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‘Two-state solution’ proposed for renaming PCOS
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New terminology is warranted for improved diagnosis and treatment of polycystic ovary syndrome phenotypes, according to researchers.
“We would like to propose a nosological ‘two-state solution’ to the conflict. The endocrine syndrome of hyperandrogenism and chronic anovulation, eg, the National Institutes of Health (NIH) phenotype, should have a new name that acknowledges both its reproductive features as well as its long-term metabolic risks. The phenotypes diagnosed by ovarian morphology, eg, the remaining Rotterdam phenotypes, should continue to be known as PCOS,” wrote Andrea Dunaif, MD, vice chair for research in the department of medicine at Northwestern University Feinberg School of Medicine, and Bart Fauser, MD, of the department of reproductive medicine and gynecology at the University Medical Center in Utrecht, the Netherlands.
Andrea Dunaif
The researchers cited recommendations from the NIH Office for Disease Prevention’s Evidence-based Methodology Workshop on PCOS held last year, which suggested clarifying benefits and drawbacks from diagnostic criteria; causes, predictors and long-term consequences; and treatment and prevention strategies. They added that the syndrome is often overlooked outside of obstetrics and gynecology visits.
Currently, the diagnostic criteria for PCOS by the NIH include hyperandrogenism and chronic anovulation; Rotterdam includes two of the following: hyperandrogenism, chronic anovulation and polycystic ovaries. Finally, the Androgen Excess Society criteria state that PCOS is marked by hyperandrogenism plus ovarian dysfunction indicated by oligo/amenorrhea and/or polycystic ovaries, according to the researchers.
“Specifically, we want to ensure that this recommendation does not lead to Balkanization of the field, which will clearly undermine the broad interdisciplinary efforts required for meaningful scientific advances in our understanding of PCOS,” they wrote.
Disclosure: The researchers report no relevant financial disclosures.
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