Background: To develop and translate rigorous, comprehensive evidence-based diagnosis, assessment and treatment guidelines to improve the lives of women with polycystic ovary syndrome (PCOS) worldwide.
Methods: Extensive multidisciplinary health professional and patient engagement informed guideline priority areas. Best practice evidence-based guideline development involved extensive evidence synthesis. Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) framework covered evidence quality, feasibility, acceptability, cost, implementation and recommendation strength. Governance included international advisory board (six continents), project board, five guideline development groups (GDG) with 63 members, consumer and translation committees. Thirty-seven organisations across 71 countries collaborated with 23 face-to-face international meetings over 15 months. Convened Committees from partner and collaborating organisations provided peer review and the guideline was approved by the NHMRC. This abstract focuses on the lifestyle management and models of care GDG.
Results: Women with PCOS should be offered regular weight monitoring. Healthy lifestyle (diet, exercise and behavioural strategies) behaviours should be recommended in all women with PCOS to achieve and/or maintain healthy weight and to optimise hormonal outcomes, general health and quality of life across the life-course. 5-10% weight loss in those with excess weight yields significant clinical improvements and is considered successful weight reduction within six months Health professionals should advise standard population recommendation for diet composition, physical activity and sedentary behaviour. Lifestyle interventions could include behavioural strategies or health behavioural or cognitive behavioural interventions. Personal sensitivities, marginalisation and potential weight-related stigma and psychological factors such as anxiety and depressive symptoms, body image concerns and disordered eating should be considered. Overall evidence is low to moderate quality, requiring significant research expansion in this neglected, yet common condition.
Conclusions: Education, self-empowerment, multidisciplinary care and lifestyle intervention for prevention or management of excess weight are important. Guideline translation will be extensive including a multilingual patient mobile application and health professional training.