PCOS DataLab
Collection
Open, AI-ready PCOS datasets designed to accelerate research, power responsible health assistants, and support innovation in FemTech and reproductive • 13 items • Updated
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What is the primary aim of the International Evidence-based Guideline for the assessment and management of polycystic ovary syndrome 2023? | The primary aim of the guideline is to aid healthcare professionals and consumers in decisions about appropriate and effective care for women with PCOS, providing evidence-based recommendations to improve quality of care, health outcomes, and quality of life. |
How were recommendations developed in the absence of direct scientific evidence specific to PCOS? | In the absence of scientific evidence in PCOS, evidence from the general population was considered and a formal transparent process was followed to obtain consensus between the engaged multidisciplinary stakeholders. |
What considerations must healthcare professionals keep in mind when applying the guideline recommendations? | Healthcare professionals must consider individual characteristics and preferences, regional healthcare settings, resources and regulations, and use their clinical judgment and expertise, applying shared decision making in consultation with the patient and/or their guardians. |
Which organizations partnered to develop the 2023 PCOS guideline? | The guideline was developed by the Centre for Research Excellence in Women’s Health in Reproductive Life (CRE WHiRL) in partnership with the American Society of Reproductive Medicine (ASRM), the Endocrine Society, the European Society of Endocrinology, and the European Society of Human Reproduction and Embryology (ESHR... |
What is the duration of the NHMRC approval for the guideline recommendations, and what does this approval signify? | The NHMRC approval is valid for five years and signifies that the guideline recommendations meet the NHMRC standard for clinical practice guidelines, being systematically derived from the best available scientific evidence for health professionals practising in an Australian healthcare setting. |
What limitations or disclaimers are associated with the use of the PCOS guideline? | The guideline partners make no warranty regarding the guideline, exclude warranties of merchantability and fitness for a particular use, are not liable for damages related to its use, and the guideline does not guarantee successful outcomes or override clinical judgment; it also does not constitute professional advice ... |
How has the PCOS guideline evolved since its original publication? | The original version was published in 2011, with an update in 2015 for the aromatase inhibitors section, an updated, expanded, and international version in 2018, and the current updated, expanded, and international version in 2023. |
What is the main purpose of the International Evidence-based Guideline for the assessment and management of Polycystic Ovary Syndrome (PCOS) 2023? | The guideline is designed to provide clear information to assist clinical decision making, support optimal patient care and improve health outcomes. |
Which organisations co-funded the international guideline effort for PCOS? | The guideline was co-funded by the American Society for Reproductive Medicine (ASRM), Endocrine Society (ENDO), European Society of Endocrinology (ESE), and European Society of Human Reproduction and Embryology (ESHRE). |
What types of groups and societies collaborated and engaged in the development of the PCOS guideline? | Collaborating and engaged groups included societies such as Androgen Excess and Polycystic Ovary Syndrome Society (AE-PCOS), Asia Pacific Initiative on Reproduction (ASPIRE), Australian Diabetes Society (ADS), British Fertility Society (BFS), International Federation of Fertility Societies (IFFS), PCOS Challenge, Royal... |
What are some of the key clinical topics covered in the PCOS guideline chapters? | Key topics include screening, diagnostic and risk assessment; psychological features and models of care; lifestyle management; management of non-fertility features; assessment and treatment of infertility; and guideline development methods. |
How was the guideline development process structured to ensure quality and inclusiveness? | The process included multidisciplinary international guideline development groups, consumer participation including Indigenous and Culturally and Linguistically Diverse populations, outcome prioritisation using the GRADE method, adaptation of existing evidence-based guidelines, evidence reviews, research integrity asse... |
What types of interventions and treatments are addressed in the guideline for managing PCOS? | The guideline addresses lifestyle interventions such as behavioural strategies, dietary and exercise interventions; pharmacological treatments including combined oral contraceptive pills, metformin, anti-obesity and anti-androgen agents; mechanical laser and light therapies for hair reduction; bariatric/metabolic surge... |
