ACOG Practice Bulletin No. 108: Polycystic Ovary Syndrome

    September 2009 in “ Obstetrics & Gynecology ”
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    TLDR The bulletin provides guidelines for diagnosing and managing PCOS, suggesting weight loss, hormonal contraceptives, and diabetes screening, with clomiphene for infertility and various treatments for excess hair.
    The ACOG Practice Bulletin No. 108 from 2009 provided guidelines for diagnosing and managing Polycystic Ovary Syndrome (PCOS), emphasizing the lack of a universally accepted definition and the importance of excluding other causes of hyperandrogenism. It noted that insulin resistance is commonly associated with PCOS and that obesity can exacerbate its effects. The bulletin recommended screening for type 2 diabetes and cardiovascular disease in women with PCOS and suggested weight loss, hormonal contraceptives, and insulin-sensitizing agents like metformin for treatment. Clomiphene citrate was recommended as the first-line treatment for infertility, with other interventions suggested if it fails. For hirsutism, no single treatment was identified as superior, but various medical and laser treatments were discussed. The recommendations were based on varying levels of evidence, with many relying on limited evidence or expert opinion.
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