GynaecologyFree in the app
PCOS
2 of 3 Rotterdam criteria after excluding other causes.
Source: International PCOS guideline 2023Criteria
- Hyperandrogenism (clinical or biochemical)
- Ovulatory dysfunction (irregular cycles)
- Polycystic ovaries (≥20 follicles per ovary) or raised AMH (adults only)
Adolescents (<8 years since menarche): no ultrasound or AMH — need both irregular cycles and hyperandrogenism.
Manage
- Weight and lifestyle; screen glucose and lipids
- Combined pill for hirsutism and cycles
- Metformin for metabolic features
- Letrozole first-line for ovulation induction
A summary for trained clinicians. Always check the full guideline, the patient in front of you and your hospital's protocol. Spotted an error? Tell us.