What role did consumers and patients play in the development of the PCOS guideline? | Consumers and patients participated as part of the consumer/patient expert team and were involved in community and consumer engagement to ensure the guideline addressed inclusiveness and stigma. |
What is the primary objective of the International Evidence-based Guideline for the assessment and management of Polycystic Ovary Syndrome (PCOS) 2023? | The primary objective is to develop and translate rigorous, comprehensive evidence-based guidelines for diagnosis, assessment and treatment, to improve the lives of those with polycystic ovary syndrome (PCOS) worldwide. |
Which criteria are recommended for diagnosing PCOS in adults according to the 2023 guideline? | PCOS in adults should be diagnosed using the revised consensus Rotterdam criteria, requiring the presence of two of the following: i) clinical/biochemical hyperandrogenism, ii) ovulatory dysfunction, and iii) polycystic ovaries on ultrasound or elevated anti-mullerian hormone (AMH) levels, after other causes of these f... |
Why are ultrasound and AMH not recommended for diagnosing PCOS in adolescents? | Ultrasound and AMH are not recommended in adolescents due to poor specificity. |
What health aspects should be addressed in the assessment and management of PCOS once diagnosed? | Assessment and management should address reproductive, metabolic, cardiovascular, dermatologic, sleep and psychological features. |
What are the recommendations regarding psychological health in women with PCOS? | Depressive and anxiety symptoms are significantly increased and should be screened for in all women with PCOS, with psychological assessment and therapy as indicated. Greater awareness of psychological features including eating disorders and impacts on body image and quality of life is needed. |
What is emphasized about lifestyle management in PCOS according to the guideline? | Supported healthy lifestyle remains vital throughout the lifespan in PCOS, with a strong focus on overall health, prevention of weight gain and if required, on weight management. |
How was the guideline development process governed and who were involved? | Governance included an international advisory panel, management committee and five guideline development groups with 52 members, consumer and translation committees. The process involved extensive health professional and consumer engagement, international society-nominated panels including consumers and experts across ... |
Why is PCOS considered a high-risk condition in pregnancy according to the guidelines? | PCOS is considered a high-risk condition in pregnancy because women with PCOS have increased metabolic risk factors, diabetes, cardiovascular disease, and sleep disorders, which require screening and management. |
What psychological aspects should healthcare professionals screen for in women with PCOS? | Healthcare professionals should screen for depressive and anxiety symptoms, eating disorders, impacts on body image, and quality of life in women with PCOS. |
What is the recommended approach to weight management and lifestyle in women with PCOS? | A supported healthy lifestyle is vital throughout the lifespan in PCOS, focusing on overall health, prevention of weight gain, and weight management if required. There is no one specific diet or exercise regimen that is superior, and patient preferences are most important. |
What pharmacological treatments are recommended for menstrual irregularity and hyperandrogenism in PCOS? | Combined oral contraceptive pills are the first-line pharmacological treatment for menstrual irregularity and hyperandrogenism, with a preference for lower dose preparations and those with fewer side effects. |
How should infertility in women with PCOS be managed according to the guidelines? | Letrozole is the first-line pharmacological infertility therapy. Clomiphene alone or combined with metformin, gonadotrophins, or ovarian surgery are second-line therapies. IVF, potentially with in vitro maturation, is offered as third-line therapy when other ovulation induction therapies have failed. |
What are the recommendations regarding the use of metformin in women with PCOS? | Metformin is recommended primarily for metabolic features in PCOS and has greater efficacy than inositol. However, metformin is not routinely recommended for use in pregnant women with PCOS. |
What strategies do the guidelines suggest to improve care and education for women with PCOS and healthcare professionals? | The guidelines recommend greater awareness and education through high-quality, evidence-based resources, shared decision making, self-empowerment, and development of integrated models of care. They also emphasize multilingual education outputs and tools like the AskPCOS app. |
Why is it important for doctors to be aware of PCOS and its features during pregnancy? | Doctors should be aware of PCOS and all its features, including during pregnancy, to allow detection of increased risks and to assist with prevention and treatment. |
What types of treatments are recommended for individuals with PCOS according to the guidelines? | The guidelines recommend effective medicines and treatments including the combined contraceptive pill, medications to balance hormones and reduce symptoms, and fertility treatments to improve chances of having a family. |
