https://orcid.org/0000-0002-9440-3411
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Geralyn Lambert-Messerlian, The Race for Diagnosis of Polycystic Ovary Syndrome, The Journal of Clinical Endocrinology & Metabolism, Volume 110, Issue 4, April 2025, Pages e1274–e1275, https://doi.org/10.1210/clinem/dgae495
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Polycystic ovary syndrome (PCOS) is a recognized risk factor for the long-term health of women. PCOS is not only a challenge for reproductive health; it conveys lifelong risks for diabetes, dyslipidemia, hypertension, obstructive sleep apnea, endometrial cancer, and cardiovascular disease, among other morbidities (1). These increased risks persist even when controlling for high body mass index, a common feature of PCOS, and most apply across premenopausal and postmenopausal women. The health consequences are exacerbated by missed or late diagnoses, which are common. One provocative study showed that it often took more than 2 years and 3 different health care providers for women to receive a diagnosis of PCOS, regardless of residing in North America, Europe, or other parts of the world (2).
An ongoing challenge in diagnosing PCOS and understanding its prevalence has been the lack of uniformity in clinical criteria (3). The National Institutes of Health (NIH), in 1990, was first to introduce diagnostic criteria for PCOS. A Rotterdam expert consensus (2003) then expanded the definition and later, the Androgen Excess and PCOS Society (2006) proposed a modification. Currently, the NIH evidence-based workshop (2012) recommends diagnosis by 2 of 3 criteria: ovulatory dysfunction, biochemical or clinical hyperandrogenism, and/or polycystic ovary morphology. Patients are categorized into 1 of 4 PCOS phenotypes based on the clinical findings.
