Polycystic ovary syndrome diagnostic criteria: Difference between revisions
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PCOS was previously defined according to the proceedings of an expert conference sponsored by the National Institutes of Health (NIH) in 1990, which described the disorder as including [[hyperandrogenism]] or hyperandrogenemia (or both), [[Oligoovulation|oligo-ovulation]], and exclusion of known disorders of androgen excess and [[anovulation]]. Another expert conference held in Rotterdam in 2003 defined PCOS, after the exclusion of related disorders, by the presence of two of the following three features [[Oligoovulation|oligo-ovulation]] or [[anovulation]], clinical or biochemical signs of [[hyperandrogenism]] (or both), and [[polycystic ovaries]]. In essence, the Rotterdam 2003 criteria expanded the NIH 1990 definition by creating two new phenotypes ovulatory women with [[polycystic ovaries]] plus [[hyperandrogenism]] and oligo-anovulatory women with [[polycystic ovaries]] but without [[hyperandrogenism]]. | PCOS was previously defined according to the proceedings of an expert conference sponsored by the National Institutes of Health (NIH) in 1990, which described the disorder as including [[hyperandrogenism]] or hyperandrogenemia (or both), [[Oligoovulation|oligo-ovulation]], and exclusion of known disorders of androgen excess and [[anovulation]]. Another expert conference held in Rotterdam in 2003 defined PCOS, after the exclusion of related disorders, by the presence of two of the following three features [[Oligoovulation|oligo-ovulation]] or [[anovulation]], clinical or biochemical signs of [[hyperandrogenism]] (or both), and [[polycystic ovaries]]. In essence, the Rotterdam 2003 criteria expanded the NIH 1990 definition by creating two new phenotypes ovulatory women with [[polycystic ovaries]] plus [[hyperandrogenism]] and oligo-anovulatory women with [[polycystic ovaries]] but without [[hyperandrogenism]]. | ||
==Diagnostic criteria== | ==Diagnostic criteria== | ||
Criteria for the | Criteria for the definition of Polycystic Ovary Syndrome (PCOS)<ref name="pmid18786289">{{cite journal |vauthors=Lujan ME, Chizen DR, Pierson RA |title=Diagnostic criteria for polycystic ovary syndrome: pitfalls and controversies |journal=J Obstet Gynaecol Can |volume=30 |issue=8 |pages=671–9 |year=2008 |pmid=18786289 |pmc=2893212 |doi= |url=}}</ref><ref name="pmid28620541">{{cite journal |vauthors=Harris HR, Terry KL |title=Polycystic ovary syndrome and risk of endometrial, ovarian, and breast cancer: a systematic review |journal=Fertil Res Pract |volume=2 |issue= |pages=14 |year=2016 |pmid=28620541 |pmc=5424400 |doi=10.1186/s40738-016-0029-2 |url=}}</ref><ref name="pmid26642102">{{cite journal |vauthors=Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E |title=AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ANDROGEN EXCESS AND PCOS SOCIETY DISEASE STATE CLINICAL REVIEW: GUIDE TO THE BEST PRACTICES IN THE EVALUATION AND TREATMENT OF POLYCYSTIC OVARY SYNDROME - PART 2 |journal=Endocr Pract |volume=21 |issue=12 |pages=1415–26 |year=2015 |pmid=26642102 |doi=10.4158/EP15748.DSCPT2 |url=}}</ref><ref name="pmid26509855">{{cite journal |vauthors=Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E |title=AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ANDROGEN EXCESS AND PCOS SOCIETY DISEASE STATE CLINICAL REVIEW: GUIDE TO THE BEST PRACTICES IN THE EVALUATION AND TREATMENT OF POLYCYSTIC OVARY SYNDROME--PART 1 |journal=Endocr Pract |volume=21 |issue=11 |pages=1291–300 |year=2015 |pmid=26509855 |doi=10.4158/EP15748.DSC |url=}}</ref> | ||
===NIH Statement (1990)=== | ===NIH Statement (1990)=== | ||
To include all of the following: | To include all of the following: | ||
* [[Hyperandrogenism]] and/or hyperandrogenemia | * [[Hyperandrogenism]] and/or hyperandrogenemia | ||
* [[Oligomenorrhea]] | * [[Oligomenorrhea]] | ||
* Exclusion of related disorders ( | * Exclusion of related disorders (including but not limited to [[21-hydroxylase deficiency|21-hydroxylase-deficiency]]<nowiki/>, [[Thyroid diseases|thyroid dysfunction]], [[hyperprolactinemia]], neoplastic androgen secretion, drug-induced androgen excess, the syndromes of severe [[insulin resistance]], [[Cushing's syndrome|Cushing syndrome]], and [[glucocorticoid resistance]]) | ||
===ESHRE/ASRM Statement (Rotterdam, 2003)=== | ===ESHRE/ASRM Statement (Rotterdam, 2003)=== | ||
To include two of the following, in addition to exclusion of related disorders : | To include two of the following, in addition to exclusion of related disorders : | ||
* [[Oligoovulation|Oligo-ovulation]] or [[anovulation]] ( [[amenorrhea]], [[Uterine bleeding|irregular uterine bleeding]]) | * [[Oligoovulation|Oligo-ovulation]] or [[anovulation]] ([[amenorrhea]], [[Uterine bleeding|irregular uterine bleeding]]) | ||