What challenges contribute to the variation in diagnosis and care of PCOS? | Challenges include accurately defining individual diagnostic criteria, marked clinical heterogeneity, the influence of excess weight, ethnic differences, variation across the life course, the misleading name focusing only on reproductive features, lack of recognition of diverse features, inadequate research funding, an... |
How does the international guideline aim to improve the health outcomes of women with PCOS? | The guideline integrates the best available evidence with international expertise and consumer preferences to promote accurate and timely diagnosis, evidence-based consistent assessment and treatment, education, empowerment, shared decision making, prevention of complications, and improved patient experience and health... |
What role do consumers and healthcare professionals play in the development of the PCOS guideline? | Over 3000 healthcare professionals and consumers with PCOS participated in 2018 and over 750 in 2023, engaging in prioritisation of clinical questions and outcomes, identification of knowledge and care gaps, and providing feedback during public consultation, translation, and evaluation. |
Which organizations partnered in the development and funding of the 2023 international PCOS guideline? | The Australian NHMRC primarily funded the guideline development led by CRE WHiRL, partnering with the American Society for Reproductive Medicine, the Endocrine Society, the European Society of Endocrinology, and the European Society of Human Reproduction and Embryology. |
What methods were used to ensure the quality and integrity of the evidence in the guideline development? | The guideline applied international best practice methods including evidence review aligned with NHMRC requirements, focusing on study designs least susceptible to bias, a priori inclusion criteria, quality appraisal, meta-analysis where appropriate, and a pilot research integrity assessment process in the infertility ... |
What methods were used to develop the international evidence-based guideline for PCOS? | The guideline development followed international best practice methods for evidence review and guideline development aligned with NHMRC requirements, including extensive engagement and processes, systematic and narrative reviews, quality appraisal, meta-analysis, and formulation of recommendations using the GRADE frame... |
How does the guideline address the issue of research integrity in infertility management? | A process of research integrity assessment was introduced as a pilot in guideline development group five (GDG 5) focused on infertility management due to concerns about evidence integrity and retractions in infertility research, with plans to extend this process in the next guideline update. |
What are the key principles underpinning the development and interpretation of the PCOS guideline? | Key principles include codesign, coproduction, patient agency and priorities, partnership in care, being patient centered, recognizing implications of PCOS across the life course, understanding individual differences and modulating factors, recognizing metabolic, dermatologic, reproductive and psychological features, e... |
Who is the intended population and audience for the PCOS guideline? | The guideline is relevant to adolescents (ages 10-19), reproductive age and postmenopausal women and people with PCOS, excluding those with hypogonadotrophic or hypergonadotrophic ovulatory dysfunction. The audience includes patients, general practitioners, specialists (obstetricians, endocrinologists, dermatologists),... |
How does the guideline ensure inclusiveness and address stigma related to PCOS? | The guideline incorporates multidisciplinary expert and consumer input across ethnicities, geographic regions, cultures, non-binary and different genders, including Indigenous Australians, and considers the impact of language and stigma associated with PCOS features, especially weight, to promote inclusiveness. |
What are the main aims and expected outcomes of the international evidence-based PCOS guideline? | The guideline aims to integrate best evidence with multidisciplinary expertise and consumer preferences to provide transparent guidance on diagnosis, assessment and treatment of PCOS, reduce variation in care, optimize prevention of complications, improve health outcomes, identify knowledge gaps, promote research and t... |
What considerations are taken into account when translating the PCOS guideline into practice? | When translating the guideline into practice, considerations include cost, accessibility, resources, ethnicity, and engagement of Aboriginal and Torres Strait Islander advisors and broader indigenous stakeholders, as well as culturally and linguistically diverse representatives for global dissemination and language tra... |
