a set of clinical, laboratory, and ultrasound investigations including: History taking for menstrual cycles and hyperandrogenism (hirsutism, acne, alopecia), 17-hydroxyprogesterone to rule out late-onset congenital adrenal hyperplasia, Thyroid-stimulating hormone (TSH), Prolactin to rule out an alternate endocrinopathy causing oligomenorrhea, Follicle-stimulating hormone (FSH) and estradiol (E2) to rule out hypogonadotropic hypogonadism (low FSH, low E2) or premature ovarian failure (high FSH, low E2), Testosterone (ideally free testosterone) +/- sex hormone binding globulin (SHBG), Androstenedione to establish hyperandrogenemia and rule out androgen-secreting neoplasms, Dihydroepiandrosteronesulfate (DHEA-S) to rule out an adrenal androgen-secreting neoplasm, Insulin resistance testing (fasting glucose and/or 2-hour 75 g oral glucose tolerance test), Transvaginal pelvic ultrasound (12 follicles 29 mm or ovarian volume 10 ml) to assess for polycystic ovary morphology.

• #27 Diagnosis and management of polycystic ovarian syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10833093/

  Biochemical hyperandrogenism is found in 60% of patients with PCOS and can be assessed using total testosterone, calculated free testosterone, dehydroepiandrosterone sulfate (DHEA-S) and androstenedione. […] If a patient meets 2 of 3 Rotterdam criteria, this satisfies criteria for PCOS diagnosis without need for laboratory confirmation of elevated androgens. […] Polycystic ovarian morphology on transvaginal ultrasonography ( 20 follicles or an ovarian volume 10 mL in at least 1 ovary) may be an additional criterion if clinical or laboratory criteria are not met.

• #28 Polycystic ovary syndrome – Wikipedia

  https://en.wikipedia.org/wiki/Polycystic_ovary_syndrome

  Serum (blood) levels of androgens, including androstenedione and testosterone may be elevated. […] The free testosterone level is thought to be the best measure, with approximately 60 percent of PCOS patients demonstrating supranormal levels. […] The ratio of LH (luteinizing hormone) to FSH (follicle-stimulating hormone), when measured in international units, is elevated in women with PCOS. […] Anti-Müllerian hormone (AMH) is increased in PCOS, and may become part of its diagnostic criteria.

• #29 What Blood Tests are Done for PCOS? – TMB – Travel Health Clinics

  https://www.tmb.ie/blog/blood-tests-pcos

  Low levels of SHBG are often found in women with PCOS, leading to increased free testosterone levels and exacerbating the clinical manifestations of the syndrome. […] A high glucose level can indicate insulin resistance, a diabetes-related condition that contributes to PCOS. […] Elevated levels of AMH are a characteristic feature of PCOS and reflect the increased number of small follicles in the ovaries, contributing to irregular menstrual cycles and difficulties in ovulation. […] Thyroid dysfunction is commonly associated with PCOS, and assessing thyroid function is essential to rule out any underlying thyroid abnormalities that may exacerbate PCOS symptoms. […] These blood tests, in conjunction with a thorough clinical evaluation, help clinicians confirm the diagnosis of PCOS and provide valuable insights into the patients overall health and associated risks. […] A comprehensive understanding of the blood tests used in the diagnosis and management of PCOS is vital for healthcare providers and patients alike.

• #30 Polycystic ovary syndrome – Knowledge @ AMBOSS

  https://www.amboss.com/us/knowledge/polycystic-ovary-syndrome/

  PCOS is diagnosed in adults based on the presence of at least two of the following criteria, after other endocrinological conditions, e.g., thyroid disease, hyperprolactinemia, have been excluded. […] A clinical picture of hyperandrogenism fulfills a diagnostic criterion of PCOS, even if serum androgen levels are normal. […] An elevated LH (with LH:FSH ratio 2:1) is a characteristic finding in most patients with PCOS but not necessary for diagnosis.

