HEALTH

How new PCOS guidelines could improve care options for women

16 October, 2023 . 0

An international first, the new Australian-led guideline for PCOS brings hope for women who have this hormonal condition. Here’s what you’ll want to know.

Polycystic ovary syndrome (PCOS) affects about one in eight women, and yet it’s still widely misunderstood.

Now the new PCOS International Guideline offers hope to patients, providing an important educational tool to help understand and manage the condition.

What exactly is PCOS?

Melbourne IVF medical director Dr Fleur Cattrall says PCOS is a widely misunderstood condition partly because the name suggests the presence of cysts.

“It’s commonly thought of as a disease of the ovary but, in fact, it’s a complex hormonal condition,” Dr Cattrall explains.

“They’re not actually cysts; they’re actually an underdeveloped follicle containing eggs – if you see more than 20 follicles in one ovary, that’s considered a polycystic ovary.”

Dr Cattrall says symptoms of PCOS include acne, hair growth, irregular periods, infertility, obesity, diabetes, anxiety and depression.

How is PCOS diagnosed?

A diagnosis of PCOS in women over the age of 20 is made when two or more of the following criteria are met:

Irregular or absent periods
Excess facial or body hair, acne, female pattern hair loss or high levels of male-type hormone (androgens) in the blood
An ultrasound identifying polycystic ovaries

However, Dr Cattrall says, diagnostic ultrasound should not be used on teens as their reproductive systems are immature and this can result in them being misdiagnosed.

“People are often given the label ‘polycystic ovarian syndrome’ because of an ultrasound, and this causes a lot of worry,” she says.

Instead, teens must satisfy the other two criteria to be diagnosed with the condition.

What does the guideline mean for women?

The PCOS guideline has been updated in line with new evidence.

“What (it) seeks to do is look at the best and most current evidence out there, and look at key areas of PCOS that consumers, health professionals and researchers have identified as being important to address,” endocrinologist and deputy chair of the new guideline Dr Anju Joham says.

Dr Joham, who is a senior research fellow at Monash University, says the new guideline recognises for the first time that PCOS can lead to a higher risk in pregnancy, such as experiencing gestational diabetes, blood pressure issues and having a higher chance of a caesarean section.

“It’s important that PCOS status is asked about in pregnancy and recognised as a risk factor, and it’s probably not routinely done at the moment,” she says.

Dr Joham says a slight increase in cardiovascular disease for those with PCOS is shown in the guideline and it encourages doctors to screen for those risk factors.

She says the guideline also highlights the link between PCOS and mental health challenges, and aims to educate health professionals about the impacts of weight stigma.

How is PCOS treated?

“We focus on the symptoms that are bothering the individual at that time,” Dr Cattrall says.

“So if they have irregular periods, then we’ve got options such as the oral contraceptive pill.

“It’s also important to optimise general health and stick to exercise and diet guidelines, which will improve hormonal balance.”

Dr Cattrall says while PCOS is a lifelong condition, it is manageable so if you think you might have it, you should talk to your GP about your symptoms and get a diagnosis from an expert.

She adds educating yourself is also important.

“There’s an app that has been produced by the people who wrote the international guideline called AskPCOS which is very, very helpful,” Dr Cattrall says.

She says anyone could read the guideline and be empowered by the knowledge it provides, and “not lose hope that there are treatments for each of their symptoms”.

Read more on women’s hormones:

Written by Brittany Busch.