How does the guideline address inclusiveness and stigma related to PCOS? | The guideline recognises the need to consider the impact of language and potential lack of inclusion by seeking multidisciplinary expert and consumer input across ethnicities, cultures, genders, and geographic regions. It considers stigma associated with PCOS features, especially weight-related stigma, and avoids terms... |
What roles are included in the governance structure of the PCOS guideline project? | The governance structure includes a Project Owner who is ultimately accountable, Senior Users representing end users, Senior Suppliers representing project suppliers, a Project Manager handling day-to-day management, an International Advisory Committee representing key stakeholders with interest but not central to proj... |
Who are some of the key members and chairs involved in the guideline development groups (GDGs)? | Key members and chairs include Prof Joop Laven (GDG 1 Chair - Screening, diagnostic and risk assessment, and life stages), Prof Anuja Dokras (GDG 2 Chair - Prevalence, screening and management of psychological features and models of care), Assoc Prof Lisa Moran (GDG 3 Chair - Lifestyle management), Prof Terhi Piltonen ... |
How were diverse international partnerships incorporated into the guideline development and dissemination? | Diverse international partnerships include culturally and linguistically diverse representatives across world regions who were engaged in all phases of guideline development. These representatives will lead dissemination efforts including language translation within their communities globally. |
What considerations are taken into account when translating the guideline into practice? | When translating the guideline into practice, issues such as cost, accessibility, resources, and ethnicity are considered. An Aboriginal and Torres Strait Islander advisor is engaged throughout and involved with broader indigenous stakeholders in the national implementation and dissemination plan. |
What approaches does the guideline use to improve gender inclusiveness in language? | The guideline uses four approaches: 1) Increasing gender-neutral terminology when gender is not central, 2) Using accessible language inclusive of persons with lower health or PCOS literacy, 3) Increasing use of the term female where biological sex is relevant, and 4) Retaining the term woman/women to encompass all gen... |
What is the role of the Project Manager in the PCOS guideline project governance? | The Project Manager acts as the Project Owner’s eyes and ears on the job, undertaking day-to-day management and making decisions on behalf of the Project Owner. |
What roles does the management committee play in the International Evidence-based Guideline for PCOS? | The management committee oversees the project to ensure the integrity of the guideline, manages stakeholder engagement, and provides strategic guidance for implementation and translation activities. |
How were the Guideline Development Groups (GDGs) formed and expanded for the 2023 PCOS guideline? | The GDGs were formed in 2018 and expanded in 2023 to extend geographical representation. They were based on skills (clinical and academic), expertise, geographical spread, and were nominated by the CRE and partner or collaborator organisations. |
What approach was used to engage consumers in the development of the 2023 PCOS guideline? | The guideline adopted the International Association for Public Participation (IPA) Public Participation Spectrum framework, engaging consumers as active contributors throughout the process with training, role descriptions, remuneration, and embedding consumer perspectives within the GRADE decision-making process. |
What types of clinical questions were prioritized in the 2023 PCOS guideline and how were they determined? | Prioritized clinical questions were informed initially by the 2018 international Delphi exercise and further contributed to by an international survey of 750 consumers with PCOS, partner organisation representatives, and multidisciplinary GDG members. The final questions addressed screening, diagnostic assessment, risk... |
Why does the 2023 PCOS guideline not provide full safety and usage information on pharmacological and surgical interventions? | Because pharmacological and surgical interventions should not be applied without consideration of the individual’s clinical profile and preferences, and readers are recommended to consult relevant regional bodies for prescribing information including indications, dosage, contraindications, supervision, and adverse effe... |
What methods and standards were followed in developing the 2023 PCOS guideline? | The guideline development methods align with international best practice and follow comprehensive evidence-based guideline development processes including the Appraisal of Guidelines for Research & Evaluation (AGREE II), the Australian NHMRC, and ESHRE processes and criteria. |
How was the economic feasibility of recommendations considered in the 2023 PCOS guideline? | Although very limited studies precluded evidence-based assessments of economic feasibility and impact, the potential impact of cost on recommendations was considered in the GRADE process. |
