Abstract
Polycystic ovary syndrome (PCOS) is a complex condition that involves metabolic, psychological and reproductive complications. Insulin resistance underlies much of the pathophysiology and symptomatology of the condition and contributes to long term complications including cardiovascular disease and diabetes. Women with PCOS are at increased risk of obesity which further compounds metabolic, reproductive and psychological risks. Lifestyle interventions including diet, exercise and behavioural management have been shown to improve PCOS presentations across the reproductive, metabolic and psychological spectrum and are recommended as first line treatment for any presentation of PCOS in women with excess weight by the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2018. However, there is a paucity of research on the implementation lifestyle management in women with PCOS by healthcare providers. Limited existing evidence indicates lifestyle management is not consistently provided and not meeting the needs of the patients. In this review, barriers and facilitators to the implementation of evidence-based lifestyle management in reference to PCOS are discussed in the context of a federally-funded health system. This review highlights the need for targeted research on the knowledge and practice of PCOS healthcare providers to best inform implementation strategies for the translation of the PCOS guidelines on lifestyle management in PCOS.
Highlights
Polycystic ovary syndrome (PCOS) is a complex condition involving reproductive, metabolic and psychosocial components
Insulin further inhibits the production of hepatic sex hormone binding globulin (SHBG) at the liver contributing to the higher serum concentration of free androgens commonly seen in PCOS [22]
Each allied health professional can provide their own expertise on management of PCOS as part of multidisciplinary care that is prioritised by the International
Summary
Polycystic ovary syndrome (PCOS) is a complex condition involving reproductive, metabolic and psychosocial components. At the most recent estimate, PCOS was expected to cost the Australian economy 400 million dollars conservatively [10]. Majority of this cost stems from expensive fertility treatments and the long term chronic sequalae of IR and metabolic syndrome including DM2 and CVD [12]. Ovary Syndrome 2018 recommended healthy lifestyle behaviours for all women with PCOS regardless of presenting symptoms [19]. In order to best provide care, barriers and facilitators to adequate and comprehensive provision of evidence-based lifestyle management for PCOS by health professionals must be understood
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