cover image: Review - Diagnosis and management of polycystic ovarian syndrome - What is the pathophysiology of PCOS?


Review - Diagnosis and management of polycystic ovarian syndrome - What is the pathophysiology of PCOS?

9 Feb 2024

more likely to be overweight or obese (53%–74%) than those with- • Diagnosis of PCOS can be made based on the presence of any 2 out the condition, and higher body mass index (BMI) is associated of menstrual irregularities, clinical or biochemical with more severe symptoms of PCOS.3–5 Patients with PCOS also hyperandrogenism or polycystic ovarian morphology on have higher rates of adverse reproduct. [...] Hirsutism, the European Society of Human Reproduction and Embry- which is the symptom most predictive of biochemical ology and the American Society for Reproductive Medicine hyperandrogeni sim, can be assessed objectively using the in 2023 and the hirsutism guideline published by the Endo- F erriman–Gallwey score, although the clinical utility of this scor- crine Society in 2018.1,3,7 We also sear. [...] How is PCOS diagnosed? How are the clinical manifestations of PCOS The Rotterdam criteria are the most widely accepted criteria for managed? diagnosis of PCOS (Box 2).1 As PCOS is considered a diagnosis of exclusion, diagnostic testing is required for patients presenting Patients with PCOS often request treatment for cycle irregularity, with symptoms, although the results of this testing may be no. [...] Compared with CHCs, insulin and cholesterol levels were management of return of ovulatory cycles that can be initiated improved with metformin with low to very low certainty of evi- by primary care physicians include weight loss of 5%–10% for dence.1 The addition of metformin to CHCs can be considered in patients with overweight or obesity, metformin, inositol or letro- patients with PCOS in high. [...] The physiological sonographic features of the ovary in healthy subjects: a joint systematic review and meta-analysis by anxie ty than those without, with an OR of 2.68 (95% CI 2.08– the Italian Society of Gynecology and Obstetrics (SIGO) and the Italian Society 3.44).1 Polycystic ovarian syndrome can have a negative impact of Endocrinology (SIE).
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