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
利益声明
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
Declarações
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
Declarações
CBL declares that he has no competing interests.
Créditos aos pareceristas
Os tópicos do BMJ Best Practice são constantemente atualizados, seguindo os desenvolvimentos das evidências e das diretrizes. Os pareceristas aqui listados revisaram o conteúdo pelo menos uma vez durante a história do tópico.
Declarações
As afiliações e declarações dos pareceristas referem--se ao momento da revisão.
Referências
Principais artigos
Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nat Rev Dis Primers. 2016 Aug 11;2:16057. Resumo
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 Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- 21-hydroxylase deficiency
- Thyroid dysfunction
- Hyperprolactinemia
Mais Diagnósticos diferenciaisDiretrizes
- International evidence-based guideline for the assessment and management of polycystic ovary syndrome
- ACOG practice bulletin: polycystic ovary syndrome
Mais DiretrizesFolhetos informativos para os pacientes
Polycystic ovary syndrome: what is it?
Polycystic ovary syndrome: what are the treatment options?
Mais Folhetos informativos para os pacientes
Conectar-se ou assinar para acessar todo o BMJ Best Practice
O uso deste conteúdo está sujeito ao nosso aviso legal