Polycystic ovary syndrome

There have been no clinical trials of primary prevention measures in polycystic ovary syndrome (PCOS). It is thought that lifestyle intervention (healthy diet, frequent exercise) and/or metformin therapy may prevent PCOS, but without appropriate clinical trials, the potential efficacy of these interventions for primary prevention is unclear.

• Weight loss and metformin may prevent diabetes and atherosclerosis. This is based on extrapolation from clinical trials in non-PCOS populations (prediabetic and diabetic).[57]Wild RA, Carmina E, Amanti-Kandarakis E, et al. Assessment of cardiovascular risk and prevention of cardiovascular disease in women with the polycystic ovary syndrome: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome (AE-PCOS) Society. J Clin Endocrinol Metab. 2010 May;95(5):2038-49. https://academic.oup.com/jcem/article/95/5/2038/2596456 http://www.ncbi.nlm.nih.gov/pubmed/20375205?tool=bestpractice.com [189]Knowler WC, Barrett-Connor E, Fowler SE, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403. http://www.nejm.org/doi/full/10.1056/NEJMoa012512#t=article http://www.ncbi.nlm.nih.gov/pubmed/11832527?tool=bestpractice.com [190]UK Prospective Diabetes Study (UKPDS) Group. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). Lancet. 1998 Sep 12;352(9131):854-65. http://www.ncbi.nlm.nih.gov/pubmed/9742977?tool=bestpractice.com

• Lifestyle modification - including increased physical activity and healthy diet resulting in weight loss and improved body composition (e.g., reduced percent body fat, reduced waist-hip ratio) - is also likely to prevent diabetes and reduce cardiovascular risk in women with polycystic ovary syndrome (PCOS), although this has not been studied as a long-term preventive measure in PCOS.[189]Knowler WC, Barrett-Connor E, Fowler SE, et al; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403. http://www.nejm.org/doi/full/10.1056/NEJMoa012512#t=article http://www.ncbi.nlm.nih.gov/pubmed/11832527?tool=bestpractice.com [248]Haqq L, McFarlane J, Dieberg G, et al. The effect of lifestyle intervention on body composition, glycemic control, and cardiorespiratory fitness in polycystic ovarian syndrome: a systematic review and meta-analysis. Int J Sport Nutr Exerc Metab. 2015 Dec;25(6):533-40. http://www.ncbi.nlm.nih.gov/pubmed/24668721?tool=bestpractice.com

• Women with PCOS should discuss with their mother and sisters that they have increased risk of PCOS compared with the general population. Screening of younger sisters may lead to early identification of PCOS.