Polycystic Ovary Syndrome

Publication Date: June 1, 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

Publication Month/Year

June 1, 2018

Last Updated Month/Year

January 9, 2023

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