The aim of this study was to compare clinical, hormonal, and metabolic variables in women with classic polycystic ovary syndrome (PCOS), in ovulatory women presenting hirsutism, normal androgen levels, and polycystic ovaries (H+PCO), and in a group with isolated hirsutism (IH) presenting with normal ovaries and androgen levels. Waist circumference, triglycerides, and homeostasis model assessment values were significantly higher in classic PCOS even after adjustment for body mass index, and metabolic syndrome was three times more frequent in classic PCOS than in H+PCO or IH (31.3% vs. 11.9% vs. 9%), but no differences were observed regarding metabolic profile and cardiovascular risk factors between the H+PCO and IH groups, which presented with significantly more metabolic syndrome than normal controls when only overweight and obese women were considered. (Fertil Steril (R) 2010;94:2493-6. (c) 2010 by American Society for Reproductive Medicine.)