PCOS Diagnosis: Understanding Hyperandrogenism and Oligoovulation through Ovarian Ultrasound and Rotterdam Criteria

The PCOS diagnosis is a clinical challenge due to its heterogeneous and multifaceted nature. This syndrome is one of the most common endocrine disorders in women of reproductive age, primarily characterized by hyperandrogenism and chronic oligoovulation. Accurate identification of these symptoms is crucial for the proper management of the condition and the improvement of the quality of life of affected patients.

Diving Deeper into PCOS Diagnosis

Hyperandrogenism clinically manifests through symptoms such as hirsutism, acne, and androgenic alopecia. Evaluating these signs, along with biochemical tests confirming elevated androgen levels, is essential for the diagnosis. Chronic oligoovulation, on the other hand, presents with menstrual irregularities, which can range from oligomenorrhea to complete amenorrhea.

The Rotterdam criteria are the most widely used for the diagnosis of PCOS, requiring the presence of at least two of the following three criteria: hyperandrogenism, oligoovulation or anovulation, and polycystic ovarian morphology observed through ovarian ultrasound. These criteria have been widely accepted due to their ability to capture the phenotypic diversity of PCOS [1].

Ovarian ultrasound is a key diagnostic tool that allows visualization of the presence of multiple small follicles in the ovaries, a characteristic finding of PCOS. However, it is important to consider that polycystic ovarian morphology is not exclusive to PCOS and can be found in women without the syndrome [2].

Conclusions

The diagnosis of PCOS requires a careful and multidimensional evaluation that includes the identification of hyperandrogenism and oligoovulation, supported by the Rotterdam criteria and ovarian ultrasound. Despite advances in understanding this syndrome, it remains underdiagnosed, highlighting the need for greater awareness and education among healthcare professionals [3]. An accurate diagnosis is fundamental for implementing effective management strategies that improve the reproductive and metabolic health of patients [4].

Referencias

• [1] Polycystic Ovary Syndrome
• [2] Polycystic Ovary Syndrome: Pathophysiology, Presentation, and Treatment With Emphasis on Adolescent Girls
• [3] A brief insight into the etiology, genetics, and immunology of polycystic ovarian syndrome (PCOS)
• [4] Polycystic Ovary Syndrome: Pathophysiology and Controversies in Diagnosis

Created 6/1/2025