Criteria - all 3 of the following:
(1) hirsutism and/or hyperandrogenemia (as manifestations of hyperandrogenism)
(2) oligo or anovulation and/or polycystic ovaries (as manifestations of ovarian dysfunction)
(3) exclusion of other disorders associated with androgen excess (see below)
where:
• Disorders to exclude include: hyperprolactinemia, adrenal hyperplasia with 21-hydroxylase deficiency, thyroid dysfunction, Cushing's syndrome, severe insulin resistance, androgen-secreting tumors, and anabolic drug use/abuse.
• A woman with regular, predictable vaginal bleeding and with no evidence of hirsutism has good evidence for normal ovulation.
• Hirsutism was based on the Ferriman-Gallwey score.
• Free testosterone levels is the most common test for demonstrating androgen excess. Other androgens may include dehydroepiandrosterone sulfate (DHEAS) and androstenedione.
Common findings in PCOS not used in the definition (page 4242, Azziz et al):
(1) obesity
(2) insulin resistance and hyperinsulinism
(3) increased serum LH