What are the key steps involved in the development of the International Evidence-based Guideline for PCOS? | The key steps include creating multidisciplinary guideline development groups, scoping and defining topics, identifying and prioritising clinical questions, defining PICO, identifying existing guidelines to adapt, systematically searching for evidence, identifying and selecting evidence, appraising methodological quali... |
How does the guideline development process ensure editorial independence and manage conflicts of interest? | The guideline is editorially independent; the primary funders, NHMRC, were not involved in development and did not influence the scope. Partners nominated experts who acted as independent experts during public consultation. All feedback was reviewed blinded to the organisation providing it. All committee and GDG member... |
What are the main aims and guiding principles of the international translation and dissemination program for the PCOS guideline? | The aims are to educate and build capability of healthcare professionals, augment health literacy of PCOS consumers, and promote best practice evidence-based PCOS care. The guiding principles include that components are informed by the needs and preferences of women with PCOS, resources are co-created with end-users, d... |
What diagnostic criteria for PCOS in adults are recommended in the 2023 guideline update? | The 2023 guideline recommends diagnosis requires two of the following: clinical/biochemical hyperandrogenism, ovulatory dysfunction, or polycystic ovaries on ultrasound, and adds elevated anti-mullerian hormone (AMH) levels as a criterion. |
Why are AMH levels and ultrasound not recommended for diagnosing PCOS in adolescents according to the guideline? | Because of overlap with normal reproductive physiology in adolescents, AMH levels and ultrasound are not recommended for diagnosis within 8 years of menarche to avoid over diagnosis. |
What additional conditions should be excluded when diagnosing PCOS, and what further evaluations are recommended for severe clinical features? | Exclusion of thyroid disease (thyroid stimulating hormone), hyperprolactinemia (prolactin), and non-classic congenital adrenal hyperplasia (17-hydroxy progesterone) is recommended. Further evaluation is recommended in those with amenorrhea and severe clinical features, including consideration of hypogonadotropic hypogo... |
How does the guideline address the challenges in defining diagnostic features of PCOS around menarche and menopause? | The guideline acknowledges that diagnostic features naturally evolve around menarche and menopause and aims to facilitate timely and appropriate diagnosis while avoiding over diagnosis, especially in adolescents, by refining diagnostic features focused on specificity and recommending follow-up reassessment for young wo... |
Why are ultrasound and anti-mullerian hormone (AMH) levels not recommended for diagnosis within 8 years of menarche? | Ultrasound and anti-mullerian hormone (AMH) levels are not recommended in diagnosis in those within 8 years of menarche to improve diagnostic accuracy by focusing on specificity and to reduce resource use in diagnosis. |
How does the guideline suggest identifying young women 'at risk' when diagnosis is unclear? | Young women 'at risk' can be identified with follow-up reassessment when diagnosis is unclear. |
What is the guideline's stance on the current name of the condition PCOS? | The guideline endorses the recommendation from the NIH 2012 workshop that the name of the condition is a distraction and should be changed, and efforts are underway with consumer partnership towards a name change. |
What factors should be considered when discussing the timing of assessment and diagnosis of PCOS with patients? | Psychosocial and cultural factors and patient preferences should be considered when discussing the value and optimal timing of assessment and diagnosis of PCOS. |
What is emphasized as vitally important to women at the time of PCOS diagnosis? | Education is vitally important, including reassurance about the potential for prevention of complications, good general reproductive potential and family size, and acknowledging that some medical assistance may be required. |
How does the guideline recommend partnering with women with PCOS in their diagnosis and care? | Self-empowerment is a priority, and personal characteristics, preferences, culture, and values should be considered when undertaking assessment, providing information, or recommending interventions or treatments. |
What categories of recommendations are used in the PCOS guideline and how are they defined? | The categories include Evidence-based recommendations (EBR) where sufficient evidence exists, Consensus recommendations (CR) made in absence of adequate evidence but informed by general population evidence and consensus, and Practice points (PP) where evidence was not sought but important clinical or implementation iss... |
