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CPE-010 · Criteria
PC-02: Criterion: irregular cycles
Criterion: irregular cycles. Evaluates cycle length below 21 or above 35 days, OR fewer than 8 cycles a year, OR amenorrhea for more than 3 months (adults).
Condition
- cycle length < 21 or > 35 days, OR fewer than 8 cycles a year, OR amenorrhea for more than 3 months (adults)
What it reports
- Irregular cycles / ovulatory dysfunction
Diagnostic boundary
- Counts toward criteria only when other causes are excluded.
Evidence
- EV-PCOS-2023Teede HJ, Tay CT, Laven JJE, et al. Recommendations From the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. J Clin Endocrinol Metab. 2023;108(10):2447-2469.Supports: Adult diagnosis: irregular cycles plus hyperandrogenism once other causes are excluded; ultrasound or AMH when one is missing Adolescent criteria require both irregular cycles and hyperandrogenism Glycemic, cardiometabolic, sleep and mood assessment; endometrial risk in prolonged anovulation
- EV-ROTTERDAM-2004Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41-47.Supports: Two of three criteria: oligo-anovulation, hyperandrogenism, polycystic ovaries, after excluding other disorders
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
PCOS-FX-01
Irregular cycles and hirsutism, exclusions complete
A 26-year-old with 8 cycles a year and an mFG of 9.
PCOS-FX-02
Irregular cycles and polycystic ovaries
No hyperandrogenism, 22 follicles per ovary.
PCOS-FX-04
Irregular cycles only
One criterion is not enough.
PCOS-FX-05
Criteria met, no exclusion tests
TSH, prolactin and 17-OHP missing.
PCOS-FX-06
Prolactin 68 ng/mL
Another cause of oligomenorrhea.
PCOS-FX-07
TSH 9.2 mIU/L
Thyroid disease explains irregular cycles.
PCOS-FX-08
17-hydroxyprogesterone 340 ng/dL
Non-classic CAH possible.
PCOS-FX-09
Total testosterone 215 ng/dL and rapid virilization
Not explained by PCOS.
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