• #31 PCOS Tests, Polycystic Ovarian Syndrome – Testing and Diagnosis

  https://www.advancedfertility.com/infertility-testing/pcos-fertility-testing

  What matters most is not what we name it, but whether we recognize the problem and treat it effectively. […] Laboratory testing for patients suspected of having PCOS: Serum testosterone, Prolactin, 17-OH progesterone, 17 hydroxyprogesterone, 17 OHP, LH, FSH, estradiol, Dehydroepiandrosterone sulfate, DHEAS, Thyroid stimulating hormone, TSH. […] In a polycystic ovary, the numerous small cystic structures, also called antral follicles, give the ovaries a characteristic polycystic (many cysts) appearance on ultrasound. […] Many (but not all) women with PCOS have an abnormal FSH to LH ratio. […] In order for proper follicle and egg development to proceed, FSH (follicle stimulating hormone) and LH (luteinizing hormone) each need to be present at certain levels and at specific times during the normal menstrual cycle.

• #32 Polycystic Ovary Syndrome – PCOS | Choose the Right Test

  https://arupconsult.com/content/polycystic-ovarian-syndrome

  Assessment for PCOM is not required in individuals who meet other biochemical or clinical criteria for PCOS; however, it may be useful to confirm a PCOS diagnosis when only one other criterion has been met. Although ultrasound has long been the standard method to detect PCOM, recent guidelines now support the use of anti-Mllerian hormone (AMH) to detect PCOM in adults, given that it has been shown to strongly correlate with antral follicle count.

• #33 Diagnosing and treating PCOS | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/polycystic-ovary-syndrome/diagnosing-and-treating-pcos

  A blood test for anti-mullerian hormone (AMH) level can be done instead of an ultrasound. […] You dont need to have an ultrasound to confirm PCOS if you have irregular or no periods and high androgen levels. […] Your doctor may ask you to do different tests before they confirm a PCOS diagnosis. The tests will depend on your individual symptoms. […] Blood tests for testosterone and free androgen index (FAI) can identify high androgen levels. […] Your doctor may also recommend blood tests to exclude conditions with similar symptoms to PCOS. […] Your doctor or specialist may perform an abdominal ultrasound to check for signs of PCOS (e.g. partly-developed eggs on your ovaries, enlarged ovaries or a thickened uterus lining). […] It’s hard to diagnose PCOS in young women in the first few years after their periods start.

• #34 Diagnosis and treatment of polycystic ovary syndrome (PCOS) using virtual health | This Changed My Practice (TCMP) by UBC CPD

  https://thischangedmypractice.com/diagnosis-and-treatment-pcos-using-virtual-health/

  In order to make the diagnosis, Rotterdam (2003) recommended a set of clinical, laboratory, and ultrasound investigations including: History taking for menstrual cycles and hyperandrogenism (hirsutism, acne, alopecia), 17-hydroxyprogesterone to rule out late-onset congenital adrenal hyperplasia, Thyroid-stimulating hormone (TSH), Prolactin to rule out an alternate endocrinopathy causing oligomenorrhea, Follicle-stimulating hormone (FSH) and estradiol (E2) to rule out hypogonadotropic hypogonadism (low FSH, low E2) or premature ovarian failure (high FSH, low E2), Testosterone (ideally free testosterone) +/- sex hormone binding globulin (SHBG), Androstenedione to establish hyperandrogenemia and rule out androgen-secreting neoplasms, Dihydroepiandrosteronesulfate (DHEA-S) to rule out an adrenal androgen-secreting neoplasm, Insulin resistance testing (fasting glucose and/or 2-hour 75 g oral glucose tolerance test), Transvaginal pelvic ultrasound (12 follicles 29 mm or ovarian volume 10 ml) to assess for polycystic ovary morphology.

• #35 Polycystic Ovarian Syndrome: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/256806-overview

  Exclude all other disorders that can result in menstrual irregularity and hyperandrogenism, including adrenal or ovarian tumors, thyroid dysfunction, congenital adrenal hyperplasia, hyperprolactinemia, acromegaly, and Cushing syndrome. […] Baseline screening laboratory studies for women suspected of having PCOS may include the following: Thyroid function tests (eg, TSH, free thyroxine), Serum prolactin level, Total and free testosterone levels, Free androgen index, Serum hCG level, Cosyntropin stimulation test, Serum 17-hydroxyprogesterone (17-OHPG) level, Urinary free cortisol (UFC) and creatinine levels, Low-dose dexamethasone suppression test, Serum insulin-like growth factor (IGF)1 level. […] Other tests used in the evaluation of PCOS include the following: Androstenedione level, FSH and LH levels, GnRH stimulation testing, Glucose level, Insulin level, Lipid panel.

