Longterm management of Polycystic Ovarian Syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) has been associated with numerous reproductive and metabolic abnormalities. Despite tremendous advances in the management of reproductive dysfunction, insight into the metabolic implications of PCOS is limited by the lack of uniform diagnostic criteria, the heterogeneity of the condition and the presence of confounders including obesity. Obesity clearly has a role in long term health and may best predict both reproductive and metabolic dysfunction as well as negatively affect the response to treatment in women with PCOS. Diabetes, cardiovascular disease and cancer are also at the forefront of any risk assessment or comprehensive treatment strategy for these women. Lifestyle modifications including dietary changes, increased exercise and weight loss are appropriate first line interventions for many women with PCOS. Pharmaceuticals including metformin, lipid lowering agents and oral contraceptives should be tailored to the individual’s risk profile and treatment goals.

► Longterm complications of PCOS include type 2 diabetes, cardiovascular disease and cancer risk. ► Obesity and glucose intolerance are common features that compound longterm risks of PCOS. ► Lifestyle modification is first line treatment of obese women with PCOS and may improve outcome. ► Management of PCOS also includes pharmacologic interventions targeted to individual needs.