Diagnosis and Management of Polycystic Ovarian Syndrome: Primary Care Perspective

Polycystic ovarian syndrome (PCOS) is a prevalent endocrine disorder in young women, marked by irregular periods, hyperandrogenism, insulin resistance, and risks like infertility, metabolic syndrome, and cardiovascular issues. This article outlines a streamlined physician approach to suspected cases, using Rotterdam criteria for diagnosis via symptoms, labs (e.g., testosterone, LH:FSH), and ultrasound while ruling out differentials like thyroid dysfunction or tumors. For a 20s patient with irregular menses and acne not seeking pregnancy, it recommends lifestyle changes, cyclical progesterone or low-androgen OCPs for cycles, anti-androgens for acne/hirsutism, and metformin for insulin sensitivity—tailored to priorities, with specialist referral and preconception counseling for future fertility.