Polycystic Ovary Syndrome: Diagnostic Criteria and Individualized Management across the Lifespan

Video Transcription

Video Summary

In a comprehensive webinar on polycystic ovary syndrome (PCOS), Dr. Jessica Abramowitz, an endocrinologist at UT Southwestern Medical Center, discussed the diagnosis, management, and long-term risks associated with PCOS. Emphasizing its prevalence and hormonal complexity, she outlined diagnostic criteria primarily based on the Rotterdam guidelines, requiring two of three features: ovulatory dysfunction, clinical or biochemical hyperandrogenism, and polycystic ovarian morphology. She explained clinical assessment methods for hyperandrogenism, including the Ferriman-Gallwey score for hirsutism, biochemical tests (total/free testosterone, DHEAS), and the role of ultrasound and anti-Mullerian hormone (AMH) levels.<br /><br />Dr. Abramowitz highlighted the importance of excluding other endocrine disorders such as thyroid dysfunction, hyperprolactinemia, non-classic congenital adrenal hyperplasia, and Cushing’s syndrome. She stressed age-specific considerations in diagnosis, particularly in adolescents and perimenopausal women.<br /><br />The webinar addressed comorbidities of PCOS, including insulin resistance, type 2 diabetes, cardiovascular disease, dyslipidemia, hypertension, sleep apnea, obesity, depression, and anxiety. Recommended screenings include oral glucose tolerance tests, lipid profiles, blood pressure monitoring, and mental health assessments, with individualized monitoring schedules.<br /><br />On treatment, Dr. Abramowitz discussed symptom-based approaches: lifestyle modifications, combined oral contraceptives for menstrual regulation and hyperandrogenism, metformin for metabolic issues, anti-androgens like spironolactone, fertility treatments, and emerging use of GLP-1 receptor agonists for weight and metabolic improvements. She emphasized patient education, shared decision-making, avoiding weight stigma, and multidisciplinary care. Communication strategies included culturally sensitive, evidence-based counseling to counter misinformation.<br /><br />The session concluded with a Q&A, addressing practical clinical questions about hormone testing, medication use during pregnancy, treatment options, and monitoring. Dr. Abramowitz’s presentation underscored the complexity of PCOS and the need for individualized comprehensive care to optimize health outcomes.

Keywords

Polycystic Ovary Syndrome

PCOS diagnosis

Rotterdam criteria

hyperandrogenism

ovulatory dysfunction

insulin resistance

metformin treatment

combined oral contraceptives

GLP-1 receptor agonists

multidisciplinary care