Practical Approach to the PCOS Patient

Abstract

The purpose of this review is to provide an overview of polycystic ovary syndrome (PCOS) with a discussion on our current understanding of the pathophysiology and sequela of this syndrome. A diagnostic algorithm, as well as the challenges clinicians may face when evaluating these patients is also included. Clinical treatment strategies for fertility and non-fertility PCOS patients are described in detail. Recent discussions on the inaccuracies and lack of standardization for the measurement of androgens, both clinically and chemically, are highlighted. A meta-analysis and a randomized controlled trial evaluating the efficacy of commonly used ovulation induction medications are also included along with recommendations from national committee reports and consensus opinions. PCOS is recognized as one of the most common endocrinopathies in women worldwide which continues to attract increased attention and research. Inheritance patterns are multifactorial and may be influenced trans-generationally due to the epigenetic influence of metabolic syndrome. Women with PCOS are at an increased risk of long-term health consequences for which they should be appropriately monitored and treated, in order to decrease the overall morbidity associated with this syndrome. Treatment should be individualized based on the phenotypic presentation of the patient as well as their fertility desires. For some patients, referral to a specialist and multidisciplinary care may be required.