Polycystic ovarian syndrome (PCOS) is a common endocrine disorder affecting women after the menarche. It may be associated with subfertility, type 2 diabetes mellitus, cardiovascular disease (CVD), hirsutism, and acne.
The old National Institute of Health criteria1 suggest a prevalence of about 5% in this population but the new Rotterdam criteria2 may result in about 20% of women in this age group having PCOS. Crucially, the Rotterdam criteria only require two of three features: hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology on ultrasound scan (USS). So, a woman with oligomenorrhoea and polyfollicular ovaries on USS can be diagnosed as having PCOS. But should more women be labelled and given a ‘condition’? What is the evidence of benefit?
There are several reasons why benefit might not follow:
first, the evidence that those with PCOS have an increased risk of CVD (not an increased risk of …