Rotterdam Criteria

The Rotterdam Criteria are the internationally accepted diagnostic standard for PCOS, established at a 2003 consensus workshop and endorsed by major medical organizations including ACOG, the Endocrine Society, and the European Society of Human Reproduction and Embryology. To receive a PCOS diagnosis, a woman must meet at least two of three criteria: irregular or absent menstrual periods (indicating ovulatory dysfunction), clinical or biochemical signs of excess androgens (such as hirsutism, acne, or elevated testosterone on bloodwork), or polycystic ovaries visible on ultrasound—while other conditions that mimic these symptoms have been excluded. The Rotterdam Criteria expanded earlier diagnostic definitions to recognize different PCOS phenotypes, acknowledging that the condition presents differently across women.