Diagnosis of polycystic ovary is not an easy task.

The doctors are baffled about the exact diagnosis of PCOS because the diagnostic criteria of PCOS changes with age!!!

The diagnosis of polycystic ovarian syndrome particular in the teenager and young adult group primarily rests on the following clinical, lab. and sonographic tests like i) Clinical (visible) or lab. evidence of HA=Hyper Androgenism, ii) Clinical history of Oligo An=Oligomenorrhoea (infrequent menstrual periods)/Amenorrhoea (cessation of menstrual period more than six months), and iii) Ultra-sonography evidence of PCOM=Polycystic Ovarian Morphology, i.e. large cystic ovaries. But, the clinical problem is that the prevalence of these three different above mentioned diagnostic criteria of PCOS changes with age. The clinical presentation of Oligo-An varies by age, because amenorrhea and oligomenorrhea being common among adolescents, while menstrual cycles may become regular with increasing age in women with PCOS. HA (Excess Androgen i.e. excess male hormone features) partially resolves before menopause in women with PCOS. It’s known to us that ovarian volume and follicle number decrease with age in women both with and without PCOS. It’s also known that in most cases aging may be associated with a defect in insulin action. Therefore, the clinical features and metabolic consequences of PCOS may vary with age, and these age-related changes may affect the observed incidence of PCOS in almost all countries. Therefore there we doctors or any caregiver should remember about these age related change in the menstrual cycle and clinical expression of androgen levels including absence of sonological features of cystic appearance of ovaries.