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Endocrine Society releases clinical practice guidelines on PCOS
An Endocrine Society-appointed task force has released new clinical practice guidelines for the diagnosis and treatment of polycystic ovary syndrome, according to a press release.
The syndrome became the subject of controversy at recent reproductive medicine scientific conferences and NIH meetings due the poorly understood nature of the condition and to its name focusing on a trait that is not always present.
“The Endocrine Society’s clinical practice guideline is designed to help physicians and patients navigate our evolving understanding of this complex condition,” Richard S. Legro, MD, of the Penn State University College of Medicine and chair of the task force, said in a press release. “The Society’s recommendations allow physicians to make the diagnosis if clear symptoms are present without resorting to universal hormone tests or ultrasound screening.”
Richard S. Legro
In general, the task force recommends that the diagnosis of PCOS in adults should be based on the Rotterdam criteria; therefore, it can only be made if two of the following three criteria are met: androgen excess, ovulatory dysfunction or polycystic ovaries.
Disorders that mimic the clinical features of PCOS are thyroid disease, hyperprolactinemia and nonclassic congenital adrenal hyperplasia, according to the guidelines.
The task force recognized the difficulty of diagnosing PCOS in adolescents and menopausal women.
“We suggest hormonal contraceptives as the first-line treatment in adolescents with suspected PCOS (if the therapeutic goal is to treat acne, hirsutism, or anovulatory symptoms, or to prevent pregnancy),” the task force wrote.
Due to the increased risk of pregnancy complications such as gestational diabetes, preterm delivery and preeclampsia, the task force also suggests BMI, blood pressure and oral glucose tolerance test screenings before conception.
BMI and waist circumference should also be monitored to gauge metabolic risk, whereas adolescents and adult women with PCOS should undergo an OGTT because they are at increased risk for type 2 diabetes and impaired glucose tolerance.
Clomiphene is the first-line therapy for infertility; metformin benefits metabolic and/or glycemic parameters and improves menstrual irregularities, the task force said.
Disclosure: The researchers report no relevant financial disclosures.