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PCOS is the commonest endocrinopathy of reproductive years with a quoted prevalence of 5-11%, depending upon populations studied.1 Despite being a liberally diagnosed, the disorder remains relatively poorly understood. The syndrome was first described in 1935 as a conglomeration of symptoms of menstrual irregularity and signs of hyperandrogenism (hirsutism) and of enlarged cystic ovaries. Currently, at least three nomenclatures are widely recognized for diagnosing PCOS, with a considerable overlap in the diagnostic criteria (Table 1).2 It is imperative to appreciate the heterogeneity within the population diagnosed with PCOS and to recognize that PCOS remains a diagnosis of exclusion. The common systemic disorders that may mimic PCOS include hypothyroidism, hyperprolactinemia, late onset congenital adrenal hyperplasia, androgen secreting tumors, Cushing’s syndrome and exogenous androgen exposure; these must be excluded prior to arriving at a diagnosis ofPCOS. -