A Commentary on the New Evidence-Based Lifestyle Recommendations for Patients with Polycystic Ovary Syndrome and Potential Barriers to Their Implementation in the United States.

Abstract

Polycystic ovary syndrome (PCOS) is a complex endocrine condition that represents a lifelong health concern for one in ten women worldwide.1 PCOS is commonly diagnosed by the presence of ovulatory dysfunction, androgen excess, and/or ovaries with polycystic morphology on ultrasound examination.2 Half of patients experience overweight or obesity.3 Most are at increased risk for serious comorbidities, including infertility, pregnancy complications (e.g. gestational diabetes mellitus), impaired glucose tolerance, insulin resistance, Type 2 diabetes mellitus, cardiovascular disease, gynecological cancers, anxiety, depression, eating disorders, and poor health-related quality of life.4,5 Over the past decade, clinicians and researchers have increasingly recommended lifestyle modifications to achieve and maintain healthy weights and improve metabolic outcomes in women with PCOS.6 Now, with the recent publication of the first international evidence-based guideline for PCOS, diet and exercise have been solidified as fundamental components of the condition’s management.7,8 It is clear that the expertise of a registered dietitian is essential to provide adequate nutrition care for this patient population. However, accumulating survey evidence suggests that dietitians receive limited referrals for PCOS and generally feel uninformed about its specific sequelae and treatments.9–11 This commentary aims to address these two gaps by summarizing the new international recommendations for lifestyle management of PCOS,7,8 and exploring some challenges that the current referral and knowledge landscapes might pose to their implementation in the United States. It concludes with a call to action for dietitians and provides additional recommendations and resources for those that care for women with PCOS.