• #36 Diagnosis and treatment of polycystic ovary syndrome (PCOS) using virtual health | This Changed My Practice (TCMP) by UBC CPD

  https://thischangedmypractice.com/diagnosis-and-treatment-pcos-using-virtual-health/

  In order to make the diagnosis, Rotterdam (2003) recommended a set of clinical, laboratory, and ultrasound investigations including: History taking for menstrual cycles and hyperandrogenism (hirsutism, acne, alopecia), 17-hydroxyprogesterone to rule out late-onset congenital adrenal hyperplasia, Thyroid-stimulating hormone (TSH), Prolactin to rule out an alternate endocrinopathy causing oligomenorrhea, Follicle-stimulating hormone (FSH) and estradiol (E2) to rule out hypogonadotropic hypogonadism (low FSH, low E2) or premature ovarian failure (high FSH, low E2), Testosterone (ideally free testosterone) +/- sex hormone binding globulin (SHBG), Androstenedione to establish hyperandrogenemia and rule out androgen-secreting neoplasms, Dihydroepiandrosteronesulfate (DHEA-S) to rule out an adrenal androgen-secreting neoplasm, Insulin resistance testing (fasting glucose and/or 2-hour 75 g oral glucose tolerance test), Transvaginal pelvic ultrasound (12 follicles 29 mm or ovarian volume 10 ml) to assess for polycystic ovary morphology.

• #37 Polycystic Ovarian Syndrome: Practice Essentials, Background, Etiology

  https://emedicine.medscape.com/article/256806-overview

  Exclude all other disorders that can result in menstrual irregularity and hyperandrogenism, including adrenal or ovarian tumors, thyroid dysfunction, congenital adrenal hyperplasia, hyperprolactinemia, acromegaly, and Cushing syndrome. […] Baseline screening laboratory studies for women suspected of having PCOS may include the following: Thyroid function tests (eg, TSH, free thyroxine), Serum prolactin level, Total and free testosterone levels, Free androgen index, Serum hCG level, Cosyntropin stimulation test, Serum 17-hydroxyprogesterone (17-OHPG) level, Urinary free cortisol (UFC) and creatinine levels, Low-dose dexamethasone suppression test, Serum insulin-like growth factor (IGF)1 level. […] Other tests used in the evaluation of PCOS include the following: Androstenedione level, FSH and LH levels, GnRH stimulation testing, Glucose level, Insulin level, Lipid panel.

• #38 PCOS (Polycystic Ovary Syndrome) Diagnosis & Blood Tests

  https://www.webmd.com/women/do-i-have-pcos

  If you have PCOS, you then may get a blood glucose and cholesterol test. Doctors often do these tests to check on your overall health and chance of having other conditions: Lipid profiles checks your cholesterol and triglycerides. PCOS can make you more likely to develop heart disease. Glucose test helps to see if you have diabetes. More than half of women who have PCOS get this disease. Insulin: Your doctor will want to find out how well your body responds to insulin, which helps control your blood sugar level. If your body doesnt respond to the insulin its making, you may have insulin resistance. Its common among women with PCOS and can lead to diabetes.

• #39 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  In a patient not seeking pregnancy, the Endocrine Society recommends hormonal contraception (i.e., oral contraceptive, dermal patch, or vaginal ring) as the initial medication for treatment of irregular menses and hyperandrogenism manifesting as acne or hirsutism. […] The Endocrine Society further recommends depression screening, as well as screening for symptoms of obstructive sleep apnea in overweight and obese patients with PCOS.

