Updated RCOG guidelines on PCOS

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Today the Royal College of Obstetricians and Gynaecologists have updated their guidelines on the diagnosis and treatment of PCOS. Dr Thozhukat Sathyapalan, co-author of the new guidelines, also stated that PCOS is a common disorder that affects 20% of women, so 2 in 10 rather than the widely accepted 1 in 10.

Under the Rotterdam Consensus Criteria, PCOS is diagnosed when the patient has 2 of the following criteria: Polycystic Ovaries, Lack of Ovulation and signs of Hyperandrogenism (excessive levels of androgens resulting in symptoms such as excess hair, acne, scalp hair loss etc.)

After initial diagnosis women with PCOS should be assessed for their individual risk of long term health risks including cardiovascular disease, type 2 diabetes and endometrial cancer. Women with PCOS should also be routinely screened for conditions such as depression and anxiety as they have an increased risk of developing these. Further assessment and counselling should be offered if appropriate.

The guideline also reinforces that the first line of treatment should centre around changes in lifestyle e.g. diet, exercise and weight loss; supported by pharmacological treatment if needed. Those who are morbidly obese and have not had success with standard weight loss strategies may be considered for bariatric surgery.

Those who have an absence of periods are at a higher risk of endometrial hyperplasia, a thickening of the lining of the womb caused by an overgrowth of cells which can increase your risk of cancer. The risk can be reduced by inducing a minimum of 2-3 bleeds a year. However women who turn down treatment and/or have abnormal bleeding are advised to have regular transvaginal ultrasounds to measure their endometrial thickness.

You can read the full press release and new guidelines on the RCOG website.