» Articles » PMID: 24151290

Diagnosis and Treatment of Polycystic Ovary Syndrome: an Endocrine Society Clinical Practice Guideline

Overview
Specialty Endocrinology
Date 2013 Oct 24
PMID 24151290
Citations 587
Authors
Affiliations
Soon will be listed here.
Abstract

Objective: The aim was to formulate practice guidelines for the diagnosis and treatment of polycystic ovary syndrome (PCOS).

Participants: An Endocrine Society-appointed Task Force of experts, a methodologist, and a medical writer developed the guideline.

Evidence: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence.

Consensus Process: One group meeting, several conference calls, and e-mail communications enabled consensus. Committees and members of The Endocrine Society and the European Society of Endocrinology reviewed and commented on preliminary drafts of these guidelines. Two systematic reviews were conducted to summarize supporting evidence.

Conclusions: We suggest using the Rotterdam criteria for diagnosing PCOS (presence of two of the following criteria: androgen excess, ovulatory dysfunction, or polycystic ovaries). Establishing a diagnosis of PCOS is problematic in adolescents and menopausal women. Hyperandrogenism is central to the presentation in adolescents, whereas there is no consistent phenotype in postmenopausal women. Evaluation of women with PCOS should exclude alternate androgen-excess disorders and risk factors for endometrial cancer, mood disorders, obstructive sleep apnea, diabetes, and cardiovascular disease. Hormonal contraceptives are the first-line management for menstrual abnormalities and hirsutism/acne in PCOS. Clomiphene is currently the first-line therapy for infertility; metformin is beneficial for metabolic/glycemic abnormalities and for improving menstrual irregularities, but it has limited or no benefit in treating hirsutism, acne, or infertility. Hormonal contraceptives and metformin are the treatment options in adolescents with PCOS. The role of weight loss in improving PCOS status per se is uncertain, but lifestyle intervention is beneficial in overweight/obese patients for other health benefits. Thiazolidinediones have an unfavorable risk-benefit ratio overall, and statins require further study.

Citing Articles

Diagnosis and management of infertility in patients with polycystic ovary syndrome (PCOS): guidelines from the Italian Society of Human Reproduction (SIRU) and the Italian Centers for the Study and Conservation of Eggs and Sperm (CECOS Italy).

Palomba S, Seminara G, Tomei F, Marino A, Morgante G, Baldini D Reprod Biol Endocrinol. 2025; 23(1):37.

PMID: 40055752 PMC: 11889853. DOI: 10.1186/s12958-025-01372-5.


Natural compounds in the management of polycystic ovary syndrome: a comprehensive review of hormonal regulation and therapeutic potential.

Yuan J, Li Z, Yu Y, Wang X, Zhao Y Front Nutr. 2025; 12:1520695.

PMID: 40008316 PMC: 11850276. DOI: 10.3389/fnut.2025.1520695.


Diagnosis and Treatment of Adolescent Polycystic Ovary syndrome:A Review.

Zhang Y, Yang K, Fan T, Zheng D, Liu H Int J Womens Health. 2025; 17:459-474.

PMID: 39995885 PMC: 11847718. DOI: 10.2147/IJWH.S506498.


Baseline and Corticotropin-Stimulated Blood Steroid Profiles in Women of Reproductive Age in India: A Cross-Sectional Study and Global Literature Review.

Revanasiddappa S, Dhananjaya M, Kansal N, Lila A, Sarathi V Cureus. 2025; 17(1):e77748.

PMID: 39981462 PMC: 11840271. DOI: 10.7759/cureus.77748.


Comparative efficacy of pharmacological interventions on metabolic and hormonal outcomes in polycystic ovary syndrome: a Network Meta-Analysis of Randomized controlled trials.

Bo Y, Zhao J, Liu C, Yu T BMC Womens Health. 2025; 25(1):64.

PMID: 39955537 PMC: 11829492. DOI: 10.1186/s12905-025-03594-6.


References
1.
Ibanez L, de Zegher F, Potau N . Anovulation after precocious pubarche: early markers and time course in adolescence. J Clin Endocrinol Metab. 1999; 84(8):2691-5. DOI: 10.1210/jcem.84.8.5883. View

2.
Dokras A, Clifton S, Futterweit W, Wild R . Increased prevalence of anxiety symptoms in women with polycystic ovary syndrome: systematic review and meta-analysis. Fertil Steril. 2011; 97(1):225-30.e2. DOI: 10.1016/j.fertnstert.2011.10.022. View

3.
Wild R, Vesely S, Beebe L, Whitsett T, Owen W . Ferriman Gallwey self-scoring I: performance assessment in women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2005; 90(7):4112-4. DOI: 10.1210/jc.2004-2243. View

4.
Talbott E, Zborowski J, Rager J, Boudreaux M, Edmundowicz D, Guzick D . Evidence for an association between metabolic cardiovascular syndrome and coronary and aortic calcification among women with polycystic ovary syndrome. J Clin Endocrinol Metab. 2004; 89(11):5454-61. DOI: 10.1210/jc.2003-032237. View

5.
Ratziu V, Bellentani S, Cortez-Pinto H, Day C, Marchesini G . A position statement on NAFLD/NASH based on the EASL 2009 special conference. J Hepatol. 2010; 53(2):372-84. DOI: 10.1016/j.jhep.2010.04.008. View