Evidence summaries and recommendations from the international evidence‐based guideline for the assessment and management of polycystic ovary syndrome: Lifestyle management

Abstract

Summary Lifestyle is fundamental in chronic disease prevention and management, and it has been recommended as a first‐line treatment in the Australian polycystic ovary syndrome (PCOS) guideline 2011. The first international evidence‐based guideline on PCOS was developed in 2018, which expanded the scope and evidence in the Australian guideline. This paper summarizes the lifestyle recommendations and evidence summaries from the guideline. International multidisciplinary guideline development groups delivered the International Evidence‐based Guideline for the Assessment and Management of Polycystic Ovary Syndrome 2018. The process followed the Appraisal of Guidelines for Research and Evaluation II and The Grading of Recommendations, Assessment, Development and Evaluation framework. Extensive communication and meetings addressed six prioritized clinical questions through five reviews. Evidence‐based recommendations were formulated before consensus voting within the panel. Evidence shows the benefits of multicomponent lifestyle intervention, efficacy of exercise and weight gain prevention with no specific diet recommended. Lifestyle management is the first‐line management in the intervention hierarchy in PCOS. Multicomponent lifestyle intervention including diet, exercise and behavioural strategies is central to PCOS management with a focus on weight and healthy lifestyle behaviours. The translation programme optimizes reach and dissemination for health professionals and consumers.

Dietary and Physical Activity Habits in Adolescent Girls with Polycystic Ovary Syndrome (PCOS)-HAstudy

“…The International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome (PCOS) emphasizes the importance of diet and PA in the prevention of metabolic and reproductive complications related to PCOS and the role of weight control in overweight and obese PCOS patients. A 5% reduction in body weight is associated with an improvement in both metabolic and reproductive health markers, as well as with psychological benefits [15][16][17]. Patients with PCOS, with improper diet and low levels of PA, are probably more prone to weight gain than the population of healthy women [15,18,19].…”

“…A 5% reduction in body weight is associated with an improvement in both metabolic and reproductive health markers, as well as with psychological benefits [15][16][17]. Patients with PCOS, with improper diet and low levels of PA, are probably more prone to weight gain than the population of healthy women [15,18,19]. As reminded by Eleftheriadou et al and Teede et al, it is not clear whether the prevalence of obesity in the population may affect the prevalence of PCOS [19,20].…”

Endocrine Disorders Accompanying Obesity - Effect or Cause?

“…Studies in women with PCOS show that weight loss achieved by a lifestyle intervention may reduce hyperinsulinemia and thus break the vicious cycle of excessive androgen synthesis [69]. Similar changes occur in obese women who experience weight loss as a result of bariatric procedures.…”

GLP-1 Receptor Agonists: Beyond Their Pancreatic Effects

“…When accompanied by metabolic disorders, such as IR and dyslipidaemia, it can lead to hyperlipidaemia, hypertension, metabolic syndrome and diabetes. In addition, skin problems such as hirsutism and androgenic alopecia cowing to the excessive levels of androgens might also occur (140)(141)(142)(143). Although the pathogenesis of PCOS has not been fully elucidated, recent studies have indicated that excess levels of androgens might be the main pathogenic causative factor of PCOS (144)(145)(146).…”