34 in patients at particularly elevated risk testing

[34]
In
patients at particularly elevated risk, testing before 30 years of age may be indicated. Patients who initially test
negative for diabetes should be periodically reassessed throughout their lifetime.
Patients with PCOS are also at an increased risk for endometrial hyperplasia and carcinoma.
[4, 35]
The chronic
anovulation in PCOS leads to constant endometrial stimulation with estrogen without progesterone, and this
increases the risk of endometrial hyperplasia and carcinoma. The Royal College of Obstetricians and
Gynaecologists (RCOG) recommends induction of withdrawal bleeding with progestogens a minimum of every 3-4
months.
[4]
No known association with breast or ovarian cancer has been found; thus, no additional surveillance is needed.
[4]
Patient Education
Discuss with patients the symptoms of polycystic ovarian syndrome (PCOS) as well as their increased risk for
cardiovascular and cerebrovascular disease. Educate women with this condition regarding lifestyle modifications

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such as weight reduction, increased exercise, and dietary modifications.
[2, 3, 4]
(See Diet and Activity.)
For more information, see Women's Health Center, as well as Ovarian Cysts, Amenorrhea, and Female Sexual
Problems.
Clinical Presentation
References
1. Azziz R, Carmina E, Dewailly D, et al; Task Force on the Phenotype of the Polycystic Ovary Syndrome of The
Androgen Excess and PCOS Society. The Androgen Excess and PCOS Society criteria for the polycystic ovary
syndrome: the complete task force report. Fertil Steril . 2009 Feb. 91(2):456-88. [Medline].
2. Vause TD, Cheung AP, Sierra S, et al. Ovulation induction in polycystic ovary syndrome. J Obstet Gynaecol
Can . 2010 May. 32(5):495-502. [Medline].
3. American College of Obstetricians and Gynecologists. Polycystic ovary syndrome. Washington, DC: American
College of Obstetricians and Gynecologists; 2009. ACOG practice bulletin; no. 108. [Full Text].
4. Royal College of Obstetricians and Gynaecologists. Long-term consequences of polycystic ovary syndrome.
London, UK: Royal College of Obstetricians and Gynaecologists; 2007. Green-top guideline; no. 33. [Full Text].
5. Consensus on infertility treatment related to polycystic ovary syndrome. Fertil Steril . 2008 Mar. 89(3):505-22.
[Medline].
6. Barber TM, Franks S. Genetic basis of polycystic ovary syndrome. Expert Review of Endocrinology &
Metabolism . 2010. 5(4):549-61.
7. Stein I, Leventhal M. Amenorrhea associated with bilateralpolycystic ovaries. Am J Obstet Gynecol . 1935.
29:181.
8. Stein IF. Duration of infertility following ovarian wedge resection. West J Surg . 1964. 72:237.
9. PCOS Consensus Workshop Group. Rotterdam ESHRE/ASRM-Sponsored PCOS Consensus Workshop
Group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary
syndrome. Fertil Steril . 2004 Jan. 81(1):19-25. [Medline].