What is PCOS and how is it diagnosed?
PCOS is a hormonal-metabolic syndrome diagnosed by two of three Rotterdam criteria: oligo/anovulation, hyperandrogenism (clinical or biochemical), or polycystic ovarian morphology on ultrasound.
Full answer
Polycystic ovary syndrome (PCOS) is a hormonal-metabolic syndrome affecting 6-12% of reproductive-age women. Diagnosis follows the Rotterdam criteria: two of three of (1) oligo- or anovulation, (2) clinical or biochemical hyperandrogenism, (3) polycystic ovarian morphology on ultrasound. PCOS associates strongly with insulin resistance, central adiposity, metabolic syndrome, and elevated cardiovascular risk — independent of body weight. Workup includes total testosterone, free testosterone, SHBG, DHEA-S, LH/FSH ratio, fasting insulin, glucose, A1C, and a lipid panel. Treatment is individualized to the patient's primary concern (cycle regulation, fertility, hyperandrogenic symptoms, or metabolic risk).
Educational. Not a substitute for individualized provider review.
- SHBG — Primary source · oMeds
- Reviewed by Dr. Laura Purdy, MD, MBA · Clinical Director, oMeds · Last reviewed 2026-05-29