Recommendations From The 2023 International Evidence-Based Guideline For The Assessment And Management Of Polycystic Ovary Syndrome

    October 2023 in “ Fertility and Sterility ”
    Helena Teede, Chau Thien Tay, Joop Laven, Anuja Dokras, Lisa J. Moran, Terhi Piltonen, Michael Costello, Jacky Boivin, Leanne M. Redman, Jacqueline Boyle, Robert J. Norman, Aya Mousa, Anju E. Joham, Wiebke Arlt, Ricardo Azziz, Adam Balen, Lisa Bedson, Lisa Berry, Jacky Boivin, Jacqueline Boyle, Leah Brennan, Wendy Brown, Tania S. Burgert, Maureen Busby, Carolyn Ee, Rhonda Garad, Melanie Gibson-Helm, Cheryce L. Harrison, Roger Hart, Kristine Hopkins, Angelica Lindén Hirschberg, Tuong Vinh Ho, Kathleen Hoeger, Cailin Jordan, Richard S. Legro, Rong Li, Marla E. Lujan, Rong Ma, Darren Mansfield, Kate Marsh, Edgar Mocanu, Ben Willem J. Mol, Rachel Mormon, Robert J. Norman, Sharon E. Oberfield, Malika Patel, Loyal Pattuwage, Alexia S Peña, Leanne M. Redman, Luk Rombauts, Daniela Romualdi, Duru Shah, Poli Mara Spritzer, Elisabet Stener‐Victorin, Fahimeh Ramezani Tehrani, Shakila Thangaratinam, Mala Thondan, Eszter Vanky, Chandrika Wijeyaratne, Selma F. Witchel, Dongzi Yang, Bülent O. Yildiz, Simon Alesi, Snigdha Alur-Gupta, Jodie Avery, Mahnaz Bahri Khomami, Jamie L. Benham, Hugh Bidstrup, Su Jen Chua, Laura G. Cooney, Tine De Coster, Carolyn Ee, Victoria W. Fitz, Madeleine Flanagan, Maria Forslund, Geranne Jiskoot, Maryam Kazemi, Punith Kempegowda, Yvonne V. Louwers, Marla E. Lujan, Johanna Melin, Eka Melson, Yitayeh Belsti Mengistu, Negar Naderpoor, Adriana C. H. Neven, Hester Pastoor, Thaine Mirla Rocha, Angelo Sabag, Anuradhaa Subramanian, Katrina Tan
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    TLDR The 2023 guideline for PCOS suggests using updated diagnostic criteria, assessing related health risks, and recommends lifestyle changes and specific treatments for symptoms and fertility issues.
    The 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (PCOS) provides 254 recommendations for consistent, evidence-based care to improve health outcomes in PCOS. The guideline emphasizes the importance of diagnosing PCOS using the 2018 criteria, which requires the presence of two of the following: clinical/biochemical hyperandrogenism, ovulatory dysfunction, and polycystic ovaries on ultrasound. As of 2023, anti-Müllerian hormone (AMH) can be used instead of ultrasound. The guideline also highlights the increased risk of cardiovascular disease, type 2 diabetes, and psychological issues in women with PCOS and recommends regular assessments for these conditions. Lifestyle interventions, including diet and exercise, are recommended to improve metabolic health and manage weight. The guideline also provides several recommendations for managing PCOS-related hirsutism and hair loss, including the use of anti-androgens, combined oral contraceptive pills, and mechanical laser and light therapies. For infertile anovulatory women with PCOS, Letrozole is recommended as the first-line pharmacological treatment for ovulation induction. The guideline emphasizes the importance of shared decision-making and patient agency in managing PCOS.
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