Endocrine Society Releases PCOS Guideline

The Endocrine Society has published a Clinical Practice Guideline designed to clarify the criteria for the diagnosis and treatment of polycystic ovary syndrome (PCOS), which affects about 5 million women in the United States, according to the National Institutes of Health.

In “Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline,” The Endocrine Society recommends that a diagnosis be made if an adult woman has 2 of the 3 principal features of PCOS: excess production of male hormones, called androgens; the formation of polycystic ovaries; and anovulation, a condition in which the ovary does not release a mature egg each month.

The organization also advises that women should have their body mass index, blood pressure, and oral glucose assessed prior to conceiving a child and suggests that women with PCOS should be examined for skin and hair complications, including excess hair growth and acne, following diagnosis. Finally, The Endocrine Society recommends that clinicians give adolescents and adult women with PCOS an oral glucose tolerance test to check for type 2 diabetes or impaired glucose tolerance, since they are at increased risk of these conditions.

Although polycystic ovary syndrome is the most common endocrinopathy among women in the US, it is “frequently missed or misdiagnosed,” says Richard S. Legro, MD, professor of obstetrics and gynecology at the Penn State University College of Medicine, and chair of the task force that authored the new guideline. The guideline “aims to simplify diagnosis and simplify treatment choices” for PCOS patients, he says.

“This should be of great interest to primary care physicians, as the complaints of women with PCOS—menstrual irregularity, infertility, hirsutism and obesity—are common complaints of women presenting for primary care. Further, all of our recommended diagnostic and treatment strategies are familiar to primary care givers, which should ease uptake of the recommendations.”

The Clinical Practice Guideline will be available in the December 2013 issue of the Journal of Clinical Endocrinology and Metabolism, a publication of The Endocrine Society.

—Mark McGraw