Empowering women with PCOS

Abstract

Although our calendars are filled with more awareness months, weeks, and days than we can keep track of, September—the month dedicated to raising awareness of polycystic ovary syndrome (PCOS)—should not go unnoticed. PCOS is one of the most common endocrine conditions in women of reproductive age, yet we know surprising little about its aetiology. The actual prevalence of PCOS worldwide is also unknown because different sets of diagnostic criteria make comparison between studies difficult and data from many geographical regions are limited. However, estimates using the Rotterdam criteria indicate that 15–20% of women are affected. Diagnosis using these criteria requires the presence of at least two of the following characteristics: clinical or biochemical signs of hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. However, the spectrum of clinical manifestations of PCOS is much broader. Diabetes, insulin resistance, obesity and being overweight, endometrial cancer, depression, and sleep disorders are all more prevalent in women with PCOS. The disorder is also a common cause of infertility and pregnancy complications. Earlier this year, The Lancet Diabetes & Endocrinology published analysis from the PregMet2 trial suggesting that metformin treatment might reduce the risk of late miscarriage and pre-term birth in comparison with placebo in pregnant women with PCOS. A careful investigation of the long-term effects of metformin in mothers and children is necessary, nonetheless these are promising results in a highly neglected area of research. Metformin is not approved by the medical regulatory authorities for use in PCOS, neither are any of the drugs currently used to control its symptoms. The multifactorial and heterogeneous nature of PCOS together with the lack of clear diagnostic criteria and therapeutic options make its diagnosis and management often frustrating for both physicians and patients. Some PCOS symptoms, such as pelvic pain or sudden weight gain, are often dismissed as common or not serious. Shockingly, half of all women with PCOS are thought to remain undiagnosed. Health professionals should empower women to be proactive about their health and well-being, and together find strategies to help to manage PCOS symptoms and reduce the risk for lifelong associated disorders.