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Polycystic Ovary Syndrome: Common Questions and Answers.
Am Fam Physician. 2023 Mar; 107(3):264-272.AF

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of childbearing age. Its complex pathophysiology includes genetic and environmental factors that contribute to insulin resistance in patients with this disease. The diagnosis of PCOS is primarily clinical, based on the presence of at least two of the three Rotterdam criteria: oligoanovulation, hyperandrogenism, and polycystic ovaries on ultrasonography. PCOS is often associated with hirsutism, acne, anovulatory menstruation, dysglycemia, dyslipidemia, obesity, and increased risk of cardiovascular disease and hormone-sensitive malignancies (e.g., at least a twofold increased risk of endometrial cancer). Lifestyle modification, including caloric restriction and increased physical activity, is the foundation of therapy. Subsequent management decisions depend on the patient's desire for pregnancy. In patients who do not want to become pregnant, oral contraceptives are first-line therapy for menstrual irregularities and dermatologic complications such as hirsutism and acne. Antiandrogens such as spironolactone are often added to oral contraceptives as second-line agents. In patients who want to become pregnant, first-line therapy is letrozole for ovulation induction. Metformin added to lifestyle management is first-line therapy for patients with metabolic complications such as insulin resistance. Patients with PCOS are at increased risk of depression and obstructive sleep apnea, and screening is recommended.

Authors+Show Affiliations

Williams T
University of Kansas School of Medicine, Wichita, Kansas.
Moore JB
University of Kansas School of Medicine, Wichita, Kansas.
Regehr J
University of Kansas School of Medicine, Wichita, Kansas.

MeSH

PregnancyHumansFemalePolycystic Ovary SyndromeHirsutismInsulin ResistanceHyperandrogenismContraceptives, OralAcne Vulgaris

Pub Type(s)

Journal Article

Language

eng

PubMed ID

36920819

Citation

Williams, Tracy, et al. "Polycystic Ovary Syndrome: Common Questions and Answers." American Family Physician, vol. 107, no. 3, 2023, pp. 264-272.
Williams T, Moore JB, Regehr J. Polycystic Ovary Syndrome: Common Questions and Answers. Am Fam Physician. 2023;107(3):264-272.
Williams, T., Moore, J. B., & Regehr, J. (2023). Polycystic Ovary Syndrome: Common Questions and Answers. American Family Physician, 107(3), 264-272.
Williams T, Moore JB, Regehr J. Polycystic Ovary Syndrome: Common Questions and Answers. Am Fam Physician. 2023;107(3):264-272. PubMed PMID: 36920819.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Polycystic Ovary Syndrome: Common Questions and Answers. AU - Williams,Tracy, AU - Moore,Justin B, AU - Regehr,Jared, PY - 2023/3/15/entrez PY - 2023/3/16/pubmed PY - 2023/3/21/medline SP - 264 EP - 272 JF - American family physician JO - Am Fam Physician VL - 107 IS - 3 N2 - Polycystic ovary syndrome (PCOS) is the most common endocrinopathy affecting women of childbearing age. Its complex pathophysiology includes genetic and environmental factors that contribute to insulin resistance in patients with this disease. The diagnosis of PCOS is primarily clinical, based on the presence of at least two of the three Rotterdam criteria: oligoanovulation, hyperandrogenism, and polycystic ovaries on ultrasonography. PCOS is often associated with hirsutism, acne, anovulatory menstruation, dysglycemia, dyslipidemia, obesity, and increased risk of cardiovascular disease and hormone-sensitive malignancies (e.g., at least a twofold increased risk of endometrial cancer). Lifestyle modification, including caloric restriction and increased physical activity, is the foundation of therapy. Subsequent management decisions depend on the patient's desire for pregnancy. In patients who do not want to become pregnant, oral contraceptives are first-line therapy for menstrual irregularities and dermatologic complications such as hirsutism and acne. Antiandrogens such as spironolactone are often added to oral contraceptives as second-line agents. In patients who want to become pregnant, first-line therapy is letrozole for ovulation induction. Metformin added to lifestyle management is first-line therapy for patients with metabolic complications such as insulin resistance. Patients with PCOS are at increased risk of depression and obstructive sleep apnea, and screening is recommended. SN - 1532-0650 UR - https://www.unboundmedicine.com/medline/citation/36920819/Polycystic_Ovary_Syndrome:_Common_Questions_and_Answers_ DB - PRIME DP - Unbound Medicine ER -