Recommendations from the international evidence‐based guideline for the assessment and management of polycystic ovary syndrome

Teede, Helena; Misso, Marie; Costello, Michael; Dokras, Anuja; Laven, Joop S.E.; Moran, Lisa; Piltonen, Terhi; Norman, Robert J.; Andersen, Marianne; Azziz, Ricardo; Balen, Adam; Baye, Estifanos; Boyle, Jacqueline; Brennan, Leah; Broekmans, Frank J.; Dabadghao, Preeti; Devoto, Luigi; Dewailly, Didier; Downes, Linda; Fauser, Bart C.J.M.; Franks, Stephen; Garad, Rhonda; Gibson-Helm, Melanie; Harrison, Cheryce L.; Hart, Roger; Hawkes, Rachel; Hirschberg, Angelica Lindén; Hoeger, Kathleen M.; Hohmann, Femke; Hutchison, Samantha; Joham, Anju E.; Johnson, Louise; Jordan, Cailin; Kulkarni, Jayashri; Legro, Richard S.; Rong, Li; Lujan, Marla E.; Malhotra, Jaideep; Mansfield, Darren; Marsh, Kate; McAllister, Veryan; Mocanu, Edgar; Mol, Ben Willem J.; Ng, Ernest Hung Yu; Oberfield, Sharon E.; Ottey, Sasha; Peña, Alexia S; Qiao, Jie; Redman, Leanne M.; Rodgers, Raymond J.; Rombauts, Luk; Romualdi, Daniela; Shah, Duru; Speight, Jane; Spritzer, Poli Mara; Stener-Victorin, Elisabet; Stepto, Nigel K.; Tapanainen, Juha S.; Tassone, Eliza C.; Thangaratinam, Shakila; Thondan, Mala; Tzeng, Chii Ruey; Spuy, Zephne van der; Vanky, Eszter; Vogiatzi, Maria G; Wan, Ching Shan; Wijeyaratne, Chandrika; Witchel, Selma F.; Woolcock, Jane; Yildiz, Bülent O.

doi:10.1111/cen.13795

Cited by 894 publications

(469 citation statements)

References 12 publications

(17 reference statements)

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“…[46] OCPs should be continued for atleast 6–9 months before any improvement in hirsutism is noted. [44] OCPs significantly improve the cutaneous manifestations and protect the endometrium from unopposed estrogen action; however, worsening of insulin resistance and dysplipidemias have also been reported.…”

Section: Laboratory Evaluationmentioning

confidence: 99%

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Update on management of polycystic ovarian syndrome for dermatologists

Gainder

Sharma

2019

Indian Dermatol Online J

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Section: Laboratory Evaluationmentioning

confidence: 99%

“…[46] Due to risk of adverse effects like venous thromboembolism, the 35-μm ethinyloestradiol plus CPA preparations (EE+CPA) should not be considered first line in PCOS. [46]…”

Section: Laboratory Evaluationmentioning

confidence: 99%

Update on management of polycystic ovarian syndrome for dermatologists

Gainder

Sharma

2019

Indian Dermatol Online J

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“…19 Here, we demonstrate that after a 12-months weight loss programme decreased body weight, BMI, waist circumference, hip circumference and WHR in both groups, with no group differences. 19 Here, we demonstrate that after a 12-months weight loss programme decreased body weight, BMI, waist circumference, hip circumference and WHR in both groups, with no group differences.…”

Section: Discussionmentioning

confidence: 47%

Prevalence of polycystic ovary syndrome in women with severe obesity – Effects of a structured weight loss programme

