Polycystic Ovary Syndrome: Current Evidence and Practical Recommendations

The document from February 1, 2020, summarizes the management of Polycystic Ovary Syndrome (PCOS), including diagnostic criteria based on the Rotterdam criteria and the importance of insulin resistance (IR) in the condition. It notes that 95% of overweight and 75% of normal-weight women with PCOS show IR, but IR measurement is not recommended for diagnosis or treatment decisions. The document emphasizes lifestyle changes as the foundation of PCOS treatment and discusses pharmacological treatments like Metformin, particularly for women with a BMI >25 kg/m². It also covers the use of oral contraceptive pills, Letrozole as the first-line therapy for fertility, and Metformin as an alternative, with IVF as a third-line therapy. For symptoms like hirsutism, alopecia, and acne, local treatments and systemic OCPs are recommended, with antiandrogens as a potential first-line therapy in some cases. The document mentions experimental treatments like Inositol and antidiabetic medications and concludes with a call for more research to include new treatments in PCOS guidelines.