Recognizing Polycystic Ovary Syndrome in the Primary Care Setting

The 2009 document highlights the significance of recognizing and managing polycystic ovary syndrome (PCOS) in primary care. PCOS affects 5% to 10% of adolescent and premenopausal women in the U.S. and is associated with increased risks of type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), endometrial cancer, and obstructive sleep apnea (OSA). It is characterized by abnormal gonadotropin secretion, hyperandrogenism, and insulin resistance. Diagnosis follows the Rotterdam criteria, requiring two of the following three features: anovulation or oligomenorrhea, androgen excess, and polycystic ovaries on ultrasound. Management includes lifestyle modifications, particularly weight loss, and may involve oral contraceptives, spironolactone, topical antiandrogens, and insulin-sensitizing drugs like metformin, which is a first-line treatment for infertility in PCOS patients. The document stresses the importance of early identification, lifestyle changes, medication, and treatment of comorbidities to manage symptoms and reduce long-term risks.