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PCOS Updates

PCOS Evidence-based guidelinePCOS News covers details of the national education program and translation activities.

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December 2011

In this edition

10 Important points about PCOS

PCOS is a complex condition and many health professionals have indicated they find educating their clients about the PCOS quite challenging. To assist in this process we have devised a list of ten key points to be included in any PCOS client education process.

  • Adopting a healthy lifestyle is the most effective way to improve overall health for women with PCOS.
  • Early detection and prevention are vital to reducing the risk of long term health issues associated with PCOS.
  • A diagnosis of PCOS can be frustrating, however much can be done to treat PCOS and improve the lives of those affected.
  • Make informed health choices by learning as much as possible about PCOS.
  • Taking control of treatment by forming effective partnerships with health professionals contributes to improved health outcomes
  • A lifelong outlook on PCOS is important to reduce the risk of long term health issues.
  • Prevention of weight gain is vital for all women with PCOS, and if overweight a small weight reduction (5-10% of current body weight), will significantly reduce PCOS symptoms and long term complications.
  • A minimum of 150 minutes per week of physical activity may greatly improve symptoms.
  • It is important to monitor emotional wellbeing and be proactive in seeking help and support.
  • Consult reliable well researched sources of information.

PCOS resources and education opportunities

As you are aware Jean Hailes has commenced an extensive PCOS translation program. As part of that program we will be alerting you to newly produced, freely accessible resources and educational opportunities. Here are some of the current initiatives.....

  • Look out for the webcast of the national video conference on PCOS with leading experts Prof. Helena Teede and Prof. Robert Norman, which will soon be available on the Jean Hailes website for viewing.
  • Earn CPD points for GP's by completing the PCOS Active Learning Module that is freely available at the Jean Hailes website under GP and HP education.
  • A PCOS consumer resource will soon be released which is a concise booklet that can be provided to newly diagnosed women with PCOS or interested family and friends. This will also be freely accessible on the Jean Hailes PCOS guidelines webpage.
  • Download PCOS treatment algorithms available freely at: http://www.managingpcos.org.au/pcos-evidence-based-guidelines.

Photo slideshow from PCOS launch

The PCOS evidenced based guideline, which is the first internationally available was launched in Perth.

Some of the speaker highlights were as follows:

"Over 200,000 women in Australia have PCOS and most of them don't know it yet." Veryan McAllister President of POSAA (Polycystic ovary syndrome association of Australia).

"This guideline could not have been achieved without the support of a truly national Alliance that included the highly influential Jean Hailes for Women's Health and the consumer advocacy group POSAA." Prof. Rob Norman (Member of the Australian PCOS alliance).

"Essentially PCOS is about periods, fertility and body image; none of which are easy to talk about." Veryan McAllister President of POSAA (Polycystic ovary syndrome association of Australia)

"What Jean Hailes does best is translation...so much fantastic research never gets to the people for whom it was intended due to lack of effective translation services." Janet Michelmore (Director Jean Hailes)

"On average it takes up to four GP visits to get a diagnosis of PCOS." Veryan McAllister President of POSAA (Polycystic ovary syndrome association of Australia)

"Australia was uniquely placed to develop this PCOS evidence-based guideline because of the ability of its experts to collaborate and reach a consensus." Prof. Helena Teede (Project director)


Overview of the guideline development

The condition of PCOS was first recognised in 1935 by two gynaecologists Stein and Leventhal and was known as Stein-Leventhal syndrome. However, following their discovery little was fully understood of the aetiology until relatively recently.

Need

Currently 70% of Australian women with PCOS remain undiagnosed, clinical practice is inconsistent; psychological issues are neglected and there is little focus on lifestyle and prevention with most services targeting infertility and costly assisted reproductive technology.

Inception

In 2008 Jean Hailes for Women's Health facilitated a national meeting on polycystic ovary syndrome (PCOS), with 25 leaders attending from the research, clinical and community sectors. The outcome of this meeting was the establishment of the independent PCOS Australian Alliance and the mapping of an ambitious plan to improve health outcomes in women with PCOS.

Unique model

Jean Hailes was a vital link in the development of the guideline due to its strong connection with government, the health sector and consumers. Jean Hailes for Women's Health is a national not for profit, women's health organisation, with a successful track record in translational activities.

Why Australia

Australia was in a prime position to take a leadership role in the development of the PCOS evidence-based guideline due to the structure of a federal department of health that provides an overarching policy environment and both the willingness and ability of PCOS experts to collaborate and reach consensus.