What terms are used to describe the strength of recommendations and what do they signify? | The terms 'should', 'could', and 'should not' are used. 'Should' indicates benefits exceed harms and can guide practice; 'could' or 'should/could consider' indicate conditional recommendations due to limited evidence or unclear benefit; 'should not' indicates lack of evidence or harms outweigh benefits. |
What are the categories of quality (certainty) of evidence as adapted from GRADE in the guideline? | The categories are High (very confident that the true effect lies close to the estimate), Moderate (moderate confidence; true effect likely close but possibly different), Low (limited confidence; true effect may be substantially different), and Very Low (very little confidence; true effect likely substantially differen... |
How does the guideline define irregular menstrual cycles for different time periods post menarche? | Irregular menstrual cycles are defined as normal in the first year post menarche; from >1 to <3 years post menarche as less than 21 or more than 45 days; from >3 years post menarche to perimenopause as less than 21 or more than 35 days or fewer than 8 cycles per year; and more than 1 year post menarche as cycles longer... |
What considerations are recommended for assessing and diagnosing PCOS in adolescents with irregular menstrual cycles? | The value and optimal timing of assessment and diagnosis of PCOS should be discussed with the patient and their parent/s or guardian/s, considering diagnostic challenges at this life stage and psychosocial and cultural factors. |
What biochemical tests are recommended for assessing hyperandrogenism in the diagnosis of PCOS? | Healthcare professionals should use total and free testosterone to assess biochemical hyperandrogenism; free testosterone can be estimated by the calculated free androgen index. If these are not elevated, androstenedione and dehydroepiandrosterone sulfate (DHEAS) may be considered. |
Why should laboratories use LC-MS/MS assays over direct immunoassays for measuring testosterone in PCOS diagnosis? | Because LC-MS/MS assays are validated and highly accurate, whereas direct immunoassays have limited accuracy and demonstrate poor sensitivity and precision for diagnosing hyperandrogenism in PCOS. |
What is the guideline's recommendation regarding biochemical hyperandrogenism assessment in women on the combined oral contraceptive pill (COCP)? | It is very difficult to reliably assess biochemical hyperandrogenism in women on COCP because the pill increases sex hormone-binding globulin and reduces gonadotrophin-dependent androgen production. If assessment is imperative, the pill should be withdrawn for a minimum of three months with alternative contraception ma... |
How does the guideline address the potential discrepancy between the strength of recommendations and the certainty of evidence? | The guideline notes that an apparent discrepancy may occur due to consideration of multiple outcomes and inclusion of low-quality studies, and when this happens, a justification is added under the relevant clinical question. |
Why should healthcare professionals prefer LC-MS/MS assays over direct immunoassays for measuring total or free testosterone in PCOS diagnosis? | LC-MS/MS assays are preferred because direct immunoassays have limited accuracy and demonstrate poor sensitivity and precision for diagnosing hyperandrogenism in PCOS. |
What challenges exist in assessing biochemical hyperandrogenism in women using combined oral contraceptive pills (COCP)? | It is very difficult to reliably assess biochemical hyperandrogenism in women on COCP because the pill increases sex hormone-binding globulin and reduces gonadotrophin-dependent androgen production. If assessment is imperative, the pill should be withdrawn for a minimum of three months. |
What clinical signs should be included in a comprehensive examination for clinical hyperandrogenism in adults and adolescents? | A comprehensive examination should include symptoms and signs of acne, female pattern hair loss, and hirsutism in adults, and severe acne and hirsutism in adolescents. |
How should laboratories determine normal reference ranges for androgen measurements in females? | Normal values should be determined either by the range of values in a well characterised healthy control population or by cluster analysis of general population values using the most accurate methods available. |
What is the significance of a modified Ferriman Gallwey score (mFG) of 4–6 in clinical practice? | An mFG score of 4–6 should be used to detect hirsutism, depending on ethnicity, acknowledging that self-treatment is common and can limit clinical assessment. |
What ultrasound markers and thresholds are recommended for diagnosing polycystic ovarian morphology (PCOM) in adults? | Follicle number per ovary (FNPO), follicle number per cross-section (FNPS), and ovarian volume (OV) are accurate markers. FNPO ≥ 20 in at least one ovary is the threshold for PCOM, and if using older technology, OV ≥ 10 ml or FNPS ≥ 10 in at least one ovary should be considered. |
