Consider the possibility of PCOS in patients with irregular menses or amenorrhea beginning at menarche, infertility, hirsutism, acne, central obesity, or a family history of PCOS.
Diagnose PCOS in women with two of the following three criteria: androgen excess, ovulatory dysfunction, and polycystic ovaries.
Measure serum androgens including total or free (bioavailable) testosterone level and possibly androstenedione level. If there is severe hyperandrogenemia, consider other causes.
Measure LH and FSH levels, if necessary, to exclude other causes of amenorrhea or infertility.
Perform an ultrasound of the ovaries to help make the diagnosis.
Look for evidence of insulin resistance:
Consider other causes of irregular menses and amenorrhea if other evidence of PCOS is lacking.