Obstetrics & Gynaecology · Menstrual Disorders, Amenorrhea and Menopause

A 16-year-old girl presents with oligomenorrhea since menarche (age 12), acne, and hirsutism. BMI is 31 kg/m². Serum testosterone is elevated, and LH:FSH ratio is 3:1. Pelvic ultrasound shows 13 follicles (2-9 mm) in each ovary. Thyroid function and prolactin are normal. According to the Rotterdam criteria, what is the diagnosis?

  • A Non-classical congenital adrenal hyperplasia
  • B Polycystic ovary syndrome
  • C Ovarian hyperthecosis
  • D Cushing syndrome
Correct answer: B. Polycystic ovary syndrome

Explanation

Rotterdam criteria require two of three: oligo/anovulation, clinical/biochemical hyperandrogenism, and polycystic ovaries on ultrasound. She meets all three. In adolescents, both oligomenorrhea and hyperandrogenism are required, and ultrasound criteria are less reliable before 8 years post-menarche, but the diagnosis here is supported by persistent oligomenorrhea plus hyperandrogenism.

Reference: Williams Gynecology, 4th ed.

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