Kataoka

Larsson

Björkman

et al. 2019

Clinical Endocrinology

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Objective: Existing data are contradictory on the prevalence of polycystic ovary syndrome (PCOS) and metabolic syndrome (MetS) in women with severe obesity (body mass index [BMI] ≥ 35 kg/m 2 ), and there are few studies investigating the effect of weight reduction in women with severe obesity and PCOS. The aim was to study the prevalence of PCOS and MetS among women with severe obesity and to evaluate the effect of a 12-months weight loss programme on the prevalence of PCOS and MetS. Design/Participants: In total, 298 women with severe obesity were enrolled whereof 246 women had complete screening data for PCOS and MetS before commencing treatment. Weight loss intervention included very low energy diet. At 12-months follow-up, 72 women with complete data remained and were re-examined with baseline parameters.Results: At baseline, the prevalence of PCOS was 25.6% and in this group, the prevalence of MetS was 43.4% in PCOS vs 43.3% in controls (ns). At 12-months follow-up, weight loss in women with PCOS was 12.3 ± 10.7 kg (P < .001) and in non-PCOS 13.9 ± 13.4 kg (P < .001) with no between group difference. Women without PCOS decreased in total bone mass. Conclusions:Polycystic ovary syndrome occurs in one out of four women with severe obesity. The prevalence of MetS does not differ between women with or without PCOS with severe obesity. There was a significant weight loss in both groups but no difference between groups regarding change in metabolic parameters. K E Y W O R D Shyperandrogenemia, lipids, metabolic syndrome, polycystic ovary syndrome diagnosis, prevalence, severe obesity, weight loss treatment | 751 KATAOKA eT Al.

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“…We aim to improve accuracy and to simplify and facilitate timely diagnosis, while avoiding overdiagnosis, especially in adolescents. The guideline endorses the consensus‐based Rotterdam diagnostic criteria 3 , 20 for adult women and supports them with best available evidence. Algorithm 1 (https://www.monash.edu/__data/assets/pdf_file/0018/1411641/Algorithm-1-20180618.pdf) highlights the refined diagnostic criteria in adolescents, which require both hyperandrogenism and irregular cycles, with ultrasound now not recommended for diagnosis within 8 years of menarche, owing to overlap with normal reproductive physiology.…”

Section: Screening Diagnostic Assessment Risk Assessment and Life Smentioning

confidence: 90%

“…Stakeholder engagement and processes for guideline and translation resource development are outlined in Box 5 19 . A summary of the recommendations is published elsewhere 20 . ‐ 22 The MJA has also published an editorial accompanying this supplement 23 …”

Section: Guideline Development Process and Methodsmentioning

confidence: 99%

Translation and implementation of the Australian‐led PCOS guideline: clinical summary and translation resources from the International Evidence‐based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Teede

Misso

Boyle

et al. 2018

Medical Journal of Australia

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Introduction: We have developed the first international evidence‐based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS), with an integrated translation program incorporating resources for health professionals and consumers. The development process involved an extensive Australian‐led international and multidisciplinary collaboration of health professionals and consumers over 2 years. The guideline is approved by the National Health and Medical Research Council and aims to support both health professionals and women with PCOS in improving care, health outcomes and quality of life. A robust evaluation process will enable practice benchmarking and feedback to further inform evidence‐based practice. We propose that this methodology could be used in developing and implementing guidelines for other women's health conditions and beyond. Main recommendations: The recommendations cover the following broad areas: diagnosis, screening and risk assessment depending on life stage; emotional wellbeing; healthy lifestyle; pharmacological treatment for non‐fertility indications; and assessment and treatment of infertility. Changes in management as a result of this guideline: •Diagnosis:▪when the combination of hyperandrogenism and ovulatory dysfunction is present, ultrasound examination of the ovaries is not necessary for diagnosis of PCOS in adult women;▪requires the combination of hyperandrogenism and ovulatory dysfunction in young women within 8 years of menarche, with ultrasound examination of the ovaries not recommended, owing to the overlap with normal ovarian physiology; and▪adolescents with some clinical features of PCOS, but without a clear diagnosis, should be regarded as “at risk” and receive follow‐up assessment.•Screening for metabolic complications has been refined and incorporates both PCOS status and additional metabolic risk factors.•Treatment of infertility: letrozole is now first line treatment for infertility as it improves live birth rates while reducing multiple pregnancies compared with clomiphene citrate.

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Recommendations from the international evidence‐based guideline for the assessment and management of polycystic ovary syndrome

Cited by 894 publications

References 12 publications

Update on management of polycystic ovarian syndrome for dermatologists

Update on management of polycystic ovarian syndrome for dermatologists

Prevalence of polycystic ovary syndrome in women with severe obesity – Effects of a structured weight loss programme

Translation and implementation of the Australian‐led PCOS guideline: clinical summary and translation resources from the International Evidence‐based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

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