This study investigates the prevalence of polycystic ovaries (PCOs) in women with anovulation and idiopathic hirsutism using ultrasound imaging. The study included 173 women who presented to a gynecological endocrine clinic with amenorrhea, oligomenorrhea, or hirsutism. PCOs were found in 26% of women with amenorrhea, 87% with oligomenorrhea, and 92% with idiopathic hirsutism (regular menstrual cycles). Fewer than half of the anovulatory patients with PCOs were hirsute, but 93% had at least one endocrine abnormality supporting the diagnosis of PCOs, such as elevated serum luteinizing hormone (LH), LH:follicle-stimulating hormone (FSH) ratio, or testosterone/androstenedione levels. The study concludes that PCOs, as defined by pelvic ultrasound, are common in anovulatory women (57% of cases) and are not necessarily associated with hirsutism or elevated serum LH concentrations. Most women with hirsutism and regular menses have PCOs, suggesting that the term "idiopathic" hirsutism is no longer appropriate. The findings highlight the importance of ultrasound in diagnosing PCOs and their prevalence in anovulatory women.This study investigates the prevalence of polycystic ovaries (PCOs) in women with anovulation and idiopathic hirsutism using ultrasound imaging. The study included 173 women who presented to a gynecological endocrine clinic with amenorrhea, oligomenorrhea, or hirsutism. PCOs were found in 26% of women with amenorrhea, 87% with oligomenorrhea, and 92% with idiopathic hirsutism (regular menstrual cycles). Fewer than half of the anovulatory patients with PCOs were hirsute, but 93% had at least one endocrine abnormality supporting the diagnosis of PCOs, such as elevated serum luteinizing hormone (LH), LH:follicle-stimulating hormone (FSH) ratio, or testosterone/androstenedione levels. The study concludes that PCOs, as defined by pelvic ultrasound, are common in anovulatory women (57% of cases) and are not necessarily associated with hirsutism or elevated serum LH concentrations. Most women with hirsutism and regular menses have PCOs, suggesting that the term "idiopathic" hirsutism is no longer appropriate. The findings highlight the importance of ultrasound in diagnosing PCOs and their prevalence in anovulatory women.