Teacher Series: PCOS: A hidden disease - does she have it?

Presented by Tracey A. Parnell, MD. 

Polycystic ovary syndrome (PCOS) is a common yet underdiagnosed endocrinopathy usually estimated to affect anywhere between  5-12% of women of reproductive age globally, with some population estimates as high as 20% depending on the diagnostic criteria used.[1] [2] [3] [4] Many women may not recognize that they have the condition, or are misdiagnosed, and don't receive appropriate evaluation and treatment.  This has numerous implications for a woman's long-term health and quality of life.

Fertility teachers and practitioners play a crucial role in the early identification and recognition of PCOS.  They can also provide consistent and regular support in diet, lifestyle, and behavioral modifications as well as discuss OTC supplements that may be beneficial to the patient. [5][6]

Learning Outcomes: 

 

  • Understand screening tools used for PCOS diagnosis
  • List some research-based supplement suggestions for PCOS management
  • Review the basic underlying pathophysiology of PCOS
  • Generate awareness of the complexity of PCOS hormonal interaction

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About the Faculty

 

Tracey A. Parnell, MD, is a Canadian physician and researcher with a passion for reproductive medicine that empowers patients and providers. She is the Research Evaluation and Quality Improvement Sector Lead for the Rural Coordination Centre of BC, which works on behalf of the Joint Standing Committee, an entity that advises the BC government and the BC Medical Association.

She is an Assistant Clinical Professor at the University of British Columbia and the Director of Communications and Development for the International Institute for Restorative Reproductive Medicine, an organization uniting providers who share a common belief that patients deserve scientifically-based and well-researched reproductive healthcare services that cooperate with and restore reproductive function.

Disclosure: Tracey Parnell serves as a trustee on the board of IIRRM.  This position is unpaid. No other financial or relationship interests were declared.

 

References

 

[1] Knochenhauer ES, Key TJ, Kahsar-Miller M, Waggoner W, Boots LR, Azziz R. Prevalence of the polycystic ovary syndrome in unselected black and white women of the southeastern United States: A prospective study. J Clin Endocrinol Metab 1998;83:3078–3082

[2]Bozdag G, Mumusoglu S, Zengin D, Karabulut E, Yildiz BO. The prevalence and phenotypic features of polycystic ovary syndrome: A systematic review and meta-analysis. Hum Reprod 2016;31:2841–2855

[3] March WA, Moore VM, Willson KJ, Phillips DI, Norman RJ, Davies MJ. The prevalence of polycystic ovary syndrome in a community sample assessed under contrasting diagnostic criteria. Hum Reprod. 2010 Feb;25(2):544-51. doi: 10.1093/humrep/dep399. Epub 2009 Nov 12. PMID: 19910321.

[4] Deswal R, Narwal V, Dang A, Pundir CS. The Prevalence of Polycystic Ovary Syndrome: A Brief Systematic Review. J Hum Reprod Sci. 2020 Oct-Dec;13(4):261-271. doi: 10.4103/jhrs.JHRS_95_18. Epub 2020 Dec 28. PMID: 33627974; PMCID: PMC7879843.

[5] Kim CH, Lee SH. Effectiveness of Lifestyle Modification in Polycystic Ovary Syndrome Patients with Obesity: A Systematic Review and Meta-Analysis. Life (Basel). 2022 Feb 18;12(2):308. doi: 10.3390/life12020308. PMID: 35207595; PMCID: PMC8876590.

[6] Lim SS, Hutchison SK, Van Ryswyk E, Norman RJ, Teede HJ, Moran LJ. Lifestyle changes in women with polycystic ovary syndrome. Cochrane Database Syst Rev. 2019 Mar 28;3(3):CD007506. doi: 10.1002/14651858.CD007506.pub4. PMID: 30921477; PMCID: PMC6438659.

[7] Azziz R. Polycystic Ovary Syndrome. Obstet Gynecol. 2018;132(2):321-336. doi:10.1097/AOG.0000000000002698

[8] Diagnosis and Management of Asymptomatic Primary Hyperparathyroidism. NIH Consens Statement Online 1990 Oct 29-31 [cited year month day];8(7):1-18.

[9] Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41-47. doi:10.1093/humrep/deh098

[10] Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome. Fertil Steril. 2004;81(1):19-25. doi:10.1016/j.fertnstert.2003.10.004

[11] Lujan ME, Chizen DR, Pierson RA. Diagnostic criteria for polycystic ovary syndrome: pitfalls and controversies. J Obstet Gynaecol Can. 2008;30(8):671-679. doi:10.1016/S1701-2163(16)32915-2

[12] Diamanti-Kandarakis E, Kouli CR, Bergiele AT, et al. A survey of the polycystic ovary syndrome in the Greek island of Lesbos: hormonal and metabolic profile. J Clin Endocrinol Metab. 1999;84(11):4006-4011. doi:10.1210/jcem.84.11.6148

[13 ] Asunción M, Calvo RM, San Millán JL, Sancho J, Avila S, Escobar-Morreale HF. A prospective study of the prevalence of the polycystic ovary syndrome in unselected Caucasian women from Spain. J Clin Endocrinol Metab. 2000;85(7):2434-2438. doi:10.1210/jcem.85.7.6682

[14] Nordio, M., & Proietti, E. (2012). The combined therapy with myo-inositol and D-chiro-inositol reduces the risk of metabolic disease in PCOS overweight patients compared to myo-inositol supplementation alone. European review for medical and pharmacological sciences, 16 5, 575-81 .

[15] Clements RS Jr, Darnell B. Myo-inositol content of common foods: development of a high-myo-inositol diet. Am J Clin Nutr. 1980;33(9):1954-1967. doi:10.1093/ajcn/33.9.1954

[16]Pizzo A, Laganà AS, Barbaro L. Comparison between effects of myo-inositol and D-chiro-inositol on ovarian function and metabolic factors in women with PCOS. Gynecol Endocrinol. 2014;30(3):205-208. doi:10.3109/09513590.2013.860120

[18] Havel PJ. A scientific review: the role of chromium in insulin resistance. Diabetes Educ. 2004;Suppl:2-14.

[19] Teede HJ, Misso ML, Costello MF, Dokras A, Laven J, Moran L, Piltonen T, Norman RJ; International PCOS Network. Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Hum Reprod. 2018 Sep 1;33(9):1602-1618. doi: 10.1093/humrep/dey256. Erratum in: Hum Reprod. 2019 Feb 1;34(2):388. PMID: 30052961; PMCID: PMC6112576.