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.

New clinical guidelines to help with heavy menstrual bleeding

ABC Health & Wellbeing, 20/10/2017

25 percent of Australians who menstruate experience heavy menstrual bleeding. Now, new guidelines for doctors will help ensure these people have access to the best available treatment for heavy menstrual bleeding.

Professor Anne Duggan, senior medical advisor at the Australian Commission on Safety and Quality in Health Care, said some patients were not being offered the full range of treatments.

clinical guidelines

Implementation resources

These resources can be used to promote and explain what the Heavy Menstrual Bleeding Clinical Care Standard means to health services, clinicians, patients and their carers.

 

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.