A practical approach to the diagnosis of polycystic ovary syndrome
The diagnosis of polycystic ovary syndrome (PCOS) is primarily achieved through clinical history and physical findings. The principle features are hirsutism or biochemical evidence of excess androgen production and irregular menstrual bleeding caused by the chronic anovulation. Associated findings i...
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| Published in | American journal of obstetrics and gynecology Vol. 191; no. 3; pp. 713 - 717 |
|---|---|
| Main Author | |
| Format | Journal Article |
| Language | English |
| Published |
Philadelphia, PA
Mosby, Inc
01.09.2004
Elsevier |
| Subjects | |
| Online Access | Get full text |
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| Abstract | The diagnosis of polycystic ovary syndrome (PCOS) is primarily achieved through clinical history and physical findings. The principle features are hirsutism or biochemical evidence of excess androgen production and irregular menstrual bleeding caused by the chronic anovulation. Associated findings include insulin resistance with compensatory hyperinsulinemia and obesity. Ultrasound imaging of the ovary has facilitated the diagnosis. It is important to exclude conditions that may mimic PCOS, such as hyperthecosis, congenital adrenal hyperplasia, 21-hydroxylase deficiency, Cushing's syndrome, and androgen-producing neoplasms. These disorders are usually revealed by appropriate laboratory assessment. Screening tests include measurement of serum total testosterone, DHEA sulfate, and 17-hydroxyprogesterone. In addition, in the obese individual, determinations of glucose and insulin levels, as well as a lipid profile, are highly recommended. |
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| AbstractList | The diagnosis of polycystic ovary syndrome (PCOS) is primarily achieved through clinical history and physical findings. The principle features are hirsutism or biochemical evidence of excess androgen production and irregular menstrual bleeding caused by the chronic anovulation. Associated findings include insulin resistance with compensatory hyperinsulinemia and obesity. Ultrasound imaging of the ovary has facilitated the diagnosis. It is important to exclude conditions that may mimic PCOS, such as hyperthecosis, congenital adrenal hyperplasia, 21-hydroxylase deficiency, Cushing's syndrome, and androgen-producing neoplasms. These disorders are usually revealed by appropriate laboratory assessment. Screening tests include measurement of serum total testosterone, DHEA sulfate, and 17-hydroxyprogesterone. In addition, in the obese individual, determinations of glucose and insulin levels, as well as a lipid profile, are highly recommended. The diagnosis of polycystic ovary syndrome (PCOS) is primarily achieved through clinical history and physical findings. The principle features are hirsutism or biochemical evidence of excess androgen production and irregular menstrual bleeding caused by the chronic anovulation. Associated findings include insulin resistance with compensatory hyperinsulinemia and obesity. Ultrasound imaging of the ovary has facilitated the diagnosis. It is important to exclude conditions that may mimic PCOS, such as hyperthecosis, congenital adrenal hyperplasia, 21-hydroxylase deficiency, Cushing's syndrome, and androgen-producing neoplasms. These disorders are usually revealed by appropriate laboratory assessment. Screening tests include measurement of serum total testosterone, DHEA sulfate, and 17-hydroxyprogesterone. In addition, in the obese individual, determinations of glucose and insulin levels, as well as a lipid profile, are highly recommended.The diagnosis of polycystic ovary syndrome (PCOS) is primarily achieved through clinical history and physical findings. The principle features are hirsutism or biochemical evidence of excess androgen production and irregular menstrual bleeding caused by the chronic anovulation. Associated findings include insulin resistance with compensatory hyperinsulinemia and obesity. Ultrasound imaging of the ovary has facilitated the diagnosis. It is important to exclude conditions that may mimic PCOS, such as hyperthecosis, congenital adrenal hyperplasia, 21-hydroxylase deficiency, Cushing's syndrome, and androgen-producing neoplasms. These disorders are usually revealed by appropriate laboratory assessment. Screening tests include measurement of serum total testosterone, DHEA sulfate, and 17-hydroxyprogesterone. In addition, in the obese individual, determinations of glucose and insulin levels, as well as a lipid profile, are highly recommended. |
| Author | Jeffrey Chang, R. |
| Author_xml | – sequence: 1 givenname: R. surname: Jeffrey Chang fullname: Jeffrey Chang, R. organization: Department of Reproductive Medicine, University of California, San Diego, School of Medicine, La Jolla, Calif |
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| Cites_doi | 10.1016/S0140-6736(85)92552-8 10.1210/jcem-57-2-356 10.1055/s-2007-1016308 10.1016/S0015-0282(16)46633-1 10.1210/jcem-22-3-325 10.1111/j.1471-0528.1949.tb07115.x 10.1016/j.fertnstert.2003.10.004 10.1093/humrep/deh098 10.1210/jcem-65-3-499 10.1136/bmj.293.6543.355 10.1210/jcem.85.7.6661 10.1007/BF00280883 10.1016/0026-0495(94)90209-7 10.2337/diacare.22.1.141 |
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| Keywords | Polycystic ovary syndrome Androgens Hirsutism Ovarian diseases Gynecology Cyst Female sterility Benign neoplasm Diagnosis Polycystic ovary Polycystic ovary syndrome Hirsutism Androgens Obstetrics Female genital diseases |
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| References_xml | – start-page: 377 year: 1992 end-page: 384 ident: bib19 article-title: Diagnostic criteria for polycystic ovary syndrome: toward a rational approach publication-title: Polycystic ovary syndrome – volume: 43 start-page: 647 year: 1994 end-page: 654 ident: bib10 article-title: Metformin therapy in polycystic ovary syndrome reduces hyperinsulinemia, insulin resistance, hyperandrogenemia, and systolic blood pressure, while facilitating normal menses and pregnancy publication-title: Metabolism – volume: 84 start-page: 165 year: 1999 end-page: 169 ident: bib6 article-title: Prevalence and predictors of risk for type 2 diabetes mellitus and impaired glucose tolerance in polycystic ovary syndrome: a prospective, controlled study in 254 affected women publication-title: J Clin Endocrinol Metab – volume: 85 start-page: 2402 year: 2000 end-page: 2410 ident: bib18 article-title: Quantitative insulin sensitivity check index: a simple, accurate method for assessing insulin sensitivity in humans publication-title: J Clin Endocrinol Metab – volume: 57 start-page: 356 year: 1983 ident: bib7 article-title: Insulin resistance in nonobese patients with polycystic ovarian disease publication-title: J Clin Endocrinol Metab – volume: 44 start-page: 870 year: 1999 end-page: 874 ident: bib2 article-title: Prevalence of polycystic ovary syndrome in women seeking treatment from community electrologists. 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| SubjectTerms | 17-alpha-Hydroxyprogesterone - blood Adrenal Hyperplasia, Congenital Androgens Androgens - biosynthesis Anovulation Biological and medical sciences Cushing Syndrome Dehydroepiandrosterone Sulfate - blood Diagnosis, Differential Female Female genital diseases Gynecology. Andrology. Obstetrics Hirsutism Hirsutism - complications Humans Hyperinsulinism Insulin Resistance Medical sciences Non tumoral diseases Obesity Ovary - diagnostic imaging Polycystic ovary syndrome Polycystic Ovary Syndrome - diagnosis Testosterone - blood Theca Cells - pathology Ultrasonography |
| Title | A practical approach to the diagnosis of polycystic ovary syndrome |
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