Polycystic ovary syndrome
Polycystic ovary syndrome is a heterogeneous endocrine, metabolic and reproductive condition characterised by ovulatory dysfunction and hyperandrogenism, with polycystic ovarian morphology in some people; diagnose by the appropriate criteria, exclude mimics and manage reproductive, metabolic, psychological and endometrial risks together.
Definition
Polycystic ovary syndrome, increasingly termed polyendocrine metabolic ovarian syndrome in 2026 international and draft NICE materials, is a heterogeneous condition diagnosed in adults by two of ovulatory dysfunction, clinical or biochemical hyperandrogenism and polycystic ovarian morphology after alternative causes are excluded. The established PCOS term remains widely used in UK examinations and current clinical records.
First principles
PCOS is a heterogeneous endocrine and metabolic syndrome
PCOS involves variable combinations of ovulatory dysfunction, clinical or biochemical hyperandrogenism and polycystic ovarian morphology. Insulin resistance and compensatory hyperinsulinaemia are common but not required for diagnosis, and PCOS can occur at any body size. Avoid reducing the condition to ovarian cysts or weight: reproductive, metabolic, dermatological, psychological and sleep-related features all matter.
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