PCOS radio interview

Have you listened to the highly informative podcast of Professor Helena Teede, Director of Research at The Jean Hailes Foundation for Women's Health, with Dr Sally ('Feelgood') Cockburn on Melbourne's 3AW (693) radio station about the signs and symptoms of Polycystic Ovary Syndrome (PCOS), treatment options, the issues facing women living with PCOS (including any associated stigma and emotional health issues), myths and misconceptions, as well as diabetes and how it relates to PCOS. 


Latest PCOS research

A great deal of worldwide research is being conducted into PCOS and we aim to provide you with links of some of the latest work in this area.

Research

Polycystic ovary syndrome and cardiovascular disease

Bethesda, Md. – One in 15 women of childbearing age is diagnosed with a disorder commonly referred to as polycystic ovary syndrome (PCOS). The condition is one of the most common causes of women not ovulating and thus causes difficulty in conceiving. Fertility is not the only health consequence these women face, however. PCOS has been associated with an increased risk for cardiovascular disease (CVD), the leading killer of women and men alike.

Sarah Berga, MD, former Chair of the Department of Gynecology and Obstetrics at the Emory University School of Medicine, is a researcher whose work focuses on understanding the impact of metabolic and psychological stresses on the reproductive system and as a cause of infertility, as well as on PCOS. She will provide an overview of her team's work in a presentation entitled, "CVD and PCOS." Her remarks are part of the Physiology of Cardiovascular Disease: Gender Disparities conference, October 12 at the University of Mississippi in Jackson. The conference is sponsored by the American Physiological Society with additional support from the American Heart Association.

PCOS and Health

Among the cardinal features of PCOS are a lack of ovulation and a tendency towards weight gain and obesity. No studies have found a link between the syndrome and premature death. Research has, however, shown PCOS is associated with increases in artery-clogging triglycerides (fats) and insulin resistance (IR), which boosts the chances for diabetes, a risk factor for cardiovascular disease. "Although we understand that PCOS is a definite risk factor for CVD, we don't know how great of a risk factor PCOS is and thus we need to put the risk in context," says Berga.

Given the ambiguity, there is no universal protocol for treating women with PCOS-related CVD factors, according to Berga. "Some women need intervention based on existing guidelines, either to control their blood sugar to head off diabetes, or reduce their cholesterol to moderate the risk of premature heart disease. For the rest, it's a matter of treating each woman based on their individual needs. We know that PCOS puts these women at risk for CVD-related disease, but we do not yet understand the extent to which it does so."

Does this mean that all women with PCOS should be tested and treated for diabetes? She and others recommend that women with PCOS be periodically screened for diabetes and treated for it if they meet certain formal criteria. However, pharmacological intervention to forestall diabetes has not been endorsed and it has not been established that giving women with PCOS metformin will delay or prevent diabetes.

PCOS – An Adaptation from Earlier Times?

Women with PCOS don't ovulate on a regular basis in their early years, and yet they tend to have better fertility than other women later in their reproductive years. The reason for this may be that the female body adapted to periods of famine by increasing insulin resistance in order to conserve calories, and extended the period of conception into the future when food might be more abundant. In essence, there is the impression that either oocyte number (the germ cell involved in reproduction) is increased or the rate of loss of oocytes is decreased in women with PCOS.

"PCOS might have been a good thing to have in times of food scarcity because it allowed the window of fertility to be extended and it allowed women to survive and reproduce in low fuel environments. Today we have calories all around us, and yet the body's possible adaptation to another time still remains for some women," according to Berga. "One way to look at PCOS is as a past adaptation gone astray."

PCOS vs. Stress-Sensitivity in Infertility

PCOS is not the only reason women do not ovulate and have difficulty conceiving. Some women are unable to do so as a result of stress sensitivity. Both PCOS and stress-induced reproductive compromise may be rooted in evolutionary circumstances. Stress sensitivity turns off the brain message to the ovaries when the environment is not conducive to gestation and renders the woman anovulatory. "Both PCOS and stress sensitivity are ways to ensure that reproduction is successful. PCOS allows for reproduction in stressful times and stress sensitivity turns off reproduction during adverse conditions," says Dr. Berga.

Feedback

We are keen to provide you with information that is both useful and relevant to you. Please provide any feedback on this newsletter and ideas you would like included in future additions to: rhonda.garad@jeanhailes.org.au

Content updated 4 December 2011

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