Diagnosing Polycystic Ovary Syndrome

The document from 2006 discusses the diagnostic criteria and features of polycystic ovary syndrome (PCOS), a condition with a wide spectrum of presentations affecting women's reproductive and metabolic health. The Rotterdam consensus from 2003 established that at least two of the following features are required for diagnosis: polycystic ovaries, oligo-ovulation or anovulation, and clinical or biochemical evidence of androgen excess. The article notes that PCOS is the most common cause of anovulatory infertility (73% of cases) and is often associated with menstrual disturbances and hirsutism. A study of 1,871 women with PCOS showed that 30% had regular menstrual cycles, 50% had oligomenorrhoea, and 20% were amenorrhoeic. Obesity is prevalent in 35-50% of women with PCOS. Androgenic alopecia is found in 5-10% of women with PCOS, and a separate study found that 67% of women with androgenic alopecia had PCOS. The diagnosis of PCOS is supported by clinical examination, ultrasonography, and hormonal investigations, including serum testosterone and luteinizing hormone (LH) levels. Insulin resistance, which occurs in 30-60% of women with PCOS, necessitates metabolic screening, particularly for type 2 diabetes in obese women. The document also emphasizes the importance of differentiating PCOS from other conditions that may present with similar symptoms, such as Cushing's syndrome or androgen-secreting tumors.