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Semin Reprod Med 2021; 39(03/04): 069-070
DOI: 10.1055/s-0041-1735506
Preface

Polycystic Ovary Syndrome

Authors

  • Aya Mousa

    1   Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia

  • Anju Joham

    1   Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
    2   Diabetes and Vascular Medicine Unit, Monash Health, VIC, Australia

  • Jacqueline Boyle

    1   Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventive Medicine, Monash University, VIC, Australia
    3   Women's and Children's, Monash Health, VIC, Australia
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Aya Mousa, PhD, BHSc (Hons-I)
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Anju Joham, MBBS, FRACP, PhD
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Jacqueline Boyle, MBBS, FRANZCOG, MPH & TM, PhD

Polycystic ovary syndrome (PCOS) is an endocrine disorder affecting 8–13% of reproductive age women worldwide and up to 21% of Aboriginal and Torres Strait Islander (Indigenous) women in Australia.[1] [2] [3] Hyperandrogenism and insulin resistance are key pathological determinants, influenced by genetic predisposition, in utero hormonal exposures, obesity, and lifestyle and environmental factors.[4] [5] Obtaining a timely PCOS diagnosis can be challenging, with many women experiencing significant delays, inadequate or conflicting information, and overall poor satisfaction with care, especially in areas such as psychological and psychosexual health, lifestyle management, and prevention. Over-diagnosis can also be problematic, including when polycystic ovarian morphology on ultrasound is incorrectly used as the single criterion equated with PCOS.[6] Clinically, treatments for PCOS tend to focus on specific aspects such as infertility, whereas current evidence signals a need to shift this focus toward a more holistic, person-centered approach to managing PCOS and its broader complications. The importance of timely, accurate diagnosis; provision of appropriate, tailored information; and recognition of the heterogeneous and often simultaneous biopsychosocial symptoms of PCOS, cannot be underestimated.

In this issue, we discuss the diagnosis and prevalence of PCOS, including reviewing the diagnostic recommendations from the international evidence-based guidelines,[7] as well as the prevalence of PCOS and associated features and complications among Indigenous women globally. We describe new advances in the epidemiology of PCOS and the potential for novel biomarkers such as metabolomics to aid in diagnosis and management. The relationships between PCOS and pre-gestational or gestational diabetes in pregnancy are also discussed, with reference to the impact of these metabolic conditions on breastmilk composition and lactogenesis. We examine current treatments of PCOS, with emphasis on lifestyle management in clinical practice. The main barriers and recommendations to improve lifestyle management are presented, focusing on behavior change and integrated models of care. Finally, the PCOS research and guideline translation program is evaluated with recommendations for future directions to accelerate the delivery of consistent, evidence-based care. The articles in this issue target some of the gaps identified in the international guidelines,[7] in the hope of expanding the current evidence base and providing a valuable resource to clinicians and scientists in this field. We hope that these articles shed new insights on the diagnosis, prevalence, epidemiology and treatment of PCOS to improve PCOS screening and management for current and future generations.



Publication History

Article published online:
16 September 2021

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