Clinical Practice Guideline

RETIRED: Diagnosis and Treatment of Polycystic Ovary Syndrome

December 19, 2013

Full Guideline: Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline
JCEM December 2013

Richard S. Legro, Silva A. Arslanian, David A. Ehrmann, Kathleen M. Hoeger, M. Hassan Murad, Renato Pasquali, Corrine K. Welt

Objective:

The aim was to formulate practice guidelines for the diagnosis and treatment of polycystic ovary syndrome (PCOS).

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.

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Endocrine Society Guideline Methodologists

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We are seeking two members to undertake training to become GRADE-certified Endocrine Society Guideline Methodologists (ESGM) for the development of Endocrine Society Clinical Practice Guidelines. ESGMs will materially participate in the guideline development process and thus will be guideline authors, and will also gain valuable career development experience in the process.

We are seeking two members to undertake training to become GRADE-certified Endocrine Society Guideline Methodologists (ESGM) for the development of Endocrine Society Clinical Practice Guidelines. ESGMs will materially participate in the guideline development process and thus will be guideline authors, and will also gain valuable career development experience in the process.

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