Am Fam Physician. 2024;110(5):547-548
Author disclosure: No relevant financial relationships.
KEY POINTS FOR PRACTICE
• PCOS can be diagnosed without using ultrasonography in women with ovulatory dysfunction and clinical or biochemical evidence of hyperandrogenism.
• In adults, antimüllerian hormone levels can be used instead of ultrasonography to indicate polycystic ovaries.
• Consider treating hirsutism and irregular cycles with a combined oral contraceptive. Limit metformin use to patients with obesity and metabolic risk factors.
From the AFP Editors
Polycystic ovary syndrome (PCOS) is the most common endocrinopathy in reproductive-aged women, affecting up to 13% of this population. An international group of professional organizations has developed an evidence-based guideline for the assessment and management of PCOS.
DIAGNOSIS
To diagnose PCOS, two of the following criteria are required:
clinical or biochemical evidence of hyperandrogenism,
ovulatory dysfunction,
ultrasound images showing polycystic ovaries or elevated antimüllerian hormone levels.
Hyperandrogenism
At least 60% of women with PCOS have evidence of hyperandrogenism using clinical or biochemical markers. To diagnose clinical hyperandrogenism, the modified Ferriman-Gallwey score is recommended to assess facial and terminal hair growth, although presentations differ among ethnicities.
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