KatCarney

OB/GYN News
Sept 1, 2000

Endocrine Society Aims to Raise PCOS Awareness.

Author/s: Bruce Jancin

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

The goal of the campaign is to stop the pigeonholing of polycystic ovary syndrome (PCOS) as an obscure reproductive disorder and to create instead a broad new awareness that PCOS is actually an endocrine disorder--an extremely common one that can result in serious long-term consequences for patients, Dr. Andrea Dunaif explained at a press briefing that was held during the society's annual meeting.

PCOS, which is 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, who is the 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 now planning an extensive physician education campaign to help teach primary care physicians how to better make the diagnosis of PCOS.

"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 PC OS. And roughly 40% of those already have type 2 diabetes or prediabetes," 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 continued.

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 screening for atherosclerosis and selected malignancies.

The Endocrine Society's public advocacy arm, the Hormone Foundation, kicked off the PCOS campaign by sponsoring a daylong public education symposium to close out the society's annual meeting.

The symposium was aimed at increasing women's awareness of the symptoms and the potentially dangerous consequences of the disorder.

"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 during the briefing.

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 testosterone and/or dehydroepiandrosterone sulfate

Insulin resistance

Increased LH:FSH ratio

Sources: The Hormone Foundation, Polycystic Ovarian Syndrome Association


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