title: Do hyperandrogenic women with normal menses have polycystic ovary syndrome?
abstract: OBJECTIVE
  To determine the prevalence of polycystic ovary syndrome (PCOS) among hyperandrogenic women who report normal menses.
  
  
  METHODS
  Prospective observational study.
  
  
  METHODS
  Academic practice in reproductive endocrinology.
  
  
  METHODS
  Fifty-eight consecutively seen new patients with hyperandrogenism who reported normal menses.
  
  
  METHODS
  Ovulatory status was assessed with timed serum progesterone measurements. The following tests also were carried out: vaginal ultrasound examination; measurement of the ovarian response of 17-hydroxyprogesterone (17-OHP) after the administration of leuprolide acetate, 1 mg SC; and determination of fasting serum LH, FSH, E2, 17-OHP, insulin, and androgen levels.
  
  
  METHODS
  Determination of ovulatory status, polycystic appearance of ovaries, and increased response of 17-OHP to leuprolide acetate.
  
  
  RESULTS
  Twelve (20.7%) of the hyperandrogenic women were anovulatory and met the usual criteria for the diagnosis of PCOS. The ovulatory patients had lower serum total and unbound testosterone levels. Thirty-one (53.4%) of the ovulatory women had polycystic ovaries on ultrasound examination and/or an increased 17-OHP response to leuprolide acetate, suggesting the diagnosis of PCOS despite the presence of ovulation. Considering both the anovulatory and ovulatory patients, 74% of the hyperandrogenic women studied could have PCOS.
  
  
  CONCLUSIONS
  The data suggest that most (74%) hyperandrogenic women who report normal menses have evidence for the diagnosis of PCOS.
authors.affiliation: Department of Obstetrics and Gynecology, Columbia University College of Physicians and Surgeons, New York, New York 10032, USA.
authors.forename: E
authors.initials: E
authors.lastname: Carmina
authors.forename: R A
authors.initials: RA
authors.lastname: Lobo
mesh_terms: D019326:17-alpha-Hydroxyprogesterone / Q000378:metabolism; D000328:Adult; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D017588:Hyperandrogenism / Q000209:etiology*; D008597:Menstrual Cycle / Q000502:physiology*; D010053:Ovary / Q000473:pathology; D010060:Ovulation / Q000502:physiology; D011085:Polycystic Ovary Syndrome / Q000150:complications / Q000453:epidemiology* / Q000473:pathology; D015995:Prevalence; D011446:Prospective Studies; D011966:Receptors, LHRH / Q000819:agonists