Diagnosis of Polycystic Ovary Syndrome (PCOS) – Key Vocabulary

Vocabulary flashcards covering essential terms related to the diagnosis, evaluation, and associated conditions of polycystic ovary syndrome (PCOS).

Polycystic Ovary Syndrome (PCOS)

A common endocrinopathy (5–10 % of women) characterized by oligomenorrhea, hyperandrogenism, and often polycystic ovarian morphology plus cardiometabolic risk factors.

Oligomenorrhea

Fewer than nine menstrual periods per year; typical menstrual dysfunction in PCOS.

Amenorrhea

No menstrual periods for ≥3 consecutive months; may be a presentation of PCOS.

Hyperandrogenism

Clinical (hirsutism, acne, female-pattern hair loss) and/or biochemical evidence of excess androgens.

Hirsutism

Excess terminal body hair in a male distribution; common sign of PCOS-related hyperandrogenism.

Virilization

Severe androgen excess signs (voice deepening, clitoromegaly, rapid onset hirsutism) suggesting tumors or hyperthecosis rather than typical PCOS.

Polycystic Ovarian Morphology (PCOM)

≥12 (Rotterdam) or ≥20–25 (updated proposals) small follicles (2-9 mm) and/or ovarian volume >10 mL on transvaginal ultrasound.

Rotterdam Criteria

Preferred diagnostic scheme; PCOS diagnosed when any 2 of 3 features are present: oligo-/anovulation, hyperandrogenism, or PCOM, after exclusion of mimicking disorders.

1990 NIH Criteria

Older PCOS definition requiring BOTH hyperandrogenism and chronic anovulation; imaging not mandatory.

AE-PCOS Criteria

2006 Androgen Excess Society proposal emphasizing hyperandrogenism plus ovarian dysfunction; excludes non-hyperandrogenic phenotypes.

Transvaginal Ultrasound (TVUS)

Imaging modality of choice to assess ovarian morphology in suspected PCOS.

Ferriman-Gallwey Score

Clinical scale (0–36) quantifying hair growth in nine androgen-sensitive body areas to grade hirsutism.

Total Testosterone

Primary biochemical test for hyperandrogenemia; levels >150 ng/dL warrant tumor evaluation.

Liquid Chromatography–Tandem Mass Spectroscopy (LC-MS/MS)

Gold-standard laboratory method for accurate testosterone measurement in women.

Free Testosterone

Biologically active testosterone fraction; direct assays often unreliable—may be calculated from total T and SHBG via validated formulas.

Sex Hormone–Binding Globulin (SHBG)

Plasma protein binding androgens; low levels in PCOS indicate more free testosterone and higher metabolic risk.

Dehydroepiandrosterone Sulfate (DHEAS)

Adrenal androgen; measured mainly when severe hyperandrogenism suggests adrenal tumor.

Androstenedione

Intermediate androgen; sometimes isolated elevation in PCOS, clinical utility variable.

17-Hydroxyprogesterone

Morning early-follicular serum test to screen for nonclassic 21-hydroxylase–deficient CAH (NCCAH).

Nonclassic Congenital Adrenal Hyperplasia (NCCAH)

21-hydroxylase deficiency presenting with PCOS-like hyperandrogenism; excluded when 17-hydroxyprogesterone <200 ng/dL.

Androgen-Secreting Tumor

Ovarian or adrenal neoplasm causing rapid, severe hyperandrogenism; requires urgent evaluation.

Ovarian Hyperthecosis

Diffuse ovarian stromal luteinization leading to marked androgen excess, more often postmenopausal.

Insulin Resistance

Reduced insulin sensitivity common in PCOS (30 % lean, 70 % obese); contributes to metabolic risk.

Oral Glucose Tolerance Test (OGTT)

Preferred screen for impaired glucose tolerance/type 2 diabetes in PCOS because fasting glucose alone misses many cases.

Metabolic Dysfunction–Associated Steatotic Liver Disease (MASLD)

New term for nonalcoholic fatty liver disease; prevalence increased in PCOS and linked to obesity, insulin resistance, hyperandrogenism.

Obstructive Sleep Apnea (OSA)

Sleep-disordered breathing frequently associated with PCOS; screen if snoring, daytime sleepiness, morning headaches.

Body Mass Index (BMI)

Anthropometric measure; elevated in 40–85 % of women with PCOS.

Homeostasis Model Assessment of Insulin Resistance (HOMA-IR)

Calculated index of insulin resistance using fasting glucose and insulin; not recommended routinely in PCOS care.

Patient Health Questionnaire-9 (PHQ-9)

Validated nine-item depression screening tool advised for all women with PCOS.

Generalized Anxiety Disorder-7 (GAD-7)

Seven-item questionnaire to screen for anxiety, recommended in PCOS evaluations.