Editing Polycystic ovary syndrome (section)

=== Hormone levels ===
[[Testosterone]] levels are usually elevated in women with PCOS.<ref name="MazzeStrockSimonson2007" /><ref name="pmid32462512">{{cite journal | vauthors = Loh HH, Yee A, Loh HS, Kanagasundram S, Francis B, Lim LL | title = Sexual dysfunction in polycystic ovary syndrome: a systematic review and meta-analysis | journal = Hormones (Athens) | volume = 19 | issue = 3 | pages = 413–423 | date = September 2020 | pmid = 32462512 | doi = 10.1007/s42000-020-00210-0 | s2cid = 218898082 | url = | quote = A total of 5366 women with PCOS from 21 studies were included. [...] Women with PCOS [...] [had higher] serum total testosterone level (2.34 ± 0.58 nmol/L vs 1.57 ± 0.60 nmol/L, p < 0.001) compared with women without PCOS. [...] PCOS is characterized by high levels of androgens (dehydroepiandrosterone, androstenedione, and testosterone) and luteinizing hormone (LH), and increased LH/follicle-stimulating hormone (FSH) ratio [52].}}</ref> In a 2020 [[systematic review]] and [[meta-analysis]] of sexual dysfunction related to PCOS which included 5,366&nbsp;women with PCOS from 21&nbsp;studies, testosterone levels were analyzed and were found to be 2.34&nbsp;nmol/L (67&nbsp;ng/dL) in women with PCOS and 1.57&nbsp;nmol/L (45&nbsp;ng/dL) in women without PCOS.<ref name="pmid32462512" /> In a 1995 study of 1,741&nbsp;women with PCOS, mean testosterone levels were 2.6&nbsp;(1.1–4.8) nmol/L (75&nbsp;(32–140)&nbsp;ng/dL).<ref name="pmid8567849">{{cite journal | vauthors = Balen AH, Conway GS, Kaltsas G, Techatrasak K, Manning PJ, West C, Jacobs HS | title = Polycystic ovary syndrome: the spectrum of the disorder in 1741 patients | journal = Hum Reprod | volume = 10 | issue = 8 | pages = 2107–11 | date = August 1995 | pmid = 8567849 | doi = 10.1093/oxfordjournals.humrep.a136243 | url = | quote = The criteria for the diagnosis of the polycystic ovary syndrome (PCOS) have still not been agreed universally. A population of 1741 women with PCOS were studied, all of whom had polycystic ovaries seen by ultrasound scan. The frequency distributions of the serum concentrations of [...] testosterone [...] were determined and compared with the symptoms and signs of PCOS. [...] A rising serum concentration of testosterone [mean and 95th percentiles 2.6 (1.1-4.8) nmol/1] was associated with an increased risk of hirsutism, infertility, and cycle disturbance. [...] If the serum testosterone concentration is >4.8 nmol/1, other causes of hyperandrogenism should be excluded.}}</ref> In a 1998 study which reviewed many studies and subjected them to meta-analysis, testosterone levels in women with PCOS were 62 to 71&nbsp;ng/dL (2.2–2.5&nbsp;nmol/L) and testosterone levels in women without PCOS were about 32&nbsp;ng/dL (1.1&nbsp;nmol/L).<ref name="pmid15251757">{{cite journal | vauthors = Steinberger E, Ayala C, Hsi B, Smith KD, Rodriguez-Rigau LJ, Weidman ER, Reimondo GG | title = Utilization of commercial laboratory results in management of hyperandrogenism in women | journal = Endocr Pract | volume = 4 | issue = 1 | pages = 1–10 | date = 1998 | pmid = 15251757 | doi = 10.4158/EP.4.1.1 | url = }}</ref> In a 2010 study of 596 women with PCOS which used [[liquid chromatography–mass spectrometry]] (LC–MS) to quantify testosterone, median levels of testosterone were 41 and 47&nbsp;ng/dL (with 25th–75th percentiles of 34–65&nbsp;ng/dL and 27–58&nbsp;ng/dL and ranges of 12–184&nbsp;ng/dL and 1–205&nbsp;ng/dL) via two different labs.