медицинские статьи

STUDY HIGHLIGHTS

• The guidelines contain special information regarding the diagnosis of PCOS among adolescents and postmenopausal women. Anovulatory symptoms and the presence of polycystic ovaries alone are insufficient to make the diagnosis of PCOS among adolescents. Hyperandrogenism needs to be present.
• The diagnosis of PCOS is difficult after menopause, but a history of menstrual irregularities and hirsutism helps. The presence of polycystic ovaries is less likely after menopause.
• Women diagnosed with PCOS should undergo screening tests for diabetes using an oral glucose tolerance test and should be screened for depression. Diabetes screening should occur every 3 to 5 years after a normal result.
• Overweight and obese women with PCOS should be evaluated for possible obstructive sleep apnea symptoms and tested with polysomnography for suspected disease.
• However, women with PCOS do not need to be routinely screened for endometrial cancer or nonalcoholic fatty liver disease.
• Hormonal contraceptives are the first-line treatment of anovulatory symptoms and hirsutism in PCOS. There is no recommendation for one form of contraceptive vs another.
• Weight loss likely improves reproductive and metabolic outcomes of PCOS, but it is unlikely to be effective among women at a normal body weight.
• Metformin should be used in cases of PCOS featuring diabetes or glucose intolerance. It is a second-line drug for women with menstrual irregularities who cannot tolerate hormonal contraceptives.
• Clomiphene citrate or comparable estrogen modulators are the first-line treatment of anovulatory infertility among women with PCOS.
• Thiazolidinediones are not recommended for the treatment of PCOS because of safety concerns. More research is required before a strong recommendation is made regarding the use of statins in PCOS.
• There is limited difference in the treatment recommendations for adolescents and adults. The optimal duration of treatment with either hormonal contraceptives or metformin is unknown.
• http://www.medscape.org/viewarticle/813644?src=cmemp