Polycystic Ovary Syndrome
Publication Date: May 31, 2018
Last Updated: March 14, 2022
Recommendations
An increase in exercise combined with dietary change has consistently been shown to reduce diabetes risk comparable to or better than medication. (A)
574
Improving insulin sensitivity with insulin-sensitizing agents is associated with a decrease in circulating androgen levels, improved ovulation rate, and improved glucose tolerance. (A)
574
For women with PCOS, letrozole should be considered as first-line therapy for ovulation induction because of the increased live birth rate compared with clomiphene citrate. (A)
574
The addition of eflornithine to laser treatment is superior in the treatment of hirsutism than laser alone. (A)
574
Women with a diagnosis of PCOS should be screened for type 2 diabetes and impaired glucose tolerance with a fasting glucose level followed by a 2-hour glucose level after a 75-g glucose load. (B)
574
Women with PCOS should be screened for cardiovascular risk by determination of BMI, fasting lipid and lipoprotein levels, and metabolic syndrome risk factors. (B)
574
Reduction in body weight has been associated with improved pregnancy rates and decreased hirsutism, as well as improvements in glucose tolerance and lipid levels. (B)
574
There may be an increase in pregnancy rates by adding clomiphene citrate to metformin, particularly in obese women with PCOS. (B)
574
If clomiphene citrate or letrozole use fails to result in pregnancy, the recommended second-line intervention is either exogenous gonadotropins or laparoscopic ovarian surgery. (B)
574
Combination low-dose hormonal contraceptives are most frequently used for long-term management and are recommended as the primary treatment of menstrual disorders. (C)
574
Women in groups at higher risk of nonclassical congenital adrenal hyperplasia and a suspected diagnosis of PCOS should be screened to assess the 17-hydroxyprogesterone value. (C)
574
A low-dose regimen is recommended when using gonadotropins in women with PCOS. (C)
574
There is no clear primary treatment for hirsutism in PCOS. (C)
574
Recommendation Grading
Overview
Title
Polycystic Ovary Syndrome
Authoring Organization
American College of Obstetricians and Gynecologists
Publication Month/Year
May 31, 2018
Last Updated Month/Year
April 1, 2024
Document Type
Consensus
External Publication Status
Published
Country of Publication
US
Inclusion Criteria
Female, Adolescent, Adult, Older adult
Health Care Settings
Ambulatory
Intended Users
Physician, nurse, nurse practitioner, physician assistant
Scope
Diagnosis, Management
Diseases/Conditions (MeSH)
D011085 - Polycystic Ovary Syndrome
Keywords
polycystic ovary syndrome (PCOS), PCOS, polycystic ovary syndrome, hyperandrogenism, ovulatory dysfunction, polycystic ovaries