Endocrine Abstracts

JOINT2078

Introduction: Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in reproductive-aged women, characterized by a range of clinical phenotypes that include reproductive, endocrine, and metabolic alterations.

Materials and Methods: We surveyed Italian Association of Clinical Endocrinologists members to examine PCOS diagnosis and management practices. The questionnaire included 4 demographic questions and 21 PCOS-related questions. Responses were collected anonymously via Lime Survey, preventing duplicate submissions. A total of 2412 members received an email with a link to the survey. Statistical analyses were performed using R software (version 3.4.3) with the EZR extension.

Results: 503 out of 2412 physicians filled in the questionnaire, but 52 did not complete it fully. Thus, 451 participants (response rate 18.7%) were included in the analysis. Most respondents were female (62.5%) and over 55 years old (45.2%), Most endocrinologists (72.9%) see fewer than 5 patients per week with menstrual cycle issues, infertility, or hirsutism, while only 4% see more than 10 weekly. Patients with PCOS are 32.6% adolescents, 47.7% women of childbearing age, and 19% women of all ages, with no perimenopausal women. PCOS is confirmed in less than one-third of cases. 74.5% of respondents indicated that both endocrinologists and gynecologists had the expertise to manage PCOS, and most (56.3%) stated that they personally manage this condition from diagnosis to therapy 96.1% of respondents include pelvic US in diagnosing PCOS, mostly referring patients to gynecologists (78.5%) or radiologists (13.5%), with only 3.1% performing it themselves. All endocrinologists assess glucose metabolism: 30.2% using OGTT for all patients, 35.5% for at-risk patients, 30.4% considering fasting blood glucose and insulin, and 4.0% only fasting glucose. 61.0% believe diagnosing PCOS in adolescents is crucial if they show symptoms, 27.9% base it on symptom severity, and 11.1% say diagnosis can wait. Also, 67.2% consider patients’ pregnancy desires critical in therapy decisions, with 28.8% referring to gynecologists for reproductive health (17.7%) or contraceptive counseling (11.1%). As for the concomitant presence of overweight/obesity, most manage this condition on their own (27.3%) or in collaboration with a dietitian (63.6%), whereas only a few (8.6%) refer the patient to another specialist.

Conclusions: The variability in PCOS diagnosis and management underscores the need for specialized, individualized care from a multidisciplinary healthcare team. A major pitfall identified in this survey is the assessment of IR during OGTT by most respondents, which is critical for prescribing metformin to about 40% of women with PCOS.