Though PCOS is a common endocrine disorder, there are controversies
related to diagnosis and management. Hyperandrogenism with anovulation has always
been indicative of PCOS. Though these symptoms are common in women with PCOS,
neither is regarded as an absolute criterion for the diagnosis. With the introduction of
ultrasound criteria, there has been an extension to the spectrum of PCOS. To date, there
is no clear-cut definition of clinical and biochemical hyperandrogenemia questioning
their role in the diagnosis. Subjective assessment of hirsutism and polycystic ovarian
morphology again questions the reliability of these modalities. Diagnosis of PCOS in
adolescence and perimenopause is again a challenge. In this review, we detail the
controversies related to the diagnosis and elaborate on other novel modalities that can
assist in the diagnosis.
Keywords: 11 oxygenated androgens, Acne, Adolescence, AMH, Antral follicle count, Assay interference, Biochemical hyperandrogenism, Clinical hyperandrogenism, Endocrine disruptors, Hirsutism, Insulin resistance, Menstruation disturbances, MiRNA, Ovarian volume, Oxidative stress markers, Perimenopause, Polycystic ovary syndrome, Rotterdam criteria, SHBG, Ultrasonography.
