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 In the U.S., up to 12 percent of women have polycystic ovarian
syndrome (PCOS), a hormone disorder that causes irregular periods,
acne, weight gain, and difficulty getting pregnant. Most women with
PCOS have multiple cysts on their ovaries.
They're also at increased risk for cholesterol and blood sugar
problems, the researchers write in the American Journal of
Obstetrics and Gynecology.
“Recognition of these abnormalities can allow the provider and the
patient to work together to determine the next steps in health care
improvement including nutritional changes and exercise, weight loss,
starting a medication, and/or referral to a specialist,” said lead
author Dr. Amy Dhesi of Kaiser Permanente Los Angeles Medical
Center.
Dhesi worked on the study while at Rutgers - New Jersey Medical
School in Newark.
The American Congress of Obstetricians and Gynecologists (ACOG)
recommends that all women with PCOS get screened every two to five
years for high blood sugar and every two years for high cholesterol.
The tests recommended are a 2-hour glucose tolerance test and a
fasting lipid profile, but many doctors use less sensitive blood
sugar tests that may not pick up on early issues.
In an online survey, Dhesi and her team asked gynecologists what
tests, if any, they would order for PCOS patients at a first visit,
and what follow-up tests they would conduct.
The research team got complete responses from 157 physicians. About
half said at least 10 percent of their patients have PCOS. About 22
percent said they would not order any screening test at the first
visit for at least half of their PCOS patients.
The most common tests doctors used to screen for blood sugar issues
in PCOS patients were the less sensitive hemoglobin A1C, which shows
the average blood sugar level over the past few months, and fasting
glucose tests.
Only 7 percent said they would order a 2-hour glucose test for at
least the majority of their PCOS patients at the first visit.
The doctors were more compliant with cholesterol testing
recommendations; 54 percent said they would order a fasting lipid
profile in at least half of their PCOS patients.
Only nine of the doctors said they typically order both a lipid
profile and a 2-hour oral glucose tolerance test at the initial
visit for most patients with PCOS.
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The main reason doctors gave for not ordering 2-hour oral glucose
tolerance tests was that it's inconvenient for patients. Also, more
than one in five doctors said glucose test results would not affect
how they treat the patient.
Most said they wouldn't order a repeat blood sugar test unless the
patient's medical history changed.
But 76 percent said they would order repeat cholesterol tests even
in PCOS patients with normal cholesterol levels.
Dr. Richard Legro, vice-chair of research at Penn State University
College of Medicine in Hershey, emphasized the importance of
catching blood sugar and cholesterol issues in the early stages.
“Early detection can lead to prevention of developing diabetes and
heart disease," said Legro, who wasn't involved with the new study.
"Patients are more likely to change their lifestyle when they know
they have a related abnormality.”
Legro told Reuters Health by email that follow up tests are vital to
monitor how these issues may change and if they are improving with
treatment.
Dhesi said it's important for PCOS patients to talk to their doctors
about possible health risks and monitoring for them.
“It is important for patients with PCOS and their health care
providers to discuss the common metabolic abnormalities associated
with PCOS . . . and work towards a common goal to improve their
health for the future,” Dhesi told Reuters Health by email.
SOURCE: bit.ly/2atNfZO American Journal of Obstetrics and
Gynecology, online July 22, 2016.
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