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Polycystic ovarian disease : diagnostic criteria and workup

Polycystic ovarian disease : diagnostic criteria and workup

This table is a summarized representation of the given text on PCOS diagnostic criteria and suggested investigations.

Criteria/NoteDescription
Primary Diagnostic CriteriaConsider diagnosis of PCOS if two of three of the following criteria are present ( CKS )
OvulationInfrequent or no ovulation, is typically seen as irregular or absent menstruation.
HyperandrogenismClinical/biochemical signs (e.g., hirsutism, acne, or elevated testosterone levels).
Polycystic Ovaries (Ultrasound)Presence of 12+ follicles (2–9 mm diameter) in one/both ovaries or increased ovarian volume (>10 cm³).
Additional Notes
Polycystic Ovaries RequirementNot necessary for diagnosis; mere presence doesn't establish diagnosis.
Ethnicity VariationsNon-Caucasian ethnicity might need different diagnostic criteria due to PCOS variations.
AdolescentsBoth hyperandrogenism and irregular cycles are required for diagnosis.
Androgen ExcessExercise caution before diagnosing PCOS if there are androgen excess signs without irregular cycles.
At 'Increased Risk' in AdolescentsFeatures of PCOS but not meeting criteria? Consider 'increased risk' and reassess at/full reproductive maturity (8 years post-menarche).
Suggested InvestigationsDescription
TestosteroneMeasure total testosterone (normal to slightly elevated in PCOS).
SHBGMeasure sex hormone-binding globulin (SHBG) - indicates hyperinsulinaemia levels.
Free Androgen IndexCalculate to assess active testosterone levels.
Hormonal ContraceptionStop hormonal contraception at least 3 months before assessing...

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