The Polycystic Ovary Syndrome consists of a constellation of clinical and biochemical findings. The presence of these criteria can help identify a woman at risk, although affected women may vary in which findings are present.



(1) menstrual and ovulatory changes

(2) hyperandrogenism, clinically and biochemically

(3) appearance of the ovaries on imaging studies

(4) exclusion of other conditions producing increased androgens

(5) features of the metabolic syndrome


Menstrual and ovulatory changes:

(1) irregular menses, amenorrhea, oligomenorrhea, dysfunctional uterine bleeding

(2) anovulatory infertility


Clinical and biochemical hyperandrogenism:

(1) hirsutism

(2) acne

(3) high normal or elevated serum free testosterone

(4) high normal or elevated serum androstenedione


Appearance of the ovaries on imaging studies:

(1) may be normal size or enlarged

(2) typically each ovary shows > 10 cortical cystic follicles, usually < 6 mm in diameter


Exclusion of other conditions associated with increased androgens:

(1) adrenal hyperplasia

(2) adrenal tumors

(3) ovarian tumors


Features of the metabolic syndrome:

(1) central obesity

(2) insulin resistance with hyperinsulinemia



• The more features that are present, the more confident the diagnosis.

• While most women manifest ovarian changes, a few women may have normal-appearing ovaries on imaging studies.


To read more or access our algorithms and calculators, please log in or register.