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A 19-year-old woman presented to her primary care physician for evaluation of oligomenorrhea. She has had fewer than 6 menstrual cycles per year since menarche at 13 years of age. Her last menstrual cycle was 9 months ago, and at that time, she sought gynecologic evaluation. Her gynecologist considered the possibility of polycystic ovary syndrome (PCOS) and obtained laboratory measurements for thyrotropin, prolactin, follicle-stimulating hormone, and luteinizing hormone but questioned the diagnosis of PCOS because of a normal luteinizing hormone-to-follicle-stimulating hormone ratio (Table 1). The gynecologist referred the patient to an endocrinologist.
Sam S, Ehrmann DA. Hormonal Evaluation of Hyperandrogenism in Women. JAMA. 2015;314(23):2557-2558. doi:10.1001/jama.2015.11612