Polycystic ovarian syndrome is a common disorder causing androgen excess, ovulatory dysfunction and polycystic ovaries. PCOS can only be diagnosed if other potential causes of androgen excess are first ruled out (Congenital adrenal hyperplasia, Cushing’s, androgen tumors, etc) Thus, PCOS is a diagnosis of exclusion. In the developed world, PCOS is the most common endocrine disorder causing androgen excess and affects anywhere from 4-12% of all women. It appears to affect all races and nationalities.
In order to diagnose PCOS, the Rotterdam consensus of 2003 states that 2 out of the 3 criteria must be met: 1) elevated circulating androgens 2) oligo or anovulation 3) polycystic ovaries on ultrasound. Some controversy exists regarding the last criteria, since as many as 25% of females with normal androgen levels and regular menses may have polycystic ovaries.
|Image from the Florida Department of Health webpage|
PCOS remains a multi-factorial and complicated disorder. However, many different treatments and therapies are now available to resolve the clinical manifestations of this disease. Primary care physicians and gynecologists should be consulted first if one suspects PCOS. The appropriate referrals can then be made to reproductive endocrinology for more extensive workup.
For more information about PCOS as well as information about latest treatment guidelines and support groups, check out http://www.soulcysters.com/and http://www.pcosupport.org/
Common lab tests and treatment found here
Infertility resource center found here
Submitted by Emily Yen, Class of 2011, Women’s Health Pathway Student
Legro, Richard., “Polycystic Ovary Syndrome, Hirsutism and other Androgenic Excess Disorders,” PRECIS: Reproductive Endocrinology, American College of Obstetricians and Gynecologists, 2002
Schorge JO, Schaffer JI, Halvorson LM, Hoffman BL, Bradshaw KD, Cunningham FG, "Chapter 17. Polycystic Ovarian Syndrome and Hyperandrogenism" (Chapter). Williams Gynecology: McGraw Hill Companies, 2008