The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report
Open accessAbstract
Objective To review all available data and recommend a definition for polycystic ovary syndrome (PCOS) based on published peer-reviewed data, whether already in use or not, to guide clinical diagnosis and future research.Design Literature review and expert consensus.Setting Professional society.Patients None.Intervention(s) None.Main outcome measure(s) A systematic review of the published peer-reviewed medical literature, by querying MEDLINE databases, to identify studies evaluating the epidemiology or phenotypic aspects of PCOS.Result(s) The Task Force drafted the initial report, following a consensus process via electronic communication, which was then reviewed and critiqued by the Androgen Excess and PCOS (AE-PCOS) Society AE-PCOS Board of Directors. No section was finalized until all members were satisfied with the contents, and minority opinions noted. Statements were not included that were not supported by peer-reviewed evidence.Conclusion(s) Based on the available data, it is the view of the AE-PCOS Society Task Force that PCOS should be defined by the presence of hyperandrogenism (clinical and/or biochemical), ovarian dysfunction (oligo-anovulation and/or polycystic ovaries), and the exclusion of related disorders. However, a minority considered the possibility that there may be forms of PCOS without overt evidence of hyperandrogenism, but recognized that more data are required before validating this supposition. Finally, the Task Force recognized and fully expects that the definition of this syndrome will evolve over time to incorporate new research findings.
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Polycystic ovary syndrome is associated with an increased risk of impaired glucose tolerance, impaired fasting glucose, and type 2 diabetes mellitus.
“Polycystic ovary syndrome is one of the most common endocrine disorders affecting adolescent females [1–4] and is associated with an increased risk of impaired glucose tolerance (IGT), impaired fasting glucose, and type 2 diabetes mellitus.”
From Dysglycemia screening with oral glucose tolerance test in adolescents with polycystic ovary syndrome and relationship with obesity (2022) · cites this paper as [1]
The report’s discussion of insulin resistance in PCOS (page unavailable) describes impaired glucose tolerance and states that type 2 diabetes is more common among women with PCOS. It does not establish an increased risk of impaired fasting glucose; it instead notes that basal glucose measures can miss glucose intolerance. (LLM, conf=0.87)
Experimental — accuracy not yet measuredApproximately 20-30% of women with PCOS exhibit increased levels of DHEA and DHEAS.
“Approximately 20–30% of women who are identified with polycystic ovarian syndrome exhibit increased levels of dehydroepiandrosterone (DHEA) and DHEAS [60].”
From Nutritional and herbal interventions for polycystic ovary syndrome (PCOS): a comprehensive review of dietary approaches, macronutrient impact, and herbal medicine in management (2025) · cites this paper as [60]
The paper’s DHEA/DHEAS discussion (page not supplied) states that approximately 20–30% of patients with PCOS have elevated DHEAS. It does not give that prevalence for elevated DHEA, so the claim’s inclusion of both hormones is not fully supported. (LLM, conf=0.90)
Experimental — accuracy not yet measuredIndividual diagnostic criteria for PCOS lack clarity.
“There is no single diagnostic test, different sets of diagnostic criteria are still used, individual diagnostic criteria lack clarity, and exclusion of other etiologies is needed to establish the diagnosis of PCOS (4, 23, 24).”
From Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome (2016) · cites this paper as [24]
Different sets of diagnostic criteria for PCOS are still used.
“There is no single diagnostic test, different sets of diagnostic criteria are still used, individual diagnostic criteria lack clarity, and exclusion of other etiologies is needed to establish the diagnosis of PCOS (4, 23, 24).”
From Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome (2016) · cites this paper as [24]
There is no single diagnostic test for PCOS.
“There is no single diagnostic test, different sets of diagnostic criteria are still used, individual diagnostic criteria lack clarity, and exclusion of other etiologies is needed to establish the diagnosis of PCOS (4, 23, 24).”
From Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome (2016) · cites this paper as [24]
Exclusion of other etiologies is needed to establish the diagnosis of PCOS.
“There is no single diagnostic test, different sets of diagnostic criteria are still used, individual diagnostic criteria lack clarity, and exclusion of other etiologies is needed to establish the diagnosis of PCOS (4, 23, 24).”
From Delayed Diagnosis and a Lack of Information Associated With Dissatisfaction in Women With Polycystic Ovary Syndrome (2016) · cites this paper as [24]
With one published exception, current definitions of polycystic ovary syndrome in adolescent or adult women do not include insulin resistance or hyperinsulinemia as a diagnostic criterion.
“With the exception of one published recommendation, none of the current definitions of PCOS in adolescent or adult women include insulin resistance/hyperinsulinemia as a diagnostic criterion [1, 10-12, 18, 19, 112]”
From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [10]
Hyperinsulinemia is believed to worsen hyperandrogenism and the reproductive and metabolic manifestations of polycystic ovary syndrome in adolescents.
“Hyperinsulinemia is believed to exacerbate the hyperandrogenism and the reproductive and metabolic manifestations of PCOS in adolescents.”
From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [10]
Insulin resistance and hyperinsulinemia are intrinsic to polycystic ovary syndrome in adults and adolescents, whether lean or obese.
“Insulin resistance and hyperinsulinemia are intrinsic to PCOS in adults and adolescents, lean or obese.”
From The Diagnosis of Polycystic Ovary Syndrome during Adolescence (2015) · cites this paper as [10]
Currently, there is limited consensus among different medical specialties as to the optimal management of PCOS in Australia.
“Currently, there is limited consensus among different medical specialties as to the optimal management of PCOS in Australia. 7,53”
From Assessment and management of polycystic ovary syndrome: Summary of an evidence-based guideline (2011) · cites this paper as [53]
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- Authors
- Azziz, R., Carmina, E., Dewailly, D., Diamanti-Kandarakis, E., Escobar-Morreale, H. F., Futterweit, W., Janssen, O. E., Legro, R. S., Norman, R. J., Taylor, A. E., & Witchel, S. F.
- Affiliations
- Cedars-Sinai Medical Center (US)
- University of Palermo (IT)
- Centre Hospitalier Universitaire de Lille (FR)
- Hospital Universitario Ramón y Cajal (ES)
- Icahn School of Medicine at Mount Sinai (US)
- University of Duisburg-Essen (DE)
- Pennsylvania State University (US)
- The University of Adelaide (AU)
- Children's Hospital of Pittsburgh (US)
- Corresponding author
- Carmina, Enrico
- ORCID
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2009-02
- Volume
- 91
- Issue
- 2
- Pages
- 456-488
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W2035217519
- Cited by
- 2,132
- References
- 311
- Citations by year
- 2026: 80 · 2025: 149 · 2024: 126 · 2023: 170 · 2022: 171 · 2021: 140 · 2020: 148 · 2019: 124 · 2018: 115 · 2017: 119 · 2016: 109 · 2015: 141 · 2014: 142 · 2013: 111 · 2012: 93
- FWCI
- 73.76
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Adelaide Research & Scholarship (AR&S) (University of Adelaide) (submittedVersion)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian function and disorders
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic and Kidney Cyst Diseases
- Keywords
- polycystic ovary syndrome, PCOS diagnostic criteria, hyperandrogenism, ovarian dysfunction, oligoanovulation, polycystic ovary, PCOS phenotypes
- MeSH terms
- Diagnosis, Differential, Female, Health Status Indicators, Humans, Menstruation Disturbances, Terminology as Topic, Ovarian Function Tests, Ovary, Ovulation, Phenotype, Polycystic Ovary Syndrome, Predictive Value of Tests, Biomarkers, Hyperandrogenism, Evidence-Based Medicine
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