KatCarney

Campaign Aims to Redefine PCOS as Endocrine Disorder.(Endocrine Society plans campaign for physician education in diagnosis and treatment of polycystic ovary syndrome)(Brief Article)
Author/s: Bruce Jancin
Issue: August 15, 2000

It's only recently 'that we've realized it has important medical' implications.

TORONTO -- The Endocrine Society is gearing up for a major public and physician education campaign targeting polycystic ovary syndrome.

The goal is to stop the pigeon' holing of polycystic ovary syndrome (PCOS) as an obscure reproductive disorder and to create a broad new awareness that PCOS is an endocrine disorder--an extremely common one with serious long-term consequences, Dr. Andrea Dunaif said at a press briefing at the society's annual meeting.

PCOS, the most common female hormonal problem, affects an estimated 5%-10% of women.

"It is definitely underdiagnosed. I think the basis of the problem is PCOS was considered a reproductive disorder and was really in the purview of obstetrics and gynecology. It's only relatively recently that we've realized it has important medical and metabolic implications. The internal medicine and primary care community is just not used to dealing with it," said Dr. Dunaif, chief of the division of women's health at Brigham and Women's Hospital and director of the national center of excellence in women's health at Harvard Medical School, Boston.

The Endocrine Society is planning an extensive physician education campaign to teach primary care physicians how to make the diagnosis.

"It's really quite straightforward: The most common symptom is irregular menstrual cycles. We find in our research that 80% of women with six or fewer periods per year have PCOS. And roughly 40% of those already have type 2 diabetes or pre-diabetes," the endocrinologist said.

Indeed, PCOS is a major risk factor for type 2 diabetes. Women with PCOS have a sevenfold increased risk of developing diabetes mellitus before age 45, she added.

Confirmation of the diagnosis of PCOS involves measurement of serum testosterone and other hormones. Affected patients need to be evaluated for the heterogeneous manifestations of PCOS via assessment of serum lipids, blood glucose and insulin, blood pressure, and testing for atherosclerosis and selected malignancies.

"We're going direct to the public to inform women that if they have irregular menstrual cycles, such as six or fewer periods per year, or excessive body hair growth, they should go to their physician and ask to be assessed for PCOS," Dr. Dunaif said.

PCOS: Making the Diagnosis

PCOS is highly variable in its presentation. There are no universally agreed upon diagnostic criteria. The diagnosis is based upon symptoms (two or more of those listed below warrant evaluation for PCOS) and history with laboratory confirmation. Vaginal ultrasound of the ovaries is sometimes employed:

PCOS Symptoms

Menstrual irregularity

Infertility

Hirsutism

Obesity

Adult or severe adolescent acne

Male-pattern hair thinning

Lipid abnormalities: high triglycerides, low HDL Cholesterol

Lab Abnormalities

Mildly elevated serum testoterone and/or dehydroepiandrosterone sulfate

Insulin resistance

Increased LH:FSH ratio

Sources: The Hormone Foundation, Polycystic Ovarian Syndrome Association.

COPYRIGHT 2000 International Medical News Group

COPYRIGHT 2001 Gale Group

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