1)      Virilization – clitoromegaly, deepening of the voice, increased muscle mass

2)      F/H of fertility problems, autoimmune disorders, premature menopause (familial medical or gynae disorders)

3)      Central obesity, moon facies, buffalo hump, plethoric complexion, thin skin, abdominal striae, ecchymotic patches, proximal myopathy, hyperglycemia (Cushing’s syndrome)

4)      Hyperprolactinemia, galactorrhea, visual field defects (pituitary tumors)

5)      Hypothyroidism/hyperthyroidism

6)      S. Prolactin concentration of more than 1000 miu/L on more than 2 occasions (cranial CT or MRI to exclude pituitary or hypothalamic tumors)

7)      Abnormally low levels of FSH and LH levels (pituitary or hypothalamic lesions)

8)      Recent curettage or endometritis, normal genitalia, normal hormonal profile, absent withdrawal bleed in progestogen challenge (Asherman syndrome – HSG for intrauterine adhesions)

9)      Prolonged secondary amenorrhea followed by intermenstrual bleeding (exclude endometrial carcinoma)