CRITERIA FOR PCOS DIAGNOSIS:
At least 2 of following present:
Exclude other causes of hyperandrogenism: ovarian/adrenal tumours, congenital adrenal hyperplasia, Cushing’s syndrome.
Suspect PCOS if presentation with:
especially if accompanied by obesity, acanthosis nigricans or FH of PCOS.
EXAMINATION and INVESTIGATION:
To establish the diagnosis:
Pelvic ultrasound (transvaginal) – classic picture of PCOS:
(AMH > 40pmol/L in most cases)
LH, total testosterone, free androgen index not mandatory for diagnosis.
To exclude other causes of oligo- and amenorrhoea:
To exclude other causes of hyperandrogenism if suspected:
Total testosterone, free androgen index (normal to moderately raised in PCOS but very high with tumours), DHEAS (very high with adrenal tumours). Ultrasound/MRI examination of ovaries and adrenals where indicated.
If overweight or frankly obese:
Anil Gudi , Amit Shah and Prof Homburg