Broadening the Scope of Polycystic Ovary Syndrome (PCOS) Care: Insights from the 2023 International Evidence-Based PCOS Guideline

Chau Thien Tay, BMedSc, MBBS (Hons), FRACP, PhD

Mahnaz Bahri Khomami, PhD, MMID, BMID

Polycystic ovary syndrome (PCOS), with an estimated 8 to 13% prevalence, stands as the most prevalent endocrinopathy affecting women of reproductive age worldwide.[1] The true prevalence may be even higher, as many cases go undiagnosed or misdiagnosed. Characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries, PCOS is originally believed to be primarily a reproductive disorder. However, we now recognize its profound impact on metabolic and psychological health.[2] These include an increased risk of insulin resistance, type 2 diabetes, cardiovascular disease, obesity, hirsutism, acne, and psychological disturbances such as depression and anxiety.[2] While considerable progress has been made in understanding PCOS since first described by Stein and Levanthal in 1935,[3] many uncertainties remain regarding its optimal management.

In 2018, the International Evidence-Based Guideline for the Assessment and Management of PCOS was published, codeveloped by researchers, health professionals, and consumers from around the world.[4] This collaborative effort aimed to develop universally agreed guideline recommendations for the accurate diagnosis and treatment of PCOS. Now, after 5 years, it is with great anticipation and excitement the Updated Guideline is set to be released later this year. The revised guideline addresses new areas of consideration to ensure its relevance and applicability to end-users, including consumers, health professionals, and policy makers.

This special issue on PCOS serves as a platform to present some of the novel topics and considerations included in the 2023 guideline update. One key focus is the empowerment of individuals with PCOS with evidence-based information and resources to allow them to actively participate in their own healthcare journey. Furthermore, this special issue sheds light on unique considerations for the management of depression and anxiety in women with PCOS. These psychological comorbidities can significantly impact quality of life and treatment outcomes, and a comprehensive approach to care necessitates addressing both the physical and emotional aspects of the syndrome. Another notable aspect of the updated guideline is the emphasis on using gender-inclusive language and considerations for culturally and linguistically diverse populations. Recognizing the diverse experiences and needs of individuals with PCOS, the guideline aims to promote inclusivity and sensitivity in all aspects of care. Weight stigma, sleep hygiene, and managing patient expectations are additional critical areas covered in this special issue. These topics reflect the evolving understanding of the multifaceted nature of PCOS and the need for comprehensive care that extends beyond conventional medical interventions.

We are honored to present this special issue on PCOS, offering insights into the new topics and considerations found in the forthcoming 2023 guideline update. By promoting evidence-based approaches and addressing the complex and diverse needs of individuals with PCOS, we aim to improve the lives of those affected by this common but complex endocrinopathy. It is our hope that this collection of articles will inspire further research, motivate dialogue, and ultimately improve clinical outcomes for individuals with PCOS worldwide.

Publikationsverlauf

Artikel online veröffentlicht:
19. Dezember 2023

• References

• 1 Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: a systematic review and meta-analysis. Hum Reprod 2016; 31 (12) 2841-2855
• 2 Azziz R, Carmina E, Chen Z. et al. Polycystic ovary syndrome. Nat Rev Dis Primers 2016; 2: 16057
• 3 Stein IF, Leventhal ML. Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 1935; 29: 181-191
• 4 Teede HLJ, Moran L, Dokras A. et al; On Behalf of the International PCOS Network. International Evidence-Based Guidelines for the Assessment and Management of Polycystic Ovary Syndrome. Melbourne: Copyright Monash University; 2018