From the Guidelines
Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting women of reproductive age, characterized by irregular menstrual cycles, excess androgen levels, and polycystic ovaries, with a prevalence of 8%–13% according to the Rotterdam criteria 1.
Key Characteristics of PCOS
- Irregular menstrual cycles
- Excess androgen levels
- Polycystic ovaries
- Insulin resistance, which plays a crucial role in many symptoms of PCOS, regardless of body mass index (BMI) 1
Diagnosis of PCOS
PCOS is diagnosed when at least two of three criteria are present:
- Irregular periods
- Excess androgens (either by blood test or physical signs)
- Polycystic ovaries on ultrasound
Treatment and Management of PCOS
Treatment typically focuses on managing individual concerns and may include:
- Lifestyle modifications like weight loss through diet and exercise
- Hormonal birth control to regulate periods
- Anti-androgen medications like spironolactone for excess hair growth
- Metformin to improve insulin sensitivity
Importance of Early Diagnosis and Treatment
Early diagnosis and treatment can help manage symptoms and reduce long-term health risks, including the development of type 2 diabetes, high blood pressure, heart problems, and endometrial cancer 1.
Recent Guidelines and Recommendations
Recent guidelines, such as the International Evidence-based Guideline for the Assessment and Management of PCOS, emphasize the importance of lifestyle management, including diet, exercise, and behavioral strategies, as the first-line treatment for PCOS 1.
Emerging Therapies for PCOS
Emerging therapies, such as anti-obesity pharmacological agents, may also play a role in the management of PCOS, particularly for individuals with obesity, by promoting weight loss and improving insulin resistance 1.
From the Research
Definition and Diagnosis of PCOS
- Polycystic Ovary Syndrome (PCOS) is recognized as the most common endocrine disorder of reproductive-aged women around the world 2.
- The diagnosis of PCOS must be based on the presence of at least two of the following three criteria: chronic anovulation, hyperandrogenism (clinical or biological), and polycystic ovaries 2.
- General agreement exists among specialty society guidelines that the diagnosis of PCOS should be based on a combination of clinical, biochemical, and ultrasound findings 3.
Symptoms and Characteristics of PCOS
- PCOS is characterized by hyperandrogenism and chronic anovulation, with symptoms arising during the early pubertal years 4.
- Common symptoms of PCOS include irregular menstrual cycles, acne, hirsutism, and infertility 2, 4.
- Women with PCOS are also at increased risk of metabolic and cardiovascular disorders, such as insulin resistance, obesity, and diabetes 3, 5.
Hormonal Changes in PCOS
- Hormonal changes play a crucial role in the development of PCOS, with alterations in insulin, growth hormones, gonadotropin-releasing hormone, and androgens 6.
- The luteinizing hormone/follicle-stimulating hormone (LH/FSH) ratio is often elevated in women with PCOS, contributing to infertility and menstrual irregularities 6.
- Other hormonal changes, such as increased ghrelin and leptin resistance, may contribute to metabolic disorders and obesity in PCOS patients 6.
Treatment and Management of PCOS
- Treatment of PCOS typically involves a combination of lifestyle modifications, hormonal therapies, and medications to manage symptoms and prevent long-term complications 2, 4.
- Oral contraceptives, metformin, and anti-androgen medications are commonly used to treat PCOS, with the goal of improving menstrual regularity, reducing androgen levels, and promoting fertility 2, 4.
- Early diagnosis and treatment of PCOS are critical to preventing long-term complications and improving quality of life for affected women 5.