Screening and diagnosis

Classification and risk stratification

Perioperative care

Quality improvement

Patient education

Nonpharmacologic interventions

Therapeutic procedures

Respiratory support

Follow-up and surveillance

Specific circumstances

Preventative measures

Medical management

Surgical interventions

Inpatient care

Diagnostic procedures

Diagnostic investigations

Insufficient evidence to make a recommendation.

Strongly favor this test or intervention.

The Revised Rotterdam diagnostic criteria for polycystic ovarian syndrome (PCOS) involves evaluating three key symptoms: amenorrhea or irregular menstrual periods, clinical or biochemical evidence of hyperandrogenism, and polycystic ovaries on pelvic ultrasound. 

The diagnostic process involves three possible symptoms:

1. Amenorrhea or irregular menstrual periods
2. Clinical or biochemical evidence of hyperandrogenism
3. Polycystic ovaries on pelvic ultrasound

The algorithm checks combinations of these symptoms to determine if the diagnostic criteria are met for PCOS. The following logical checks are applied:

- Check for the presence of amenorrhea or irregular menstrual periods (A).
- Check for the presence of clinical or biochemical evidence of hyperandrogenism (B).
- Check for the presence of polycystic ovaries on pelvic ultrasound (C).

The criteria are considered met if any two of the three symptoms are present. Specifically:

- If both A and B are true.
- If both A and C are true.
- If both B and C are true.

If at least two conditions out of the three specified are true, the output is:

Diagnostic criteria are met

If fewer than two conditions are met, the output is:

Diagnostic criteria are not met

The Revised Rotterdam diagnostic criteria is a clinical calculator used for diagnosing Polycystic Ovarian Syndrome (PCOS) in women of reproductive age. This diagnostic tool is based on the presence of two out of three criteria: oligo- or anovulation, clinical and/or biochemical signs of hyperandrogenism, and polycystic ovaries on ultrasound. The clinical utility of this calculator is to accurately diagnose PCOS, which is a common endocrine disorder in women that can lead to infertility, metabolic syndrome, and increased cardiovascular risk. The Revised Rotterdam diagnostic criteria exclude other etiologies that can cause similar symptoms, such as congenital adrenal hyperplasia, androgen-secreting tumors, and Cushing's syndrome.

Revised Rotterdam diagnostic criteria for polycystic ovarian syndrome

Polycystic ovary syndrome

Laparoscopic surgery

General counseling

Ovulation induction

Differential diagnosis

Statin therapy

Screening for obstructive sleep apnea

Adolescent patients

Adolescent patients (oligoanovulation)

Lifestyle modifications

Screening for metabolic dysfunction-associated steatotic liver disease

Screening for MASLD

Adolescent patients (hyperandrogenemia)

Screening for cardiac risk

Screening for depression/anxiety

Diagnostic criteria

Assisted reproductive technology

Adolescent patients, diagnosis

Pregnant patients

Screening for congenital adrenal hyperplasia

Insulin sensitizers

Prevention in offspring

Screening for diabetes

Adolescent patients (insulin resistance)

Screening for endometrial cancer

Hormonal contraceptives

Bariatric surgery

Weight loss medications

History and physical examination

Patients with diabetes

Management of hirsutism

Polycystic ovary syndrome

Guidelines

Key sources