Polycystic ovary syndrome

Last reviewed: 6 Jun 2022
Last updated: 14 Sep 2021

Summary

Definition

History and exam

Key diagnostic factors

  • female of reproductive age
  • irregular menstruation
  • infertility
  • hirsutism
More key diagnostic factors

Other diagnostic factors

  • acne
  • overweight or obesity
  • hypertension
  • scalp hair loss
  • oily skin or excessive sweating
  • acanthosis nigricans
Other diagnostic factors

Risk factors

  • family history of PCOS
  • premature adrenarche
  • obesity
  • low birth weight
  • fetal androgen exposure
  • environmental endocrine disruptors
More risk factors

Diagnostic investigations

1st investigations to order

  • serum 17-hydroxyprogesterone
  • serum prolactin
  • serum thyroid-stimulating hormone
  • oral glucose tolerance test
  • fasting lipid panel
More 1st investigations to order

Investigations to consider

  • serum total and free testosterone
  • serum dehydroepiandrosterone sulfate (DHEAS)
  • serum androstenedione
  • pelvic ultrasound
  • basal body temperature monitoring
  • luteal phase progesterone measurement
  • serum LH and follicle-stimulating hormone (FSH)
More investigations to consider

Treatment algorithm

ACUTE

with infertility and desiring fertility

ONGOING

not desiring current fertility

Contributors

Authors

Mark O. Goodarzi, MD, PhD
Mark O. Goodarzi

Director

Division of Endocrinology, Diabetes & Metabolism

Eris M. Field Chair in Diabetes Research

Professor of Medicine

Cedars-Sinai Medical Center

Los Angeles

CA

Disclosures

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

Disclosures

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

Disclosures

CBL declares that he has no competing interests.

  • Polycystic ovary syndrome images
  • Differentials

    • 21-hydroxylase deficiency
    • Thyroid dysfunction
    • Hyperprolactinemia
    More Differentials
  • Guidelines

    • Practice bulletin: polycystic ovary syndrome
    • Ovulation induction in polycystic ovary syndrome
    More Guidelines
  • Patient leaflets

    Polycystic ovary syndrome: what is it?

    Polycystic ovary syndrome: what treatments work?

    More Patient leaflets
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