Concise OPD-Oriented Summary for PCOS in Indian Women 1. Why PCOS is Different in India Prevalence: ~9–22% (varies by criteria). Indian phenotype: More hyperandrogenism and metabolic issues at lower BMI. Lean PCOS: 20–30% have normal BMI but significant insulin resistance and cardiometabolic risk. Typical presentation: Oligomenorrhoea, acne, hirsutism, subfertility. 2. Diagnosis (Rotterdam 2003 – 2 of 3, after exclusions) Oligo-/anovulation: Cycles >35 days or <8 cycles/year. Hyperandrogenism: Clinical: Hirsutism, acne, androgenic alopecia. Biochemical: Raised free testosterone or total testosterone (with low SHBG) or raised DHEAS. Polycystic ovaries on USG (TVS preferred): ≥20 follicles/ovary (2–9 mm) or ovarian volume >10 mL. Exclude before labelling PCOS: TSH (thyroid dysfunction). Prolactin (hyperprolactinaemia). 17-OHP (non-classical CAH, if suspected). Cushing’s (if clinical features present). 3. OPD Workup – What to Order At first visit (baseline): TSH. Prolactin. Day 2–5 FSH, LH (LH:FSH >2:1 supports but is not required). Fasting glucose + 2-hour OGTT (preferred over fasting alone). Fasting insulin (HOMA-IR >2.5 = significant insulin resistance). Fasting lipid profile (↑TG, ↓HDL common). Free testosterone or total testosterone + SHBG.