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Diagnosis of polycystic ovary syndrome in adults

Robert L Barbieri, MD
David A Ehrmann, MD
Section Editor
William F Crowley, Jr, MD
Deputy Editor
Kathryn A Martin, MD


The polycystic ovary syndrome (PCOS) is an important cause of both menstrual irregularity and androgen excess in women. PCOS can be readily diagnosed when women present with the classic features of hirsutism, irregular menstrual cycles, obesity (in some, but not all, populations), and polycystic ovarian morphology on transvaginal ultrasound (TVUS). However, there has been considerable controversy about specific diagnostic criteria when not all of these classic features are evident.

The diagnosis of PCOS will be reviewed here. The epidemiology and pathogenesis, clinical manifestations, and treatment of PCOS are described in detail separately. The diagnosis of PCOS in adolescents is also reviewed separately. (See "Epidemiology and genetics of the polycystic ovary syndrome in adults" and "Clinical manifestations of polycystic ovary syndrome in adults" and "Treatment of polycystic ovary syndrome in adults" and "Diagnostic evaluation of polycystic ovary syndrome in adolescents".)


The clinical features of PCOS are described here briefly but are reviewed in detail separately. (See "Clinical manifestations of polycystic ovary syndrome in adults".)

PCOS is thought to be one of the most common endocrinopathies in women, affecting between 5 and 12 percent of women, depending upon the population studied (see "Epidemiology and genetics of the polycystic ovary syndrome in adults", section on 'Epidemiology'). The syndrome is characterized clinically by oligomenorrhea and hyperandrogenism, as well as the frequent presence of associated risk factors for cardiovascular disease, including obesity, glucose intolerance, dyslipidemia, fatty liver, and obstructive sleep apnea. Other features include:

Menstrual dysfunction – The menstrual irregularity typically begins in the peripubertal period, and menarche may be delayed. The menstrual pattern is typically one of oligomenorrhea (fewer than nine menstrual periods in a year) and, less often, amenorrhea (no menstrual periods for three or more consecutive months). Women with PCOS often experience more regular cycles after age 40 years. (See "Clinical manifestations of polycystic ovary syndrome in adults", section on 'Menstrual dysfunction'.)

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Literature review current through: Nov 2017. | This topic last updated: Aug 15, 2017.
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