PCOS Awareness: 10 highlights of the new international PCOS guidelines explained by Dr Duru Shah
Polycystic Ovary Syndrome (PCOS) is a complex and often misunderstood hormonal disorder that affects individuals of reproductive age. In 2023, a set of updated guidelines has been unveiled, offering a fresh perspective on the diagnosis and management of PCOS. These guidelines were launched in August 2023, days before the PCOS Awareness Month in September.
The international evidence-based guidelines address prioritised questions and outcomes. These include over 25O recommendations and actionables to promote PCOS care and management. The Australian Government National Health and Medical Research Council (NHMRC) independently reviewed and approved the guidelines, created jointly by experts from 39 professional and consumer organizations across 71 countries.
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The new PCOS guidelines of 2023 offer a comprehensive roadmap for navigating the challenges posed by this hormonal disorder. Through early detection, personalized care, and the integration of physical and mental health considerations, the guidelines set the stage for improved quality of life and better long-term outcomes for individuals with PCOS. As research and medical advancements continue, these guidelines will remain a cornerstone in the evolving landscape of PCOS management.
Top 10 highlights of the 2023 PCOS Guidelines
1. Revised Diagnostic Criteria
The 2023 guidelines introduce a refined approach to PCOS diagnosis. Emphasising the significance of accurate diagnosis, the criteria now requires the presence of both ovulatory dysfunction and hyperandrogenism, while excluding other potential causes of symptoms. The first set of guidelines was created in 2018 and they have been revised in 2023.
2. Early PCOS detection in adolescents
Acknowledging the importance of early intervention, the guidelines emphasise the detection of PCOS in adolescents. Timely diagnosis and management during this crucial stage can prevent potential complications and improve long-term outcomes. The Hormone AMH (anti-müllerian hormone) has now been considered as an option if Ultrasound testing is not possible.
3. Tailored treatment plans
One size does not fit all in PCOS management. The new guidelines emphasize personalised treatment plans, considering the individual’s symptoms, medical history, and preferences. This patient-centered approach ensures that care aligns with the unique needs of each person.
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4. Lifestyle as frontline therapy
Lifestyle modifications take centerstage in these PCOS guidelines. Diet, exercise and weight management are highlighted as first-line interventions, showcasing their pivotal role in addressing metabolic concerns and improving overall well-being.
5. Pharmacological Innovations
The guidelines shed light on recent advancements in pharmacological treatments. Novel medications targeting specific PCOS-related mechanisms are explored, potentially expanding the array of options available for symptom management.
6. Fertility considerations
For those seeking fertility support, the guidelines offer comprehensive recommendations. From ovulation induction to assisted reproductive technologies, the guidelines provide evidence-based strategies to aid individuals in achieving their family planning goals.
Also read: PCOS: How does it impact women’s fertility
7. Cardiometabolic health awareness
PCOS is associated with an increased risk of cardiovascular issues. The guidelines stress regular cardiometabolic assessments and highlight the importance of addressing risk factors such as insulin resistance and dyslipidemia. Also, ethnicity is an important factor to consider when evaluating and managing cardiovascular risk in individuals with PCOS. Healthcare providers should take a holistic and culturally competent approach to address the unique needs and risk factors associated with PCOS in diverse ethnic populations, ensuring that all patients receive the best possible care and support for their cardiovascular health.
8. Mental health integration
The impact of PCOS extends beyond the physical realm. Mental health considerations are integrated into the guidelines, advocating for routine psychological assessments and appropriate interventions to address anxiety, depression, and other emotional challenges.
9. Transparency in PCOS treatment risks
Informed decision-making is pivotal. The guidelines provide clear information about the potential risks and benefits of various treatment options, enabling patients to actively participate in their healthcare journey.
10. Long-term PCOS management approach
PCOS is a lifelong condition, and the guidelines underscore the need for continuous, long-term management. Regular follow-up visits are encouraged to monitor progress, adjust treatment plans as necessary, and ensure optimal health outcomes.
These 2023 PCOS guidelines represent a significant step forward in the understanding and management of this multifaceted syndrome. By focusing on individualized care, holistic well-being, and cutting-edge treatment strategies, the guidelines empower healthcare professionals and patients alike.
(The article is written by Dr Duru Shah, Founder President of PCOS Society of India, who is a key contributor from India to the 2023 PCOS guidelines. She was also involved in the development of the 2018 PCOS guidelines.)