Polycystic ovary syndrome or PCOS is common (affecting up to 10% of women), very complex and more serious than ever! Recent research has linked this condition of androgen excess to many potential risks and complications including various cancers, cardiometabolic risks, mental health challenges, and ObGyn complications. Most recent research also links PCOS to blood dyscrasias and thyroid problems. A new classification system of four subsets of PCOS has also been proposed and will be presented.
Our understanding of the complex pathophysiology of PCOS is rapidly evolving and includes new research related to insulin resistance, SHBG, androgens, the gut microbiome, and the interplay with the pituitary-hypothalamic ovarian axis which is dysregulated by these influences.
The classic presentation includes oligomenorrhea and hyperandrogenism symptoms including acne and or hirsutism and cystic ovaries. Obesity is an independent risk factor for PCOS, however, some patients have lean variant PCOS and both of these patient subtypes will be discussed.
Diagnosing PCOS should be individualized and based on several key considerations. Many conditions can mimic PCOS and so these must be ruled out based on the clinician’s index of suspicion. The work-up may seem overwhelming but when a systematic process is followed, the work-up can be streamlined and targeted.
Management (both pharmacology and non-pharmacology) should be based on the goals and concerns of the individual patient regarding their symptoms, risks and reproductive priorities. Lifestyle changes, patient education, counseling/support, and close follow-up are all important aspects of managing patients with PCOS.
If you want to learn more about PCOS including the latest research on pathophysiology and the most current diagnostic and management guidelines, I invite you to attend my presentation. This will be an exciting and interactive session.