Approach to the Patient: Diagnostic Challenges in the Workup for Polycystic Ovary Syndrome

January 2025 in “ The Journal of Clinical Endocrinology & Metabolism ”

Anju E. Joham, Chau Thien Tay, Joop S.E. Laven, Yvonne V. Louwers, Ricardo Azziz

polycystic ovary syndrome PCOS hyperandrogenism irregular cycles polycystic ovary morphology elevated AMH levels androgen exposure adiposity-related dysfunction

Studysummary This article discusses the complex aetiology, diagnostic criteria, and challenges in diagnosing polycystic ovary syndrome, but does not report new clinical findings.

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Research cited in this study

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research Update on Polycystic Ovary Syndrome

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This review highlights key clinical recommendations from the 2018 international guidelines on PCOS management and questions if these guidelines will be widely adopted in practice.

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research Androgen Excess: Investigations and Management

82 citations , May 2016 in “Best Practice & Research in Clinical Obstetrics & Gynaecology”

This article outlines the clinical features, evaluation, and treatment strategies for androgen excess in polycystic ovary syndrome, highlighting important diagnostic and management approaches but reporting no new research results.

research Defining Hirsutism in Chinese Women: A Cross-Sectional Study

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This study determined that an mFG score of 5 or greater defines hirsutism among Southern Chinese women, with prevalence and score thresholds decreasing with age.

research Hirsutism Scoring in Polycystic Ovary Syndrome: Concordance Between Clinicians' and Patients' Self-Scoring

10 citations , June 2010 in “Fertility and Sterility”

In this study, patients with polycystic ovary syndrome self-reported higher hirsutism scores compared to clinician assessments, but only clinician scores correlated with biochemical markers of hyperandrogenism.

research Visually Scoring Hirsutism

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This review examines various methods for assessing hair growth in women, highlighting the usefulness of the mFG visual scoring method for diagnosing hirsutism despite its limitations.

research Prevalence of Hyperandrogenemia in Polycystic Ovary Syndrome Diagnosed by the National Institutes of Health 1990 Criteria

118 citations , February 2009 in “Fertility and Sterility”

This study found that approximately 75% of women with PCOS exhibited hyperandrogenemia, with free testosterone being the most frequently elevated marker.

Prevalence of Polycystic Ovaries in Women with Self-Reported Symptoms of Oligomenorrhoea and/or Hirsutism: Northern Finland Birth Cohort 1966 Study

research Prevalence of Polycystic Ovaries in Women with Self-Reported Symptoms of Oligomenorrhoea and/or Hirsutism: Northern Finland Birth Cohort 1966 Study

77 citations , March 2004 in “Human Reproduction”

This study found that women with symptoms of oligomenorrhoea and/or hirsutism are more likely to have polycystic ovaries and less favorable biochemical and clinical markers compared to asymptomatic women.

research Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome (PCOS)

4025 citations , December 2003 in “Human Reproduction”

This review discusses the evolution of diagnostic criteria for polycystic ovary syndrome and emphasizes its association with various metabolic and cardiovascular risks, but it provides no new research findings.