PCOS Diagnosis and Treatment Guidelines Developed
(HealthDay News) – Evidence-based guidelines have been developed for the diagnosis and treatment of polycystic ovary syndrome (PCOS); the clinical practice guideline was published online Oct. 22 in the Journal of Clinical Endocrinology & Metabolism.
Richard S. Legro, MD, from the Penn State University College of Medicine in Hershey, and other Endocrine Society-appointed experts developed an evidence-based guideline for the diagnosis and treatment of PCOS. Preliminary drafts of the guideline were reviewed by committees and members of The Endocrine Society and the European Society of Endocrinology.
The researchers recommend use of the Rotterdam criteria for PCOS diagnosis (presence of two of the following: androgen excess, ovulatory dysfunction, or polycystic ovaries). Diagnosis is difficult to establish for adolescents and menopausal women. Alternate androgen-excess disorders and risk factors for endometrial cancer, mood disorders, obstructive sleep apnea, diabetes, and cardiovascular disease should be excluded in PCOS evaluation. First-line management for menstrual abnormalities and hirsutism/acne is hormonal contraceptives. The current first-line therapy for infertility is clomiphene. Metformin has shown benefit for metabolic/glycemic abnormalities and menstrual irregularity, but has little or no benefit for hirsutism, acne, or infertility. For adolescents with PCOS, treatment options include hormonal contraceptives and metformin. Although the impact of weight loss in improving PCOS status is unclear, other health benefits are seen with lifestyle interventions for overweight and obese patients. An unfavorable risk-benefit ratio has been noted with thiazolidinediones, while further research is needed on statins.
"The Endocrine Society's clinical practice guideline is designed to help physicians and patients navigate our evolving understanding of this complex condition," Legro said in a statement.
Several authors disclosed financial ties to the pharmaceutical and medical technology industries.