Wh1

PCOS proposed mechanism (Insulin)

Peripheral insulin resistance → hyperinsulinemia

PCOS proposed mechanism (Androgens)

Stimulate excess ovarian androgen production

PCOS menstrual & reproductive presentation

Oligomenorrhea, amenorrhea, Irregular cycles

PCOS androgen excess presentation

Hirsutism, acne

PCOS metabolic presentation

Acanthosis nigricans

PCOS associated conditions (Metabolic & Reproductive)

Obesity, Hyperinsulinemia / insulin resistance, Infertility

PCOS lab findings (Elevated hormones)

↑ LH, LH:FSH ratio, total testosterone, free testosterone

PCOS lab findings (FSH status)

↓ FSH (or N)

PCOS Rotterdam criteria (Criteria count required)

2/3

Rotterdam criterion 1 (Androgens)

Hyperandrogenism (clinical or biochemical)

Rotterdam criterion 2 (Ovulation)

Ovulatory dysfunction (oligo- or anovulation)

Rotterdam criterion 3 (Ultrasound - Follicles)

≥12 follicles/ovary (2-9 mm diameter)

Rotterdam criterion 3 (Ultrasound - Volume)

Ovarian volume >10 mL

PCOS 2026 update (New name)

Polyendocrine metabolic ovarian syndrome (PMOS)

PCOS 2026 update (Primary clinical focus)

Insulin resistance, Cardiometabolic risk (type 2 diabetes, CVD risk)

PCOS 1st line lifestyle modification

Low-calorie diet, Moderate physical activity

PCOS hormonal contraceptives options

OCCP, progestin therapy

PCOS hormonal contraceptives benefits

Regulate cycle, ↓ androgen, alleviate acne & hirsutism

PCOS anti-androgens drug examples

Spironolactone, finasteride, flutamide