Questioning PCOS phenotypes for reclassification and tailored therapy

Precise diagnoses are essential for defining appropriate treatments. This is partic-ularly true for polycystic ovary syndrome (PCOS), whose phenotypical manifesta-tions have recently suggested a possible diversity of etiological factors. PCOS is defined on the basis of gynecological and endocrinological alterations, but the patients often display considerable metabolic impairments, such as insulin resis-tance, that may worsen typical symptoms. The Rotterdam criteria fail to address this aspect, and the medical community has recently started to consider them as misleading diagnostic tools, casting doubts on whether the term PCOS is suited to describe all the clinical manifestations observed. This Opinion collects and critically discusses the scientific reports that question the definition of PCOS, calling for a revision of the current diagnostic criteria.