New PCOS Treatment Guidelines

Endocrinologist's New PCOS Treatment Guidelines PCOS Coach Logo

Finally, a major medical association has stepped up to call for more aggressive treatment of PCOS also known as polycystic ovary syndrome. This new report should help with the epidemic of uninformed doctors who still see PCOS as a minor cosmetic complaint.

The American Academy of Clinical Endocrinologists (AACE) issued a statement recently advising doctors to take PCOS seriously. After decades of treating PCOS as a cosmetic or fertility issue doctors are now advised to address the metabolic and cardiovascular risk factors associated with PCOS.

"Data has been building up for the last 15 years," said Rhoda H. Cobin, MD, chair of the AACE task force on PCOS. "This is the first time anybody has put everything together and come forward to say, 'we need a call to action.' "

The AACE is to be applauded as the first professional society to come out with a statement pushing doctors to recognize the underlying medical risks in PCOS. The organization is calling for "widespread case finding" of PCOS, along with screening and treatment for the hidden risks of the condition, including myocardial infarction, stroke, and the complications of uncontrolled diabetes, such as retinopathy, kidney failure, and amputation. PCOS may also increase the risk of high blood pressure and atherosclerosis.

Early PCOS treatment can reduce risk of early death and debilitating complications. What are the most effective treatments for PCOS? Lifestyle modification including exercise, controlled eating, and tobacco avoidance are very important to future health, according to the experts.

While metformin, also sold as Glucophage. is now recommended as the drug of first choice for treating PCOS, there are many treatments that do not have the sometimes difficult side effects of metformin. Studies on diabetics have shown that real lifestyle changes such as exercise and diet can have a more powerful effect than metformin. In 2001 the AACE began recommending that women with PCOS be screened for diabetes by age 30.

Insulin resistance occurs in at least 75% of PCOS sufferers. The AACE recommends that women with PCOS be evaluated for insulin resistance including low levels of high-density lipoprotein cholesterol (HDL), increased triglycerides levels, hypertension, and insulin resistance with increased risk of type 2 diabetes mellitus.

The Nurses' Health Study followed 116,000 women aged 25 to 42 years for eight years. Women with irregular periods had an increase in the incidence of type 2 diabetes mellitus of 2.0- to 2.5-fold in women with a history of irregular periods. About 80% of women with irregular menstrual cycles have underlying PCOS, according to the authors of the AACE position paper. Treating PCOS effectively can make a significant difference in how women feel about themselves in addition to improving overall health.

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