Key Clinical Points Polycystic Ovary Syndrome How should this case be evaluated and managed? The Clinical Problem Laboratory tests reveal a total testosterone level of 65 ng per deciliter (2.3 nmol per liter) (assay reference range, 14 to 53 ng per deciliter ), calculated free testosterone level of 15.3 pg per milliliter (53.1 pmol per liter) (assay reference range, 0.6 to 6.8 pg per milliliter ), and glycated hemoglobin level of 5.7% (normal value, ≤5.6%). The physical examination includes a body-mass index (BMI the weight in kilograms divided by the square of the height in meters) of 29, blood pressure of 135/85 mm Hg, and moderate hirsutism without virilization. The symptoms worsened after she gained weight in college. Dark, coarse facial hair began to develop at 13 years of age.
She describes unpredictable and infrequent menses (five or six per year) since menarche at 11 years of age. The article ends with the authors' clinical recommendations.Ī 22-year-old woman reports having hirsutism and irregular menses. Evidence supporting various strategies is then presented, followed by a review of formal guidelines, when they exist. This Journal feature begins with a case vignette highlighting a common clinical problem. The most trusted, influential source of new medical knowledge and clinical best practices in the world.
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