PCOS Indicator Calculator (Rotterdam Criteria)

Assess how your presentation maps onto the Rotterdam criteria for polycystic ovary syndrome — which require two of three features plus exclusion of other causes.

🌸 Women's Health📐 Rotterdam: 2 of 3 — ovulatory dysfunction, hyperandrogenism, polycystic ovarian morphology🏥 Health
Cycle pattern
Clinical signs of excess androgens (hirsutism, acne, hair thinning)
Blood testosterone or free androgen index
Ultrasound ovarian appearance
Other causes excluded (thyroid, prolactin, adrenal)
Please enter valid values.

Formula & Reference

VariableSymbolFormulaUnits
PCOS Indicator Calculator (Rotterdam Criteria)Rotterdam: 2 of 3 — ovulatory dysfunction, hyperandrogenism, polycystic ovarian morphologycriteria met

Step-by-Step Examples

Example 1
Two Features Present

Fewer than 8 periods a year, moderate hirsutism, ultrasound not performed, other causes excluded.

  • Ovulatory dysfunction ✓
  • Clinical hyperandrogenism ✓
  • Ovarian morphology not assessed
  • 2 of 3 features met with exclusions done
✓ 2 of 3 — meets the Rotterdam threshold
Example 2
One Feature Only

Regular cycles, no androgen signs, ultrasound shows polycystic morphology.

  • Ovulatory dysfunction ✗
  • Hyperandrogenism ✗
  • Polycystic morphology ✓
  • Polycystic ovaries alone do not constitute PCOS
✓ 1 of 3 — below the threshold
Example 3
Incomplete Assessment

Irregular cycles, mild acne, no bloods or ultrasound, no exclusion testing.

  • Ovulatory dysfunction ✓
  • Mild clinical androgen signs ✓
  • But no laboratory or imaging assessment, and no exclusions
  • Assessment is incomplete despite meeting two features on symptoms
✓ 2 of 3, but requires clinical workup

Real-World Applications

Common Mistakes to Avoid

⚠️
Assuming polycystic ovaries alone means PCOS

Polycystic ovarian morphology appears on ultrasound in a substantial share of women without the syndrome. It is one of three criteria, not a diagnosis.

⚠️
Skipping the exclusion step

Rotterdam requires excluding thyroid disease, hyperprolactinaemia, non-classical congenital adrenal hyperplasia, and androgen-secreting tumours. Without that, the diagnosis is not established.

⚠️
Applying ultrasound criteria to adolescents

Polycystic ovarian morphology is common in normal adolescence, so current guidance advises against using ultrasound for PCOS diagnosis within about eight years of menarche.

Frequently Asked Questions

What are the Rotterdam criteria?
PCOS is diagnosed when two of three features are present — ovulatory dysfunction, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology — after excluding other causes.
Can I have PCOS with regular periods?
Yes. If you have hyperandrogenism plus polycystic ovarian morphology, you can meet criteria with regular cycles.
Does PCOS mean I cannot get pregnant?
No. PCOS is a common cause of ovulatory infertility, but many conceive naturally and effective treatments exist for those who need them.
Is ultrasound always needed?
No. If ovulatory dysfunction and hyperandrogenism are both present, two criteria are already met and imaging adds nothing to the diagnosis.
Why is PCOS diagnosis different in adolescents?
Irregular cycles and polycystic ovarian appearance are both common in normal puberty, so guidance advises caution and typically excludes ultrasound criteria in this group.

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