• #40 Polycystic Ovarian Syndrome – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK459251/

  When irregular menstrual cycles and hyperandrogenism are present, neither ultrasound nor AMH testing is necessary for the diagnosis of PCOS in adults. In adolescents, both hyperandrogenism and ovulatory dysfunction must be present for a diagnosis of PCOS. However, ultrasound and AMH testing are not recommended in this population due to their low specificity. […] Excluding disorders that can mimic the clinical features of PCOS is also essential, including thyroid disease, hyperprolactinemia, and atypical congenital adrenal hyperplasia due to 21-hydroxylase deficiency. […] Clinical hyperandrogenism is diagnosed in adult women who present with hirsutism, alopecia, and acne, which can serve as effective clinical indicators of biochemical hyperandrogenism. Healthcare professionals should assess biochemical hyperandrogenism in the diagnosis of PCOS by measuring total and free testosterone.

• #41 Diagnosing and treating PCOS | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/polycystic-ovary-syndrome/diagnosing-and-treating-pcos

  A blood test for anti-mullerian hormone (AMH) level can be done instead of an ultrasound. […] You dont need to have an ultrasound to confirm PCOS if you have irregular or no periods and high androgen levels. […] Your doctor may ask you to do different tests before they confirm a PCOS diagnosis. The tests will depend on your individual symptoms. […] Blood tests for testosterone and free androgen index (FAI) can identify high androgen levels. […] Your doctor may also recommend blood tests to exclude conditions with similar symptoms to PCOS. […] Your doctor or specialist may perform an abdominal ultrasound to check for signs of PCOS (e.g. partly-developed eggs on your ovaries, enlarged ovaries or a thickened uterus lining). […] It’s hard to diagnose PCOS in young women in the first few years after their periods start.

• #42 Diagnosis and management of polycystic ovarian syndrome

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10833093/

  Biochemical hyperandrogenism is found in 60% of patients with PCOS and can be assessed using total testosterone, calculated free testosterone, dehydroepiandrosterone sulfate (DHEA-S) and androstenedione. […] If a patient meets 2 of 3 Rotterdam criteria, this satisfies criteria for PCOS diagnosis without need for laboratory confirmation of elevated androgens. […] Polycystic ovarian morphology on transvaginal ultrasonography ( 20 follicles or an ovarian volume 10 mL in at least 1 ovary) may be an additional criterion if clinical or laboratory criteria are not met.

• #43 Polycystic Ovary Syndrome (PCOS) Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/404754-overview

  In polycystic ovary syndrome (PCOS), enlarged ovaries with thickened sclerotic capsules and an abnormally high number of follicles are present. The follicles may concurrently exist in varying states of growth, maturation, or atresia. PCOS is considered the most common endocrine disorder in the world in women of reproduction age. In a study of follicular and endocrine characteristics of anovulatory and sporadic ovulatory cycles in women with PCOS, follicular excess, or increased follicle number, was observed on ultrasonography across anovulatory and sporadic ovulatory cycles in patients with PCOS. […] The American Association of Clinical Endocrinologists, American College of Endocrinology, and Androgen Excess and PCOS Society have published best practices for evaluating and treating PCOS. They state that the diagnosis of PCOS is based on the presence of at least 2 of the following 3 criteria: chronic anovulation, hyperandrogenism (clinical or biological), and polycystic ovaries. They note that ultrasonography now allows diagnosis of PCOM in patients with at least 25 small follicles (2-9 mm) in the whole ovary, and ovarian size of 10 ml is the threshold between normal and increased ovary size.

• #44 Polycystic Ovary Syndrome (PCOS) Imaging: Practice Essentials, Magnetic Resonance Imaging, Ultrasonography

  https://emedicine.medscape.com/article/404754-overview

  PCOS is usually diagnosed based on the Rotterdam criteria if 2 of 3 criteria are present: (1) oligo- and/or anovulation, (2) hyperandrogenism (HA) (clinical and/or biochemical), and (3) polycystic ovary morphology (PCOM) on ultrasonography (either 12 or more follicles measuring 2-9 mm in diameter and/or an increased ovarian volume 10 cm3). Irregular menstruation is defined as less than 21 days or more than 35 days or fewer than 8 cycles per year. Clinical HA includes hirsutism, acne, or alopecia. Biochemical HA typically refers to an elevated serum testosterone level. […] In adolescent girls, large, multicystic ovaries are a common finding. For adolescents in whom diagnosis of PCOS remains uncertain after clinical and laboratory evaluation, MRI may be considered as a diagnostic imaging modality.

