Polycystic Ovary Syndrome: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps:

  • General physical examination – including blood pressure, pulse, body weight, height [obesity (overweight)]; furthermore:
    • Inspection (viewing): skin and mucous membranes, abdominal wall and inguinal region (groin area) [seborrhea (oily skin); objective evaluation of distribution/quantity of hair: increased hairiness of terminal hair (long hair) in women according to male distribution pattern in the following areas:
      • Of the sideburns (of the jaw area near the ear), the upper lip and on the chin.
      • Of the upper sternum area, around the areolas.
      • From the navel – pulling in the midline to the pubic hair. The pubic hair itself extends to the thighs. Instead of an ideal-typical sharply defined triangular shape, this creates rather a broad rhombus shape.
      • Thigh, lower leg as well as the forearms.
    • Other features to note:
      • Acne
      • Alopecia androgenitica (androgenic baldness)]
  • Gynecological examination
    • Inspection
      • Vulva (external, primary female sex organs) [in virilism/masculinization: enlargement of the clitoris].
      • Vagina (vagina)
      • Cervix uteri (cervix), or portio (cervix; transition from the cervix (cervix uteri) to the vagina (vagina)), if necessary, taking a Pap smear (for early detection of cervical cancer).
    • Palpation (bimanual; palpation with both hands) of the internal genital organs.
      • Cervix uteri (cervix).
      • Uterus (uterus) [Normal: anteflexed/angled anteriorly, normal size, no tenderness].
      • Adnexa (appendages of the uterus, i.e., the ovary and uterine tube). [Normal: free; the ovaries are larger than normal; the diagnosis of PCO syndrome is essentially based on sonography and laboratory diagnostics]
      • Parametria (pelvic connective tissue in front of the cervix to the urinary bladder and on both sides to the lateral wall of the pelvis) [Normal: free].
      • Pelvic walls [Normal: free]
      • Douglas space (pocket-like bulge of the peritoneum (abdominal wall) between the rectum (rectum) at the back and the uterus (uterus) at the front) [Normal: clear].
    • Inspection of the mammae (breasts), right and left; the nipple (nipple), right and left and the skin [Normal: unremarkable; possibly increased hairiness of the terminal hair (long hair) of the woman according to male distribution pattern in the upper sternum area, around the areolas].
    • Palpation of the mammae, the two supraclavicular pits (upper clavicle pits) and axillae (axillae) [Normal: unremarkable].
  • Health check

Square brackets [ ] indicate possible pathological (pathological) physical findings.