Polycystic ovarian syndrome: A diagnosis of exclusion

Abstract

Polycystic ovary syndrome (PCOS) is regarded as the most common endocrine disorder among reproductive-aged women; stigmata of hyperandrogenism and menstrual dysfunction, and chronicity of complaints are recognized as hallmarks of PCOS. Beyond the presenting complaints, PCOS has long-term health implications and should be regarded as a pre-morbid state. Early diagnosis of PCOS thus allows an opportunity of instituting preventive care strategies with the goal of reducing long-term risks such as of type 2 diabetes, cardiovascular disease, and depression. A number of clinical conditions can, however, mimic the clinical presentation of PCOS. This chapter underscores that diagnosis of PCOS remains one of exclusion, after systematic evaluation for a spectrum of disparate conditions, each of which entails a distinct management strategy very different from that utilized for managing PCOS. The authors herein present a succinct approach to the evaluation of a patient presenting with features of hyperandrogenism and menstrual dysfunction, as well as provide an overview of common conditions that may mimic PCOS.