• #45 Polycystic ovary syndrome An update

  https://www.racgp.org.au/afp/2012/october/polycystic-ovary-syndrome

  Polycystic ovary syndrome (PCOS) is a common condition, present in 12-21% of women of reproductive age. Up to 70% of women with PCOS remain undiagnosed. […] The Rotterdam criteria are the most widely accepted for diagnosis and the national guideline references these criteria. […] Diagnosis is dependent on identifying at least two of the following three features, as per the Rotterdam criteria: oligo/anovulation, hyperandrogenism, or polycystic ovaries on ultrasound. […] When assessing women for PCOS, it is important to consider the following points, which are addressed further in the guideline: In young women menstrual cycles may take up to 2 years to regulate after menarche. Irregular cycles persisting into the third year postmenarche should be investigated for PCOS. […] Ultrasound is not reliable in the diagnosis of polycystic ovaries in adolescent and young women. Up to 70% of young women may have polycystic ovaries on ultrasound.

• #46 Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023) – practice guidance | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-from-the-2023-international-evidence-based-guideline-for-the-assessment-and-management-of-polycystic-ovary-syndrome/

  In adolescents, both hyperandrogenism and ovulatory dysfunction are required, with ultrasound and AMH not recommended due to poor specificity. […] Insulin resistance is recognized as a key feature of PCOS, yet routinely available measures of insulin resistance are inaccurate and clinical measurement is not currently recommended. […] Once diagnosed, assessment and management should address reproductive, metabolic, cardiovascular, dermatologic, sleep, and psychological features. […] A lifelong health plan is recommended including a focus on healthy lifestyle, prevention of excess weight gain, optimization of fertility and preconception risk factors, and prevention and treatment of diverse clinical features. […] These include metabolic risk factors, diabetes, cardiovascular disease, and sleep disorders, which are all increased in PCOS.

• #47 Polycystic Ovary Syndrome (PCOS) (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/pcos.html

  Polycystic ovary syndrome (PCOS) is a common health problem that can affect teen girls and young women. […] PCOS cannot be diagnosed until 23 years after a girls first menstrual cycle because it can take up to 2 years after a first period for any girl’s cycle to become regular. […] If your doctor thinks you might have PCOS, they might want you to see a gynecologist or an endocrinologist for a diagnosis. […] Doctors sometimes order blood tests to diagnose PCOS and or to see if the symptoms are caused by other conditions, such as thyroid or other ovarian or gland problems. […] Your doctor might order a pelvic ultrasound to check your ovaries for cysts or other problems.

• #48 Diagnosing and treating PCOS | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/polycystic-ovary-syndrome/diagnosing-and-treating-pcos

  A blood test for anti-mullerian hormone (AMH) level can be done instead of an ultrasound. […] You dont need to have an ultrasound to confirm PCOS if you have irregular or no periods and high androgen levels. […] Your doctor may ask you to do different tests before they confirm a PCOS diagnosis. The tests will depend on your individual symptoms. […] Blood tests for testosterone and free androgen index (FAI) can identify high androgen levels. […] Your doctor may also recommend blood tests to exclude conditions with similar symptoms to PCOS. […] Your doctor or specialist may perform an abdominal ultrasound to check for signs of PCOS (e.g. partly-developed eggs on your ovaries, enlarged ovaries or a thickened uterus lining). […] It’s hard to diagnose PCOS in young women in the first few years after their periods start.

• #49 Polycystic Ovary Syndrome (PCOS) (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/pcos.html

  Polycystic ovary syndrome (PCOS) is a common health problem that can affect teen girls and young women. […] PCOS cannot be diagnosed until 23 years after a girls first menstrual cycle because it can take up to 2 years after a first period for any girl’s cycle to become regular. […] If your doctor thinks you might have PCOS, they might want you to see a gynecologist or an endocrinologist for a diagnosis. […] Doctors sometimes order blood tests to diagnose PCOS and or to see if the symptoms are caused by other conditions, such as thyroid or other ovarian or gland problems. […] Your doctor might order a pelvic ultrasound to check your ovaries for cysts or other problems.

