ECE2014 Symposia Focus on novel developments of PCOS conclusions from the PCOS Task Force (3 abstracts)
University Košice, Košice, Slovakia.
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Based on current definitions four different phenotypes have been established by Rotterdam criteria. In 2006 the Androgen Excess Society (AES) postulated that PCOS is basicly hyperandrogenic state and the presence of clinical and/or laboratory hyperandrogenism constitutes a sine qua non for PCOS diagnosis. These criteria were further consolidated in 2009 by the AES and PCOS Society Task Force Statement. According to these criteria two conditions are necessary for diagnosis of PCOS:
1. hyperandrogenism (clinical and/or biochemical),
2. ovarian dysfunction (ovulatory dysfunction and/or polycystic ovaries).
Hirsutism is the most common clinical feature of hyperandrogenic state, affecting ~70% of PCOS patients, whereas acne and alopecia are less common with the prevalence of 1525 and 550% of PCOS women respectively.
Elevated free testosterone levels are observed in about 70% of patients. The present recommendation is to measure free testosterone concentration either directly or to calculate it based on the total testosterone and SHBG. Approximately 2030% of patients demonstrate supranormal DHEAS levels. The value of androstendione measuring is unclear, but it may slightly increase the number of hperandrogenic subjects.
Confirmation of polycystic ovaries requires either the visualisation of 12 or more follicles measuring 29 mm or ovarian volume >10 cm3. Morphologic ovarian alteration may be detected in more than 80% of women with PCOS, although the false positive rate is relatively high. Other features of PCOS include among other, gonadotropin abnormalities, insulin resistance, dyslipidemia and obesity.
All PCOS women should be screened for cardiovascular risk factors which can be categorized as:
at risk PCOS women - obesity, smoking, hypertension, dyslipidemia, subclinical vascular disease, IGT, and family history of premature CVD,
at high risk PCOS women - metabolic syndrome, T2DM, overt vascular or renal disease.