* Clinical and/or biochemical signs of [[hyperandrogenism]] ( [[hirsutism]], elevated serum total or free [[testosterone]]) | * Clinical and/or biochemical signs of [[hyperandrogenism]] ([[hirsutism]], elevated serum total or free [[testosterone]]) | ||
* [[Polycystic ovaries]] (by ultrasonography) | * [[Polycystic ovaries]] (by ultrasonography) | ||
===AES Suggested Criteria for the Diagnosis of PCOS (2006)=== | ===AES Suggested Criteria for the Diagnosis of PCOS (2006)=== | ||
To include all of the following: | To include all of the following: | ||
* [[Hyperandrogenism]] (hirsutism and/or hyperandrogenemia) | * [[Hyperandrogenism]] ([[hirsutism]] and/or hyperandrogenemia) | ||
* Ovarian dysfunction: | * Ovarian dysfunction: [[Menstrual disorder|oligoovulation]] or [[anovulation]] and/or [[polycystic ovaries]] | ||
* Exclusion of other androgen excess or related disorders ( | * Exclusion of other androgen excess or related disorders (including but not limited to [[21-hydroxylase deficiency|21-hydroxylase-deficiency]]<nowiki/>, [[Thyroid diseases|thyroid dysfunction]], [[hyperprolactinemia]], neoplastic androgen secretion, drug-induced androgen excess, the syndromes of severe [[insulin resistance]], [[Cushing's syndrome|Cushing syndrome]], and [[glucocorticoid resistance]]) | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Latest revision as of 17:41, 1 November 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Ganti M.B.B.S. [2]
Overview
PCOS was previously defined according to the proceedings of an expert conference sponsored by the National Institutes of Health (NIH) in 1990, which described the disorder as including hyperandrogenism or hyperandrogenemia (or both), oligo-ovulation, and exclusion of known disorders of androgen excess and anovulation. Another expert conference held in Rotterdam in 2003 defined PCOS, after the exclusion of related disorders, by the presence of two of the following three features oligo-ovulation or anovulation, clinical or biochemical signs of hyperandrogenism (or both), and polycystic ovaries. In essence, the Rotterdam 2003 criteria expanded the NIH 1990 definition by creating two new phenotypes ovulatory women with polycystic ovaries plus hyperandrogenism and oligo-anovulatory women with polycystic ovaries but without hyperandrogenism.
Diagnostic criteria
Criteria for the definition of Polycystic Ovary Syndrome (PCOS)[1][2][3][4]
NIH Statement (1990)
To include all of the following:
- Hyperandrogenism and/or hyperandrogenemia
- Oligomenorrhea
- Exclusion of related disorders (including but not limited to 21-hydroxylase-deficiency, thyroid dysfunction, hyperprolactinemia, neoplastic androgen secretion, drug-induced androgen excess, the syndromes of severe insulin resistance, Cushing syndrome, and glucocorticoid resistance)
ESHRE/ASRM Statement (Rotterdam, 2003)
To include two of the following, in addition to exclusion of related disorders :
- Oligo-ovulation or anovulation (amenorrhea, irregular uterine bleeding)
- Clinical and/or biochemical signs of hyperandrogenism (hirsutism, elevated serum total or free testosterone)
- Polycystic ovaries (by ultrasonography)
AES Suggested Criteria for the Diagnosis of PCOS (2006)
To include all of the following:
- Hyperandrogenism (hirsutism and/or hyperandrogenemia)
- Ovarian dysfunction: oligoovulation or anovulation and/or polycystic ovaries
- Exclusion of other androgen excess or related disorders (including but not limited to 21-hydroxylase-deficiency, thyroid dysfunction, hyperprolactinemia, neoplastic androgen secretion, drug-induced androgen excess, the syndromes of severe insulin resistance, Cushing syndrome, and glucocorticoid resistance)
References
- ↑ Lujan ME, Chizen DR, Pierson RA (2008). "Diagnostic criteria for polycystic ovary syndrome: pitfalls and controversies". J Obstet Gynaecol Can. 30 (8): 671–9. PMC 2893212. PMID 18786289.
- ↑ Harris HR, Terry KL (2016). "Polycystic ovary syndrome and risk of endometrial, ovarian, and breast cancer: a systematic review". Fertil Res Pract. 2: 14. doi:10.1186/s40738-016-0029-2. PMC 5424400. PMID 28620541.
- ↑ Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E (2015). "AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ANDROGEN EXCESS AND PCOS SOCIETY DISEASE STATE CLINICAL REVIEW: GUIDE TO THE BEST PRACTICES IN THE EVALUATION AND TREATMENT OF POLYCYSTIC OVARY SYNDROME - PART 2". Endocr Pract. 21 (12): 1415–26. doi:10.4158/EP15748.DSCPT2. PMID 26642102.
- ↑ Goodman NF, Cobin RH, Futterweit W, Glueck JS, Legro RS, Carmina E (2015). "AMERICAN ASSOCIATION OF CLINICAL ENDOCRINOLOGISTS, AMERICAN COLLEGE OF ENDOCRINOLOGY, AND ANDROGEN EXCESS AND PCOS SOCIETY DISEASE STATE CLINICAL REVIEW: GUIDE TO THE BEST PRACTICES IN THE EVALUATION AND TREATMENT OF POLYCYSTIC OVARY SYNDROME--PART 1". Endocr Pract. 21 (11): 1291–300. doi:10.4158/EP15748.DSC. PMID 26509855.