An independent panel convened by the NIH has concluded that the name “polycystic ovary syndrome (PCOS)” causes confusion and is a barrier to progress in the realms of both research and effective patient care.1 This independent report, which is not a policy statement of the NIH or federal government, identifies future research and clinical priorities based on an assessment of all available scientific evidence related to PCOS and advocates that the name of the syndrome be changed.
The panel identified the name of the disorder as a major distraction and impediment to progress. The name itself focuses on polycystic ovarian morphology, which is neither necessary nor sufficient for a diagnosis, states the report. The advances that have been made in the understanding of PCOS are not at all reflected in the name of the syndrome, which is limiting. The panel writes that the right name for the syndrome, which has not been introduced, should reflect the syndrome’s myriad characteristics—metabolic, hypothalamic, pituitary, ovarian, and adrenal—and how they interact to affect reproductive health.
The broad diagnostic criteria of Rotterdam, which includes the classic NIH criteria and the Adrogen Excess-PCOS criteria, should continue to be used.2-4 Also, the specific phenotype of the syndrome should always be identified and reported in all notes of clinical care and in all research studies (Table).1 The panel also identified the need for improvement in the assessment methods and criteria for androgen excess, ovulatory dysfunction, and polycystic ovarian morphology.
The causes of PCOS, which affects approximately 5 million women in the United States, are not well understood.1 Both genetic components and environmental factors have been shown to play important roles in the syndrome. However, well-designed, multiethnic studies are needed to help identify factors, such as obesity, that may exacerbate a genetic predisposition, urges the panel.
“Additional studies are needed to identify new treatments that address the most common symptoms women face, such as weight gain and difficulty becoming pregnant. We also need studies to determine a woman’s risk for cardiovascular and other complications and if treatment can reduce these risks,” said Pamela Ouyang, MD, a panel member and director of the Women’s Cardiovascular Health Center at Johns Hopkins Bayview Medical Center in Baltimore, Maryland.5
Pertinent Points:
- An independent panel has concluded that the name PCOS causes confusion and is a barrier to research.
- The name PCOS midleadingly focuses on ovarian cysts, a criterion that is neither necessary nor sufficient for a diagnosis of the syndrome.
| Table. Phenotypes of PCOS |
| Androgen excess + Ovulatory dysfunction Androgen excess + Polycystic ovarian morphology Ovulatory dysfunction + Polycystic ovarian morphology Androgen excess + Ovulatory dysfunction + Polycystic ovarian morphology |
| From National Institutes of Health. 2012.1 |
B mode and 3D Ultrasound images of a fetal abdomen (35wks) revealing gallbladder calculi
This case study shows a 26 week gestation with a cystic mass close to the sacrum.
CC is a 31 year old primigravida who was referred for ultrasound at a community hospital due to suspected cardiac anomalies noted on a screening sonogram at her doctor's office. Due to concern about a probable cardiac abnormality an amniocentesis was performed at the local hospital.
Single umbilical artery color doppler, transverse scan of urinary bladder shows single umbilical artery (left), transverse section of umbilical cord showing only two vessels: one vein and one artery (right).
Normal 35 week pregnancy