• #50 Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023) – practice guidance | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-from-the-2023-international-evidence-based-guideline-for-the-assessment-and-management-of-polycystic-ovary-syndrome/

  In adolescents, both hyperandrogenism and ovulatory dysfunction are required, with ultrasound and AMH not recommended due to poor specificity. […] Insulin resistance is recognized as a key feature of PCOS, yet routinely available measures of insulin resistance are inaccurate and clinical measurement is not currently recommended. […] Once diagnosed, assessment and management should address reproductive, metabolic, cardiovascular, dermatologic, sleep, and psychological features. […] A lifelong health plan is recommended including a focus on healthy lifestyle, prevention of excess weight gain, optimization of fertility and preconception risk factors, and prevention and treatment of diverse clinical features. […] These include metabolic risk factors, diabetes, cardiovascular disease, and sleep disorders, which are all increased in PCOS.

• #51 Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023) – practice guidance | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-from-the-2023-international-evidence-based-guideline-for-the-assessment-and-management-of-polycystic-ovary-syndrome/

  In adolescents, both hyperandrogenism and ovulatory dysfunction are required, with ultrasound and AMH not recommended due to poor specificity. […] Insulin resistance is recognized as a key feature of PCOS, yet routinely available measures of insulin resistance are inaccurate and clinical measurement is not currently recommended. […] Once diagnosed, assessment and management should address reproductive, metabolic, cardiovascular, dermatologic, sleep, and psychological features. […] A lifelong health plan is recommended including a focus on healthy lifestyle, prevention of excess weight gain, optimization of fertility and preconception risk factors, and prevention and treatment of diverse clinical features. […] These include metabolic risk factors, diabetes, cardiovascular disease, and sleep disorders, which are all increased in PCOS.

• #52 Polycystic Ovary Syndrome (PCOS) | Clinical Focus | Quest Diagnostics Polycystic Ovary Syndrome (PCOS)Polycystic Ovary Syndrome (PCOS)

  https://testdirectory.questdiagnostics.com/test/test-guides/CF_PCOS/polycystic-ovary-syndrome-pcos

  The International Evidence-Based Guideline recommends that high-quality assays, including liquid chromatography mass spectrometry-based assays, be used for the most accurate assessment of total or free testosterone in PCOS. […] Ovulatory dysfunction manifests as irregular menstrual cycles and amenorrhea. […] Ultrasound is used to identify PCOM. […] Although an ovarian ultrasound is not required to diagnose PCOS in women with irregular menstrual cycles and hyperandrogenism, it can be useful for identifying the complete PCOS phenotype. […] The criteria used to diagnose PCOS are also satisfied by many other disorders (eg, congenital adrenal hyperplasia [CAH]), nonclassic CAH due to 21-hydroxylase deficiency, hyperprolactinemia, obesity, and hypothyroidism. […] Women with PCOS should be assessed for a number of comorbidities associated with this condition. […] The hyperandrogenism of PCOS can persist into menopause. […] A diagnosis of PCOS postmenopause is more likely if a patient has a past diagnosis of PCOS, a long-term history of irregular menstrual cycles and hyperandrogenism, and/or PCOM during the reproductive years.

• #53 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  Diagnosis can generally be accomplished with a careful history, physical examination, and basic laboratory testing, without the need for ultrasonography or other imaging. […] The goal of further evaluation of suspected PCOS is twofold: to exclude other treatable conditions that can mimic PCOS and to detect and treat long-term metabolic complications. […] The differential diagnosis of PCOS is broad and includes both endocrinologic and malignant etiologies. […] For any woman with suspected PCOS, the Endocrine Society recommends excluding pregnancy, thyroid dysfunction, hyperprolactinemia, and nonclassical congenital adrenal hyperplasia. […] The Endocrine Society recommends clomiphene or letrozole (Femara) for ovulation induction. Recent studies suggest that letrozole is associated with higher live-birth rates and ovulation rates compared with clomiphene in patients with PCOS.

