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Androgen Excess and PCOS Society Guidelines
The Society is actively committed to improve the knowledge and the treatment of androgen excess diseases. It has promoted the publication of guidelines devoted to controversial aspects of these disorders.
1. Assessment of Cardiovascular Risk and Prevention of Cardiovascular Diseases in PCOS
The Androgen Excess & Polycystic Ovary Syndrome (AE-PCOS) Society created a panel to provide evidence-based reviews of studies assessing PCOS-CVD risk relationships and to develop guidelines for preventing CVD. Only studies comparing PCOS with control patients were included. All electronic databases were searched; reviews included individual studies/databases, systematic reviews, abstracts and expert data. Articles were excluded if other hyperandrogenic disorders were not excluded, PCOS diagnosis was unclear, controls were not described or methodology precluded evaluation.
Conclusions. Cardiovascular risk is not the same in all PCOS patients. Women with PCOS with obesity, cigarette smoking, dyslipidemia, hypertension, impaired glucose tolerance, subclinical vascular disease are at risk, while those with metabolic syndrome and/or type II diabetes are at high risk for CVD. Body mass index, waist circumference, serum lipid/glucose and blood pressure determinations are recommended for all women with PCOS, as is oral glucose tolerance testing in those with obesity, advanced age, personal history of gestational diabetes, or family history of T2DM. Mood disorder assessment is suggested in all PCOS patients. Lifestyle management is recommended for primary CVD prevention, targeting low-density and non high-density lipoprotein cholesterol, and adding insulin-sensitizing and other drugs if dyslipidemia or other risk factors persist.
Journal of Clinical Endocrinology and Metabolism 2010; 95: 2038-49
2. Diagnosis of PCOS
Because of the ongoing controversy regarding the definition of the Polycystic Ovary Syndrome (PCOS) the Androgen Excess & PCOS (AE-PCOS) Society charged a Task Force to review all available data and recommend an evidence-based definition. The evidence gathered was based on a systematic review of the published peer-reviewed medical literature. Based on the available data, it is was view of the Task Force that there should be acceptance of the original 1990 National Institutes of Health criteria with some modifications, taking into consideration the concerns expressed in the proceedings of the 2003 Rotterdam conference. A principal conclusion of the report is that PCOS should be firstly considered a disorder of androgen excess or hyperandrogenism. However, a minority of the Writing Committee considered the possibility that there are forms of PCOS without overt evidence of hyperandrogenism, but recognized that more data are required before validating this supposition. The position statement can be found at:
Journal of Clinical Endocrinology and Metabolism 2006; 91:4237-45
The complete paper, including the analysis of PCOS phenotypes can be found at:
Fertility and Sterility 2009; 91:456-88
3. Glucose Intolerance in PCOS
The AE-PCOS Society recently published a position statement on glucose intolerance in PCOS. The position paper comprehensively reviews the literature, and offers evidence and rationale for its guidelines. The position paper recommends evaluating women with PCOS with an oral glucose tolerance test (OGTT) at initial visit, and then repeating the OGTT every 2 years if glucose tolerance was normal at baseline, or annually if impaired glucose tolerance was identified. The full position statement, along with recommended interventions for preventing glucose intolerance in PCOS, can be found at:
Journal of Clinical Endocrinology and Metabolism 2007; 92:4546-56
AE-PCOS Quarterly Literature Summary & Review
As a service to our members, the Society electronically publishes and emails to all members a quarterly literature summary and review, a listing of all citations regarding androgen excess disorders. A brief analytic review is also made of selected citations.
2010 Editor of the Literature Summary and Review is Liang Xiaoyan, M.D., Prof of Assisted Reproductive, Sixth Affiliated Hospital of Sun Yan-Sen University, Guangzhou, China.
Click on the links below to download a past copy of the quarterly literature summary and review in PDF format.
2010 1st Quarter AEPCOS Literature Summary
Members of the Society may require arrear copies of the issues of the Literature Review to:
info@ae-society. org