Polycystic ovarian syndrome: an under-recognised problem?

Polycystic ovarian syndrome (PCOS) is a multisystem condition that can blight the course of a woman’s life. The condition is common and for many is associated with considerable distress. We argue the importance of diagnosis in what is currently an under-recognised condition. of PCOS requires two of the three Rotterdam criteria to be present.1 Introducing the criteria led to an increase in PCOS prevalence from 6% to 10% in screened women of childbearing age.2 However, this is unlikely to be a true reflection of the prevalence among women who choose to consult their GP. A recent retrospective cohort study of over 2 million women in the UK reported that the prevalence of women of reproductive age with PCOS was just 1.34%, rising to 2.27% if probable cases were included.3 The authors suggested that there is significant under-diagnosis occurring, with only about 50% of women with at least two of the three criteria having a recorded diagnosis of PCOS. This might imply that GPs are attempting to avoid overmedicalisation, or it might reflect a lack of awareness. It may also indicate that it is only those women with a more severe phenotype who consult their GP.