New International Guidelines For The Diagnosis And Treatment Of Polycystic Ovary Syndrome (PCOS) Released

An international research group led by the Prof. Teede of University of Monash, Australia published last week a first of its kind evidence-based, comprehensive guideline for the diagnosis and treatment of Polycystic Ovary Syndrome (PCOS). The guideline is designed to provide clear information to assist clinical decision making and support optimal patient care and is the culmination of the work of over 3,000 health professionals and consumers internationally.

Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age. It affects 13% of women. Signs and symptoms of PCOS vary and may include infrequent, prolonged menstrual periods, excess male hormone (androgen) levels, numerous ovarian cysts, failure to ovulate, excessive hair growth, weight gain, and acne.

Infertility is one of the most common complications of PCOS. Other complications include higher risks of miscarriage, gestational diabetes, premature birth, heart disease and type 2 diabetes. However, there is still hope! Women with PCOS can still have children, they just need a little extra help!

Early diagnosis and treatment along with weight loss may reduce the risk of long-term complications such as type 2 diabetes and heart disease.

The lack of one universally accepted definition of the disease and the fact that PCOS is a complex condition with varying symptoms makes it very difficult to diagnose it accurately. This leaves over 70% of women undiagnosed and without proper treatment. To improve diagnosis rate, the new publication set international clinical guidelines for healthcare providers to follow, which will hopefully improve patient experience and outcome.

How Is PCOS Diagnosed?

The health care provider will review your medical history (including menstrual periods and weight changes), then perform a physical examination which includes a pelvic exam to identify any masses, growth or abnormalities in the reproductive organs.

To complete the diagnosis the doctor will require additional blood tests to measure hormone levels and a vaginal ultrasound to check for the presence of polycystic ovaries (ovaries with more than 12 cysts each) and thickness of uterine lining.

How Is PCOS Treated?

PCOS treatment depends on your individual concerns (infertility, hirsutism, acne or obesity). Each symptom will require a different treatment plan. Specific treatment might involve lifestyle changes and/or medication. Healthy weight and active lifestyle play an important role in PCOS management. Not only it can improve some of the symptoms, it also may increase the effectiveness of the medication. Below are listed some of the available medication to help manage PCOS symptoms.

Medication:

To regulate your menstrual cycle – The doctor may offer birth control pill or progestin therapy.

To help you ovulate – The doctor may offer Letrozole (Femara), Clomiphene (Clomid) or Metformin (Glucophage, Fortamet and others) or Gonadotropins.

To reduce excessive hair growth – the doctor may recommend birth control pill or Spironolactone (Aldactone), Eflornithine (Vaniqa) or Electrolysis.

One of the key messages from the guidelines is the acknowledgment that for successful outcome healthcare professionals and women managing PCOS need to work in partnership. In addition, the course of treatment should be multidisciplinary and address all metabolic, reproductive and psychological aspects of the disease.  And most importantly education, active lifestyle and emotional well-being are critical to the optimal patient’s outcome and experience, and we couldn’t agree more!

You know your body best and we are here to first listen and then apply the most suitable available evidence-based therapy for optimal outcome.

For further reading and resources:

Resource for women with PCOS

The International evidence-based guideline for the assessment and management of Polycystic Ovary Syndrome (PCOS)

Mobile application for PCOS management

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