European survey of diagnosis and management of the polycystic ovary syndrome: full report on the ESE PCOS special interest group

Sarantis Livadas; Bulent Yildiz; George Mastorakos; Alessandra Gambineri; Duarte Pignatelli; Francesco Giorgino; Marianne Andersen; Barbara Obermayer-Pietsch; Macut Djuro P.

doi:10.1530/endoabs.99.P145

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Endocrine Abstracts (2024) 99 P145 | DOI: 10.1530/endoabs.99.P145

ECE2024 Poster Presentations Reproductive and Developmental Endocrinology (45 abstracts)

European survey of diagnosis and management of the polycystic ovary syndrome: full report on the ESE PCOS special interest group’s 2023 questionnaire

Sarantis Livadas ¹ , Bulent Yildiz ² , George Mastorakos ³ , Alessandra Gambineri ⁴ , Duarte Pignatelli ⁵ , Francesco Giorgino ⁶ , Marianne Andersen ⁷ , Barbara Obermayer-Pietsch ⁸ & Djuro P. Macut ⁹

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Author affiliations

¹Athens Medical Centre, Athens, Greece; ²Hacettepe University School of Medicine, Division of Endocrinology and Metabolism, Department of Internal Medicine, Ankara, Turkey; ³Aretaieion Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Unit of Endocrinology, Diabetes Mellitus and Metabolism, Athens, Greece; ⁴University of Bologna, Unit of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy; ⁵Centro Hospitalar e Universitário de S. João, Department of Endocrinology, Porto, Portugal; ⁶University of Bari Aldo Moro, Section of Internal Medicine, Endocrinology, Andrology and Metabolic Diseases, Department of Precision and Regenerative Medicine and Ionian Area, Bari, Italy; ⁷Odense University Hospital, Department of Endocrinology, Odense, Denmark; ⁸und Universitätsklinik für Frauenheilkunde & Geburtshilfe Medizinische Universität Graz, Universitätsklinik für Innere Medizin, Klinische Abteilung Endokrinologie und Diabetologie, Graz, Austria; ⁹Faculty of Medicine, University of Belgrade, Clinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, Serbia

Background: Although polycystic ovary syndrome (PCOS) constitutes a common endocrinopathy, there are several issues which confuse clinicians during everyday practice.

Objective: To define the current status of knowledge of the full spectrum of PCOS among European endocrinologists.

Methods: A detailed questionnaire comprising 41 items covering various aspects of diagnosis and management of women with PCOS was shared via web among members of European Society of Endocrinology.

Results: 505 European endocrinologists (64% females), with a mean age of 47±11.6 years answered the questionnaire. Rotterdam criteria were used by 85% of endocrinologists. The most frequent age at referral was between 20-40 years (87.1%). A quarter of doctors have access to mass spectrometry for the evaluation of androgen levels. Extended metabolic profile was part of workup by the vast majority, but there was significant uncertainty regarding the diagnosis of chronic anovulation. Diabetes, gestational or type 2, was considered a major consequence for women with PCOS and screening is carried out regardless of BMI status. Lifestyle modification and metformin are considered a standard approach of all participants and oral contraceptives are a standard therapeutic modality, but there is significant discrepancy on the duration of treatment.

Conclusions: Rotterdam diagnostic criteria are currently an established diagnostic approach within the European endocrine community. This updated survey showed an advance in using steroid profiling for diagnosis and strong position on recognizing PCOS as a metabolic condition with potential broader consequences. Therapeutic aspects are currently changed into the need for more lifestyle intervention involvement and the use of metabolic therapies either as monotherapy or in combination with standard hormonal compounds.