Polycystic ovary syndrome
Summary
Definition
History and exam
Key diagnostic factors
- female of reproductive age
- irregular menstruation
- infertility
- hirsutism
Other diagnostic factors
- acne
- overweight or obesity
- hypertension
- scalp hair loss
- oily skin or excessive sweating
- acanthosis nigricans
Risk factors
- family history of PCOS
- premature adrenarche
- obesity
- low birth weight
- fetal androgen exposure
- environmental endocrine disruptors
Diagnostic tests
1st tests to order
- serum 17-hydroxyprogesterone
- serum prolactin
- serum thyroid-stimulating hormone
- oral glucose tolerance test
- fasting lipid panel
Tests to consider
- serum total and free testosterone
- serum dehydroepiandrosterone sulfate (DHEAS)
- serum androstenedione
- pelvic ultrasound
- serum anti-Mullerian hormone
- basal body temperature monitoring
- luteal phase progesterone measurement
- serum LH and follicle-stimulating hormone (FSH)
- hemoglobin A1c or fasting plasma glucose
Treatment algorithm
with infertility and desiring fertility
not desiring current fertility
Contributors
Authors
Mark O. Goodarzi, MD, PhD
Division of Endocrinology, Diabetes & Metabolism
Eris M. Field Chair in Diabetes Research
Professor of Medicine
Cedars-Sinai Medical Center
Los Angeles
CA
Disclosures
MOG has been reimbursed for one-time participation in an advisory board for Nestle Health Science on the topic of exocrine pancreatic dysfunction. MOG is an author of a number of references cited in this topic.
Peer reviewers
Antoni Duleba, MD
Professor
Department of Obstetrics and Gynecology
University of California Davis
Sacramento
CA
Disclosures
AD declares that he has no competing interests.
Richard S. Legro, MD
Professor
Department of Obstetrics and Gynecology
Penn State Hershey College of Medicine
Hershey
PA
Divulgaciones
RSL has been reimbursed by Serono for attending a medical conference and received a lecture fee, and has consulted for Ferring. He has received research funding from the NIH, the Commonwealth of Pennsylvania, and Parke Davis. He is an author of a number of references cited in this topic.
Cornelis B. (Nils) Lambalk, MD, PhD
Gynaecologist/Fertility Specialist
Division of Reproductive Medicine
Department of Obstetrics and Gynaecology
VU University Medical Centre
Amsterdam
The Netherlands
Divulgaciones
CBL declares that he has no competing interests.
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Divulgaciones
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Referencias
Artículos principales
Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016 Aug 11;2:16057. Resumen
Teede HJ, Tay CT, Laven JJE, et al. Recommendations from the 2023 international evidence-based guideline for the assessment and management of polycystic ovary syndrome. J Clin Endocrinol Metab. 2023 Sep 18;108(10):2447-69.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- 21-hydroxylase deficiency
- Thyroid dysfunction
- Hyperprolactinemia
Más DiferencialesGuías de práctica clínica
- International evidence-based guideline for the assessment and management of polycystic ovary syndrome
- ACOG practice bulletin: polycystic ovary syndrome
Más Guías de práctica clínicaFolletos para el paciente
Polycystic ovary syndrome: what is it?
Polycystic ovary syndrome: what are the treatment options?
Más Folletos para el paciente
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