On pelvic examination, which finding is typical in PCOS?

• A. Uterine tenderness on palpation.
• B. Atrophic ovaries.
• C. Bilateral enlarged, smooth, mobile ovaries.
• D. Adnexal mass.

Answer: (C)

The key idea is that polycystic ovary syndrome often presents with ovaries that are enlarged on pelvic exam, while remaining smooth and mobile. In PCOS, numerous small follicles within the ovaries cause overall enlargement, but the ovaries typically have a smooth contour and are not fixed or tender. This contrasts with uterine tenderness, which points to inflammatory or infectious processes; atrophic ovaries suggest menopause or ovarian failure; and a discrete adnexal mass would indicate a focal lesion rather than the diffuse bilateral enlargement seen in PCOS. So finding bilateral enlarged, smooth, mobile ovaries best fits PCOS.