• #54 Polycystic ovary syndrome (PCOS) diagnostic criteria – Primary Care Notebook

  https://primarycarenotebook.com/pages/gynaecology/polycystic-ovary-syndrome-pcos-diagnostic-criteria

  Thyroid dysfunction, congenital adrenal hyperplasia, hyperprolactinaemia, androgen-secreting tumours and Cushings syndrome must to be excluded before making a diagnosis of PCOS (1). […] 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) […] 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) […] 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)

• #55 Polycystic Ovary Disease

  https://mobile.fpnotebook.com/Gyn/Endo/PlycystcOvryDs.htm

  Serum Total Testosterone 20 ng/dl (Androgen tumor) […] Obtain pelvic Ultrasound and Adrenal CT or MRI for severe Virilization (deep voice, clitoromegaly) […] Evaluate for Congenital Adrenal Hyperplasia. […] Consider Oligomenorrhea/Amenorrhea secondary causes (hypothalamic and ovarian function labs). […] Consider Cushing Disease Evaluation (e.g. moon facies, thoracic kyphosis, Secondary Hypertension, purple striae) […] 24-hour Urinary Free Cortisol level […] Dexamethasone Suppression Test. […] Consider Acromegaly Evaluation (e.g. increasing hat or glove size, prominent jaw, exopthalmos) […] Insulin-like growth factor 1. […] Imaging […] Ultrasound is not required for diagnosis of PCOS (diagnosis can be made clinically) […] Obtain if Rotterdam Criteria not met or ovarian pathology suspected (e.g. Ovarian tumor). […] Polycystic appearance does not diagnose PCOS. […] PCOS clinical features must be present for diagnosis.

• #56 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  In a patient not seeking pregnancy, the Endocrine Society recommends hormonal contraception (i.e., oral contraceptive, dermal patch, or vaginal ring) as the initial medication for treatment of irregular menses and hyperandrogenism manifesting as acne or hirsutism. […] The Endocrine Society further recommends depression screening, as well as screening for symptoms of obstructive sleep apnea in overweight and obese patients with PCOS.

• #57 Polycystic ovary syndrome (PCOS): Causes, Symptoms & Treatment | UW MedicineStethascope

  https://www.uwmedicine.org/conditions-symptoms/reproductive-sex-organs/pcos

  If you don’t plan to become pregnant, your treatment may include: […] Birth control pills. These help to control menstrual cycles, lower androgen levels, and reduce acne. […] Diabetes medicine. This is often used to lower insulin resistance in PCOS. It may also help reduce androgen levels, slow hair growth, and help you ovulate more regularly. […] Women with PCOS are more likely to develop certain serious health problems. These include type 2 diabetes, high blood pressure, problems with the heart and blood vessels, and uterine cancer. Women with PCOS often have problems with their ability to get pregnant (fertility).

• #58 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  In a patient not seeking pregnancy, the Endocrine Society recommends hormonal contraception (i.e., oral contraceptive, dermal patch, or vaginal ring) as the initial medication for treatment of irregular menses and hyperandrogenism manifesting as acne or hirsutism. […] The Endocrine Society further recommends depression screening, as well as screening for symptoms of obstructive sleep apnea in overweight and obese patients with PCOS.

• #59 Diagnosis and Treatment of Polycystic Ovary Syndrome | AAFP

  https://www.aafp.org/pubs/afp/issues/2016/0715/p106.html

  In a patient not seeking pregnancy, the Endocrine Society recommends hormonal contraception (i.e., oral contraceptive, dermal patch, or vaginal ring) as the initial medication for treatment of irregular menses and hyperandrogenism manifesting as acne or hirsutism. […] The Endocrine Society further recommends depression screening, as well as screening for symptoms of obstructive sleep apnea in overweight and obese patients with PCOS.

