Australian-led PCOS guideline an international first

Medical Journal of Australia, Published online: 22 November 2019

An Australian-led international and multidisciplinary collaboration of health professionals and consumers has produced the first international evidence-based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS) with an unprecedented international translation program, summarised today in a supplement published by the Medical Journal of Australia.

Led by Professor Helena Teede, Director of the National Health and Medical Research Council Centre for Research Excellence in PCOS, Monash and Adelaide Universities, the collaborators took 2 years to write the guideline, which includes an integrated translation program incorporating resources for health professionals and consumers.

PCOS affects 8–13% of reproductive age women, with around 21% of Indigenous women affected.

Translation and implementation of the Australian-led PCOS guideline

Translation and implementation of the Australian-led PCOS guideline: clinical summary and translation resources from the International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome

Med J Aust 2018; 209 (7 Suppl): S3-S8. || doi: 10.5694/mja18.00656
Published online: 2018-10-01

Abstract

Introduction: We have developed the first international evidence-based guideline for the diagnosis and management of polycystic ovary syndrome (PCOS), with an integrated translation program incorporating resources for health professionals and consumers. The development process involved an extensive Australian-led international and multidisciplinary collaboration of health professionals and consumers over 2 years. The guideline is approved by the National Health and Medical Research Council and aims to support both health professionals and women with PCOS in improving care, health outcomes and quality of life. A robust evaluation process will diagnoenable practice benchmarking and feedback to further inform evidence-based practice. We propose that this methodology could be used in developing and implementing guidelines for other women’s health conditions and beyond.

Main recommendations: The recommendations cover the following broad areas: diagnosis, screening and risk assessment depending on life stage; emotional wellbeing; healthy lifestyle; pharmacological treatment for non-fertility indications; and assessment and treatment of infertility.

Changes in management as a result of this guideline: •Diagnosis:▪when the combination of hyperandrogenism and ovulatory dysfunction is present, ultrasound examination of the ovaries is not necessary for diagnosis of PCOS in adult women;▪requires the combination of hyperandrogenism and ovulatory dysfunction in young women within 8 years of menarche, with ultrasound examination of the ovaries not recommended, owing to the overlap with normal ovarian physiology; and▪adolescents with some clinical features of PCOS, but without a clear diagnosis, should be regarded as “at risk” and receive follow-up assessment.•Screening for metabolic complications has been refined and incorporates both PCOS status and additional metabolic risk factors.•Treatment of infertility: letrozole is now first line treatment for infertility as it improves live birth rates while reducing multiple metapregnancies compared with clomiphene citrate.

Serving up inequality: How sex and gender impact women’s relationship with food

Women’s Health Victoria, September 2017

This issues paper explores various aspects of women’s health relating to food. These include the impacts of nutritional deficiency, the links between nutrition and chronic disease and women’s food-related behaviours.

Gender itself is a key structural determinant of women’s health and inequality, playing out in women’s roles in relation to food, in psychosocial health and the socio-economic factors that impact on access to nutritious food.

Controversy exists in public health and health promotion about the approach and key messages that should be adopted in relation to food-related behaviours and body size to promote ‘health’ and prevent illness for women. This paper outlines various perspectives in this discourse and highlights principles and recommendations for designing health promotion programs and managing the risks of public health messages.

Broader definition of polycystic ovary syndrome is harming women: Australian experts

The Age, 

In an opinion article in the latest British Medical Journal, Australian researchers argue that an expanded definition had inadvertently led to overdiagnosis, and therefore too much treatment and even harm.

The widening of the definition (to include the sonographic presence of polycystic ovaries) in 2003 led to a dramatic increase in cases, from 5 to 21 per cent.