Although PCOS is the focus of intense research, the importance of the translation and application of this research to the clinical setting cannot be underestimated. The PCOS SIG's annual meeting showcased three different aspects of the disease, with the overall aim of encouraging interdisciplinary collaboration and networking in this important area. PCOS is one of the most common conditions in women of childbearing age, and is the most common cause of hyperandrogenism in this cohort. Dr Mason detailed the factors implicated in the cause of the ovulatory dysfunction in PCOS. It is clear that there are differences in the production of many of the paracrine signalling hormones between normal and polycystic ovaries. Although subtle changes can be observed in the inhibin/activin family it is difficult to assess the in vivo impact of such changes on follicle growth. Likewise, there are clearly alterations in the IGF/IGFBP system and in the production of various androgenic and other steroids and whereas these are not without interest, it is impossible to determine whether they reflect defective follicle function or cause it. It can however, be seen that the changes in testosterone and and androstenedione are considerable and intrinsic and are likely candidates for disrupting folliculogenesis in the early stages. It is the sheer magnitude of the increase in AMH production that differentiates it from other factors and underlines the likelihood that this will prove to be an important factor in the pathogenesis of PCOS. Professor Colao detailed the CVR factors present in PCOS. However, it was noted that there is a paucity both of long-term data for well-characterized women with PCOS, and for large-scale prospective clinical trials to determine the outcome morbidity and mortality of CVD in PCOS subjects. Furthermore, the link between PCOS and primary cardiovascular events has not yet been demonstrated. Professor Blume-Peytavi urged that the impact of the dermatological manifestations of this disorder should not be underestimated, describing how many women find these symptoms extremely debilitating, affecting many aspects of their lives. For patients suffering from PCOS, treatment options include reduction of androgen production and action, lifestyle modification, oral contraceptives, antiandrogens, and insulin-sensitizing agents as well as topical treatment of acne, seborrhoea and AGA. Local management of hirsutism should also include photoepilation combined with eflornithine cream.
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism