What are the Endocrine Society practice guidelines for the diagnosis and treatment of polycystic ovarian syndrome (PCOS)?

Updated: Sep 19, 2019
  • Author: Richard Scott Lucidi, MD, FACOG; Chief Editor: Richard Scott Lucidi, MD, FACOG  more...
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In October 2013, the Endocrine Society released practice guidelines for the diagnosis and treatment of PCOS. The following were among their conclusions [53] :

  • Use the Rotterdam criteria for diagnosing PCOS (presence of 2 of the following: androgen excess, ovulatory dysfunction, or polycystic ovaries).

  • In adolescents with PCOS, hyperandrogenism is central to the presentation; hormonal contraceptives and metformin are treatment options in this population. [54]

  • Postmenopausal women do not have a consistent PCOS phenotype.

  • Exclude alternate androgen-excess disorders and risk factors for cardiovascular disease, diabetes, endometrial cancer, mood disorders, and obstructive sleep apnea.

  • For menstrual abnormalities and hirsutism/acne, hormonal contraceptives are first-line treatment.

  • For infertility, clomiphene is first-line treatment.

  • For metabolic/glycemic abnormalities and for improving menstrual irregularities, metformin is beneficial.

  • Metformin is of limited or no benefit for managing hirsutism, acne, or infertility.

  • Overall, thiazolidinediones have an unfavorable risk-benefit ratio.

  • More investigation is needed to determine the roles of weight loss and statins in PCOS.

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