Current Guidelines for Diagnosing PCOS

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine disorder of reproductive-aged women. Much of the confusion surrounding PCOS diagnosis stems from the broad heterogeneity of symptomology experienced by women with PCOS. The diverse features of the syndrome have led to a number of diagnostic criteria over the years. This manuscript describes each of the current composite criteria and individually breaks down each component. The importance of accurate diagnosis for both clinical care and research is emphasized.

Systematic Review of the roles of Inositol and Vitamin D in improving fertility among patients with Polycystic Ovary Syndrome

“…The phosphorylated insulin receptor then phosphorylates the insulin receptor substrate (IRS) proteins situated within the cell membrane. Phosphorylated IRS serves as a binding site for phosphoinositide 3-kinase (PI3K), which then catalyzes the transformation of phosphatidyl-inositol-4,5-bisphosphate (PIP2) into phosphatidylinositol (3,4,5)-trisphosphate (PIP3). Alternatively, PIP2 can be cleaved by phospholipase C (PLC) to generate inositol-1,4,5-trisphosphate (IP3).…”

“…These criteria identify sub-phenotypes, which include combinations of androgen excess and ovulatory dysfunction, androgen excess and polycystic ovarian morphology (PCOM), ovulatory dysfunction and PCOM, or all three. Assuming the exclusion of other etiologies, a diagnosis is established when two of the three following conditions are met: hyperandrogenism, oligo-anovulation, or polycystic ovaries as identified by ultrasound [5]. Vitamin D deficiency (VDD), which is often observed in individuals with PCOS, can be addressed with supplemen-tation.…”

Quality of Life of Women with Polycystic Ovary Syndrome

“…Among these, the Rotterdam criteria are the most widely utilized [9][10][11][12]. To receive a diagnosis of PCOS, a minimum of two of the three Rotterdam criteria must be satisfied: ultrasound evidence of polycystic ovaries (presence of at least 20 Graff follicles measuring 2-9 mm in diameter and/or ovarian volume >10 mL), infrequent ovulation or absence of ovulation, and clinical and/or biochemical indications of hyperandrogenism [13]. When employing these criteria for PCOS diagnosis, it is essential to simultaneously rule out other endocrine causes [13].…”

Glycemic Index and Glycemic Load Estimates in the Dietary Approach of Polycystic Ovary Syndrome

“…Polycystic ovary syndrome (PCOS) is a complex, polygenic metabolic condition and the most common endocrine disorder in women of reproductive age. According to the 2003 Rotterdam criteria, PCOS is defined as clinical or biochemical hyperandrogenism, an indication of oligo-anovulation and polycystic-appearing ovarian morphology on the ultrasound, excluding any other relevant conditions [1,2]. Currently, four recognized phenotypes of PCOS include all possible combinations of these characteristics: (1) hyperandrogenism, oligo-anovulation and polycystic ovarian morphology; (2) hyperandrogenism and oligo-anovulation with normal ovarian morphology; (3) hyperandrogenism and polycystic ovarian morphology with normal ovulation; and (4) polycystic ovarian morphology and oligo-anovulation without the presence of hyperandrogenism [3].…”

“…The approaches used in PCOS treatment are mostly determined by the intended outcome. Fertility, control of menstrual irregularities, improvement of hyperandrogenism, enhancement of insulin sensitivity, and weight loss are some of the main targets that are particularly important [1,2,22]. The treatment options include pharmacologic treatment with metformin, oral contraceptives and antiandrogens, estrogen receptor modulators such as clomifene for women who are interested in becoming pregnant, exogenous gonadotropins, or even laparoscopic surgical procedures [1,2,22].…”