The Journal of Clinical Endocrinology & Metabolism· 2013Q1
Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline
- 1,904citations
- Q1SCImago
- 2013year
Short summary
New clinical practice guidelines recommend using the Rotterdam criteria (androgen excess, ovulatory dysfunction, or polycystic ovaries) for diagnosing PCOS, while noting diagnostic challenges in adolescents and menopausal women.
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Key points
- Rotterdam criteria (androgen excess, ovulatory dysfunction, polycystic ovaries) are recommended for PCOS diagnosis.
- Diagnosis is challenging in adolescents (hyperandrogenism focus) and menopausal women (no consistent phenotype).
- Hormonal contraceptives are first-line for menstrual abnormalities and hirsutism/acne.
- Clomiphene is the primary infertility treatment; metformin aids metabolic/glycemic issues.
- Lifestyle intervention is beneficial for overweight/obese patients for general health, though its direct impact on PCOS is uncertain.
AI-generated from the title and abstract; the full text is not read.
Abstract
OBJECTIVE: The aim was to formulate practice guidelines for the diagnosis and treatment of polycystic ovary syndrome (PCOS). PARTICIPANTS: An Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer developed the guideline. EVIDENCE: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence. CONSENSUS PROCESS: One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of The Endocrine Society and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines. Two systematic reviews were conducted to summarize supporting evidence. CONCLUSIONS: We suggest using the Rotterdam criteria for diagnosing PCOS (presence of two of the following criteria: androgen excess, ovulatory dysfunction, or polycystic ovaries). Establishing a diagnosis of PCOS is problematic in adolescents and menopausal women. Hyperandrogenism is central to the presentation in adolescents, whereas there is no consistent phenotype in postmenopausal women. Evaluation of women with PCOS should exclude alternate androgen-excess disorders and risk factors for endometrial cancer, mood disorders, obstructive sleep apnea, diabetes, and cardiovascular disease. Hormonal contraceptives are the first-line management for menstrual abnormalities and hirsutism/acne in PCOS. Clomiphene is currently the first-line therapy for infertility; metformin is beneficial for metabolic/glycemic abnormalities and for improving menstrual irregularities, but it has limited or no benefit in treating hirsutism, acne, or infertility. Hormonal contraceptives and metformin are the treatment options in adolescents with PCOS. The role of weight loss in improving PCOS status per se is uncertain, but lifestyle intervention is beneficial in overweight/obese patients for other health benefits. Thiazolidinediones have an unfavorable risk-benefit ratio overall, and statins require further study.
The authors' abstract, as published at the source. The Journal of Clinical Endocrinology & Metabolism, 2013 · DOI ↗
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Field: Reproductive Medicine
Reproductive MedicineMedicine