Polycystic Ovarian Syndrome : An Evidence-Based Approach to Reducing Metabolic Consequences

Polycystic ovarian syndrome (PCOS) is an endocrine metabolic disorder seen in women that continues to perplex health care providers. This confusion exists, in part, because the disorder has a wide spectrum of phenotypic expression, which lends itself to variable clinical presentation. The presence of suboptimal diagnostic criteria leads to further confusion in the respect that insulin resistance, which is thought to be the underlying pathophysiologic condition associated with PCOS, is not addressed in the current diagnostic guidelines. This is evidenced by the fact that women with PCOS have a significantly higher rate of impaired glucose tolerance, type 2 diabetes, and other associated disorders such as dyslipidemias, hypertension, and potentially, cardiovascular disease. Health care clinicians need a comprehensive approach to recognize the variable clinical features associated with PCOS to ensure that high-risk women are being identified and screened early in the disease progression. Primary interventions must focus on the implementation of an evidence-based approach aimed at reducing the cardio-metabolic consequences of PCOS, thus preventing progression to type 2 diabetes and potentially, cardiovascular disease.