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 investigations
1st investigations to order
- serum 17-hydroxyprogesterone
- serum prolactin
- serum thyroid-stimulating hormone
- oral glucose tolerance test
- fasting lipid panel
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)
Treatment algorithm
with infertility and desiring fertility
not desiring current fertility
Contributors
Authors
Mark O. Goodarzi, MD, PhD

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.
Differentials
- 21-hydroxylase deficiency
- Thyroid dysfunction
- Hyperprolactinemia
More DifferentialsGuidelines
- Practice bulletin: polycystic ovary syndrome
- Ovulation induction in polycystic ovary syndrome
More GuidelinesPatient leaflets
Polycystic ovary syndrome: what is it?
Polycystic ovary syndrome: what treatments work?
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