• #60 Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (2023) – practice guidance | American Society for Reproductive Medicine | ASRM

  https://www.asrm.org/practice-guidance/practice-committee-documents/recommendations-from-the-2023-international-evidence-based-guideline-for-the-assessment-and-management-of-polycystic-ovary-syndrome/

  PCOS should be considered a high-risk condition in pregnancy with women identified and monitored. […] An increased premenopausal risk of endometrial cancer should also be recognized, whilst absolute risks remain low. […] Symptoms of depression and anxiety are significantly increased and should be screened for in all women with PCOS, with psychological assessment and therapy as indicated. […] Greater awareness of psychological features including eating disorders and impacts on body image and quality of life is needed. […] Dissatisfaction with PCOS diagnosis and care is high and significant improvement in education and awareness is strongly recommended for women and healthcare professionals including high quality, evidence-based resources. […] Shared decision making and self-empowerment are fundamental and integrated models of care should be codesigned, funded and evaluated.

• #61

  https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/diagnosis/

  scans showing you have polycystic ovaries. […] If you’re diagnosed with PCOS, you may be treated by your GP or referred to a specialist, either a gynaecologist (a specialist in treating conditions of the female reproductive system) or an endocrinologist (a specialist in treating hormone problems).

• #62 PCOS Diagnosis — PCOS Awareness Association

  https://www.pcosaa.org/pcos-diagnosis

  How is PCOS Diagnosed? There is no one special test that can determine a PCOS diagnosis. Instead, doctors must rely on symptoms, blood tests, a physical exam, and sometimes a pelvic ultrasound to determine whether you have polycystic ovary syndrome rather than another condition that can trigger similar signs and symptoms. […] Your doctor will also ask about your family’s medical history. Your doctor will check your weight and vitals and do a complete physical exam. A number of lab tests may be ordered including blood sugar and androgen levels. A sonogram may also be done to evaluate the ovaries. […] These tests help to make a diagnosis of PCOS and exclude other causes for your symptoms. […] Your primary doctor may also refer you to a hormone specialist, or endocrinologist, to help direct the workup needed to rule out other causes and confirm the diagnosis of PCOS.

• #63 Diagnosing and treating PCOS | Jean Hailes

  https://www.jeanhailes.org.au/health-a-z/polycystic-ovary-syndrome/diagnosing-and-treating-pcos

  If you think you have polycystic ovary syndrome (PCOS), its important you see your doctor. They can help coordinate your care and refer you to specialists where needed. […] An early diagnosis and support from a team of specialists can help manage the symptoms of PCOS and reduce the risk of long-term health problems. […] Learn more about how PCOS is diagnosed and how to treat and manage common PCOS symptoms. […] If you have PCOS symptoms, see your doctor. Your doctor will review your medical history and assess your physical symptoms, weight and BMI (body mass index). They may also recommend certain tests to rule out other conditions. […] PCOS may be diagnosed if you have two or more of the following signs or symptoms: irregular or no periods, features of clinical androgen excess (e.g. pimples and excess hair growth) or higher than normal androgen levels (shown in a blood test) – androgens are male-type hormones, polycystic ovaries visible on an ultrasound (i.e. more than 20 partly-developed eggs are visible on your ovaries or your ovaries are enlarged).

• #64 PCOS Diagnosis — PCOS Awareness Association

  https://www.pcosaa.org/pcos-diagnosis

  An early diagnosis can help women with PCOS restore fertility, normalize their menstrual cycles, and protect against polycystic ovary syndrome-related risks for diabetes, heart disease, and endometrial cancer. […] Irregular menstrual periods caused by a lack of ovulation or by irregular ovulation. Periods more than 35 days apart are a strong sign of ovulation problems. […] Higher than normal androgen levels. Your doctor may look for physical signs of high levels of testosterone excess hair, male-pattern hair loss, and severe acne or use the results of blood tests. […] Polycystic ovaries on pelvic ultrasound. Thanks to newer, more sensitive ultrasound equipment, experts say doctors should look for 25 or more cysts on a woman’s ovary to diagnose polycystic ovaries.

• #65 Polycystic ovary syndrome (PCOS): Diagnosis and management – Women’s Healthcare

  https://www.npwomenshealthcare.com/polycystic-ovary-syndrome-pcos-diagnosis-and-management/

  The goals of management include suppressing androgen secretion, protecting the endometrium, improving menstrual dysfunction, improving metabolic status, and improving ovulatory fertility. […] Early diagnosis, screening for comorbidities, patient counseling, and evidence-based management are all key to improving outcomes among women with PCOS.

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