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What criteria are used to diagnose PCOS?

By Mónica Aura Masip M.D., M.Sc. (gynecologist).
Last Update: 03/04/2022

Polycystic ovary syndrome (PCOS) is characterized by infrequent or absent periods (oligoanovulation), clinical or analytical hyperandrogenism, and characteristic ultrasound morphology of the ovaries.

These patients may also have difficulty becoming pregnant as ovulation does not occur each month; and they can develop metabolic problems (insulin resistance, hypertension, obesity, increased cardiovascular risk...).

Several expert meetings have been held to agree on the criteria that will define the SOP. Already in 2003, in Rotterdam, it was determined that patients should meet 2 of these 3 criteria:

Hyperandrogenism
can manifest with acne, alopecia or hirsutism (increased hair in areas such as the chin, mustache, abdomen, back,...) or increased androgens in the blood.
Oligoanovulation
means ovulating little or never, that will produce irregular or absent periods.
Ovaries with PCOS morphology
Using an ultrasound it is possible to know how big they are and what the ovaries are like. An ovary is considered to have polycystic morphology when it measures more than 10 cc or if it has more than 12 antral follicles, although these limits are still under discussion.
Imagen: diagnostic-criteris-pcos

These criteria would not be valid for an adolescent since at puberty, physiologically, there is an increase in androgens, acne appears, and the ovaries are indistinguishable from a patient with PCOS in most cases.

In order to make an accurate diagnosis, we must allow a minimum of 5 years from the age of the first menstrual period.

 Mónica  Aura Masip
Mónica Aura Masip
M.D., M.Sc.
Gynecologist
Dr. Mónica Aura has a degree in Medicine and General Surgery from the Autonomous University of Barcelona (UAB). She is also a specialist in Gynecology and Obstetrics from the Hospital de Santa Creu y Sant Pau and has a Master's degree in Human Assisted Reproduction from the University Juan Carlos I of Madrid and another in Health Center Management from the UB.
Licence number: 31588
Gynecologist. Dr. Mónica Aura has a degree in Medicine and General Surgery from the Autonomous University of Barcelona (UAB). She is also a specialist in Gynecology and Obstetrics from the Hospital de Santa Creu y Sant Pau and has a Master's degree in Human Assisted Reproduction from the University Juan Carlos I of Madrid and another in Health Center Management from the UB. Licence number: 31588.