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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EThe goal of The Endocrine Society\u0027s clinical practice guidelines for the diagnosis and treatment of polycystic ovary syndrome (PCOS) is to address the diagnosis and treatment of PCOS from adolescence to adulthood while avoiding overlap with any other Endocrine Society guidelines for disorders related to PCOS (eg, hirsutism).\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EPolycystic Ovary Disorder\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Guidelines\u003C\/li\u003E\u003C\/ul\u003E\u003Cul class=\u0022kwd-group clinical-trial\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003EEndocrinology\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Metabolic Syndrome\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EPolycystic Ovary Disorder\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003EDiabetes \u0026amp; Endocrinology Guidelines\u003C\/li\u003E\u003C\/ul\u003E\u003Cp id=\u0022p-2\u0022\u003EThe goal of The Endocrine Society\u0027s clinical practice guidelines for the diagnosis and treatment of polycystic ovary syndrome (PCOS) is to address the diagnosis and treatment of PCOS from adolescence to adulthood while avoiding overlap with any other Endocrine Society guidelines for disorders related to PCOS (eg, hirsutism). Richard S. Legro, MD, Penn State Hershey Obstetrics and Gynecology, Hershey, Pennsylvania, USA, discussed aspects of diagnosis of PCOS contained within the new guidelines.\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EThere are currently 3 overlapping, yet unique, diagnostic criteria for PCOS: the National Institutes of Health (NIH) criteria, the \u201cRotterdam\u201d criteria, and the Androgen Excess and Polycystic Ovary Syndrome Society (AES\/PCOS) criteria. The Endocrine Society favors using the broader Rotterdam criteria, which encompasses the NIH and AES\/PCOS criteria. However, phenotypic heterogeneity is present; for example, patients with hyperandrogenism typically experience more severe reproductive and metabolic symptoms than those without hyperandrogenism.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EPCOS is associated with multiple morbidities, including infertility, obesity, cutaneous symptoms including acne and androgenic alopecia, mood disorders, sleep disorders, abnormal liver function, and a greater risk for cardiovascular disease.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003ECommonly employed treatments for PCOS include hormonal contraceptives, insulin sensitizers (eg, metformin), and antiandrogens. There are some controversies as to the safety and efficacy of these therapies. In a systemic review and meta-analysis of the adverse effects associated with PCOS treatment, common therapies for PCOS (above) were correlated with a low risk of severe adverse events [Domecq JP et al. \u003Cem\u003EJ Clin Endocrinol Metab\u003C\/em\u003E 2013]. A meta-analysis of lifestyle modifications in patients with PCOS demonstrated that lifestyle modifications reduce insulin resistance in overweight or obese patients [Prutsky G et al. \u003Cem\u003EJ Clin Endocrinol Metab\u003C\/em\u003E 2013]. In part based on this evidence, The Endocrine Society recommends (a) clomiphene citrate as the first-line therapy for infertility, (b) hormonal contraceptives as first-line for menstrual irregularities and hirsutism, and (c) lifestyle modifications (eg, exercise; calorie-restricted diet in the setting of overweight\/obesity) as needed to improve cardiovascular disease risk factors. The Endocrine Society recommends that metformin be used as a second-line therapy in women with type 2 diabetes or impaired glucose tolerance who do not achieve adequate benefit with lifestyle modifications. In addition, PCOS patients with menstrual irregularities may be candidates for metformin therapy if they cannot take or do not tolerate hormonal contraceptives.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe treatment of PCOS in adolescence is less clear, as there are less data on which to base recommendations. In this population, the diagnostic focus should be on hyperandrogenism because oligo-ovulation and polycystic ovaries are often normal during reproductive development in adolescence. Suggested treatment approaches for well-established adolescent PCOS are similar to those for adults. When clinical and biochemical hyperandrogenism occurs in premenarcheal adolescents who are at least Tanner breast stage 4 (and other causes are excluded), treatment with hormonal contraceptives is suggested.\u003C\/p\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2013 MD Conference Express\u00ae\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/13\/10\/26.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzno8e\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}