4 Interesting Facts of Polycystic ovary syndrome (PCOS)
- Reproductive endocrinopathy characterized by chronic anovulation, hyperandrogenism, and polycystic ovarian morphology; typical onset occurs in adolescent or young adult
- There is extensive overlap with 21-hydroxylase deficiency, with common features of hirsutism, acne, and irregular menses (ie, oligomenorrhea, amenorrhea) developing slowly over time
- Formal diagnosis of polycystic ovary syndrome must include a combination of 2 of the 3 following findings: clinical or biochemical hyperandrogenemia, ovulatory dysfunction, and/or polycystic ovaries as identified on pelvic imaging
- Additionally, diagnostic criteria for polycystic ovary syndrome require exclusion of nonclassical congenital adrenal hyperplasia (in addition to thyroid disease and hyperprolactinemia)
- Polycystic ovary syndrome is clinically indistinguishable from congenital adrenal hyperplasia; thus, differentiation relies upon measurements of 17-hydroxyprogesterone, often using corticotropin stimulation
- Basal serum 17-hydroxyprogesterone level of 200 to 400 ng/dL is suggestive of congenital adrenal hyperplasia, whereas 17-hydroxyprogesterone level is typically within reference range (less than 200 ng/dL) in polycystic ovary syndrome
- Corticotropin-stimulated 17-hydroxyprogesterone level must be less than 1000 ng/dL to diagnose polycystic ovary syndrome
