IS THERE A NEED FOR CLINICAL PRACTICE GUIDELINES FOR THE DIETARY TREATMENT OF WOMEN WITH POLYCYSTIC OVARY SYNDROME?

摘要

Polycystic ovary syndrome (PCOS) is a common endocrine disorder affecting 4-8% of women of reproductive age. It is associated with reproductive (hyper-androgenism, menstrual dysfunction, infertility), metabolic (increased risk factors for type 2 diabetes and cardiovascular disease) and psychological complications (anxiety and depression). The National Health and Medical Research Council identifies PCOS as an obesity-related comorbidity.1 Obesity worsens and weight loss improves the reproductive and metabolic presentation of PCOS through the underlying aetiological factor of insulin resistance.2 The benefits of exercise in PCOS are also being increasingly documented, both in combination with and independent of energy restriction.3 Adoption of lifestyle strategies offers the chance of personal responsibility and empowerment and lifestyle treatment and weight management is identified by both clinicians and women with PCOS as a key factor in its management.4-5 The importance of ensuring nutritional adequacy in young women, many who will be undertaking lifestyle management to improve fertility, is also crucial. PCOS is also an issue of increasing concern for dietitians as a result of the potential increase in the number of women presenting for treatment following the introduction of new diagnostic criteria (European Society for Human Reproduction and Embryology/American Society for Reproductive Medicine), which may expand the population of women diagnosed with PCOS by over 20%.These are internationally accepted criteria that are increasingly used by specialists for the diagnosis of PCOS in Australia.