<ref name="pmid20826578">{{cite journal | vauthors = Legro RS, Schlaff WD, Diamond MP, Coutifaris C, Casson PR, Brzyski RG, Christman GM, Trussell JC, Krawetz SA, Snyder PJ, Ohl D, Carson SA, Steinkampf MP, Carr BR, McGovern PG, Cataldo NA, Gosman GG, Nestler JE, Myers ER, Santoro N, Eisenberg E, Zhang M, Zhang H | title = Total testosterone assays in women with polycystic ovary syndrome: precision and correlation with hirsutism | journal = J Clin Endocrinol Metab | volume = 95 | issue = 12 | pages = 5305–13 | date = December 2010 | pmid = 20826578 | pmc = 2999971 | doi = 10.1210/jc.2010-1123 | url = | quote = Design and Setting: We conducted a blinded laboratory study including masked duplicate samples at three laboratories—two academic (University of Virginia, RIA; and Mayo Clinic, LC/MS) and one commercial (Quest, LC/MS). Participants and Interventions: Baseline testosterone levels from 596 women with PCOS who participated in a large, multicenter, randomized controlled infertility trial performed at academic health centers in the United States were run by varying assays, and results were compared. [...] The median testosterone level by RIA was 50 ng/dl (25th–75th percentile, 34–71 ng/dl); by LC/MS at Mayo, 47 ng/dl (25th–75th percentile, 34–65 ng/dl); and by LC/MS at Quest, 41 ng/dl (25th–75th percentile, 27–58 ng/dl) (Fig. 1). The minimum and maximum values detected by RIA were 8 and 189 ng/dl, respectively; by LC/MS at Mayo, 12 and 184 ng/dl, respectively; and by LC/MS at Quest, 1 and 205 ng/dl, respectively. [...] Our sample size was robust and the largest study to date examining quality control of total testosterone serum levels in women.}}</ref> If testosterone levels are above 100 to 200&nbsp;ng/dL, per different sources, other possible causes of [[hyperandrogenism]], such as [[congenital adrenal hyperplasia]] or an [[androgen]]-secreting [[tumor]], may be present and should be excluded.<ref name="pmid8567849" /><ref name="CarminaStanczykLobo2019">{{cite book | vauthors =  Carmina E, Stanczyk FZ, Lobo RA  | chapter = Evaluation of Hormonal Status | veditors = Strauss JF, Barbieri RL | title = Yen and Jaffe's Reproductive Endocrinology: Physiology, Pathophysiology, and Clinical Management | edition = 8th | date = 2019 | pages = 887–915.e4 | publisher = Elsevier | doi = 10.1016/B978-0-323-47912-7.00034-2 | isbn = 978-0-323-47912-7 | s2cid = 56977185 | url = }}</ref><ref name="MazzeStrockSimonson2007">{{cite book | vauthors = Mazze R, Strock ES, Simonson GD, Bergenstal RM | chapter = Type 2 Diabetes and Metabolic Syndrome in Children and Adolescents | date = 11 January 2007 | title = Staged Diabetes Management: A Systematic Approach | edition = 2nd | publisher = John Wiley & Sons | pages = 213– | isbn = 978-0-470-06171-8 | oclc = 1039172275 | chapter-url = https://books.google.com/books?id=dQVfgd71NWEC&pg=PA213 | quote = Diagnosis and treatment. The first diagnostic test [of PCOS] is a measurement of total testosterone and free testosterone by radioimmunoassay. If total testosterone is between 50 ng/dL and 200 ng/dL above normal (<2.5 ng/dL), PCOS is present. If >200 ng/dL, then serum DHEA-S should be measured. If total testosterone or DHEA-S >700 μg/dL, then rule out an ovarian or adrenal tumor. These tests should be followed by tests for hypothyroidism, hyperprolactinemia, and adrenal hyperplasia. | access-date = 18 September 2022 | archive-date = 29 May 2024 | archive-url = https://web.archive.org/web/20240529161111/https://books.google.com/books?id=dQVfgd71NWEC&pg=PA213#v=onepage&q&f=false | url-status = live }}</ref>