• hirsutism;
  • hyperandrogenism;
  • polycystic ovary syndrome

Key content

  • The presence of clinical or biochemical evidence of hyperandrogenism is a defining feature of polycystic ovary syndrome (PCOS).
  • As the criteria for diagnosing PCOS becomes more inclusive, there is an increased risk of misdiagnosing women with other causes of hyperandrogenism.
  • Biochemical testing for serum testosterone concentrations in women has important limitations.
  • Patients with concerning features should be investigated for other causes of hyperandrogenism.

Learning objectives

  • To review the different criteria for diagnosing PCOS and the repercussions for disease prevalence.
  • To learn about the differential diagnosis of hyperandrogenism.
  • To learn about the limitations of biochemical testing for testosterone in women.

Ethical issues

  • Hyperandrogenism causing hirsutism and virilisation can have significant effects on physical and psychological wellbeing.
  • Misdiagnosis can delay appropriate treatment and may affect future fertility.