Why is it important to consider causes other than PCOS when androgen levels are markedly above laboratory reference ranges? | Because other causes such as ovarian and adrenal neoplastic growths, congenital adrenal hyperplasia, Cushing’s syndrome, ovarian hyperthecosis, iatrogenic causes, and syndromes of severe insulin resistance should be considered, especially since some androgen-secreting neoplasms may only cause mild to moderate increases... |
What ultrasound marker is considered the most effective for detecting polycystic ovarian morphology (PCOM) in adults? | Follicle number per ovary (FNPO) should be considered the most effective ultrasound marker to detect polycystic ovarian morphology (PCOM) in adults. |
Why is ovarian ultrasound not necessary for PCOS diagnosis in patients with irregular menstrual cycles and hyperandrogenism? | In patients with irregular menstrual cycles and hyperandrogenism, an ovarian ultrasound is not necessary for PCOS diagnosis. |
What are the recommended thresholds for diagnosing PCOM using ovarian volume (OV) and follicle number per section (FNPS) when using older ultrasound technology? | Ovarian volume (OV) ≥ 10 ml or follicle number per section (FNPS) ≥ 10 in at least one ovary in adults should be considered the threshold for PCOM if using older technology or image quality is insufficient to allow for an accurate assessment of follicle counts throughout the entire ovary. |
What considerations should be made regarding the use of serum anti-mullerian hormone (AMH) in diagnosing PCOS? | Serum AMH could be used for defining PCOM in adults but should only be used in accordance with the diagnostic algorithm. It should not be used as a single test for the diagnosis of PCOS, is not necessary in patients with irregular menstrual cycles and hyperandrogenism, and should not yet be used in adolescents. |
How should healthcare professionals approach cardiovascular disease risk assessment in women with PCOS? | Women with PCOS should be considered at increased risk of cardiovascular disease. All women with PCOS should be assessed for cardiovascular disease risk factors, have a lipid profile at diagnosis regardless of age and BMI, and have blood pressure measured annually and when planning pregnancy or seeking fertility treatm... |
What is the recommendation regarding ultrasound use for diagnosing PCOM in adolescents? | There are no definitive criteria to define polycystic ovary morphology (PCOM) on ultrasound in adolescents, hence it is not recommended in adolescents. |
What factors influence serum AMH levels that laboratories and healthcare professionals should be aware of? | Factors influencing serum AMH include age (peaking between 20-25 years), body mass index (lower AMH with higher BMI), hormonal contraception and ovarian surgery (which may suppress AMH), and menstrual cycle day (AMH may vary across the cycle). |
Why should all women with PCOS have a lipid profile at diagnosis? | All women with PCOS, regardless of age and BMI, should have a lipid profile at diagnosis to assess cholesterol, low density lipoprotein cholesterol, high density lipoprotein cholesterol and triglyceride levels, with subsequent frequency based on hyperlipidaemia and additional risk factors or global cardiovascular risk. |
What cardiovascular assessments are recommended annually for women with PCOS? | All women with PCOS should have blood pressure measured annually and when planning pregnancy or seeking fertility treatment due to the high risk of hypertensive disorders in pregnancy and associated comorbidities. |
How should glycaemic status be assessed and monitored in women with PCOS? | Glycaemic status should be assessed at diagnosis in all adults and adolescents with PCOS and reassessed every one to three years based on individual risk factors for diabetes. |
What is the recommended test to assess glycaemic status in women with PCOS and why? | The 75g oral glucose tolerance test (OGTT) is recommended as the most accurate test to assess glycaemic status in women with PCOS, regardless of BMI. |
What are the recommendations regarding obstructive sleep apnea (OSA) in women with PCOS? | Healthcare professionals should be aware that women with PCOS have a significantly higher prevalence of OSA independent of BMI; women should be assessed for symptoms such as snoring and daytime sleepiness, screened with validated tools if symptoms are present, and treatment should target OSA-related symptom burden. |
What increased risks related to endometrial health are associated with PCOS in premenopausal women? | Premenopausal women with PCOS have a markedly higher risk of developing endometrial hyperplasia and endometrial cancer. |
What preventive strategies should women with PCOS be informed about to reduce the risk of endometrial hyperplasia and cancer? | Women with PCOS should be informed about weight management, cycle regulation, and regular progestogen therapy as preventative strategies. |
What considerations are suggested regarding cardiovascular risk assessment frequency in women with PCOS? | Consideration should be given to differences in cardiovascular risk factors and cardiovascular disease across ethnicities and age when determining the frequency of risk assessment. |
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