Die neue internationale PCOS-Leitlinie – welche Neuerungen bringt das erste Update?

Polycystic ovary syndrome (PCOS) is one of the most frequent endocrinopathies in women and is a chronic disease with long-term consequences for reproduction, metabolism and cardiovascular health. In the first update of the international guidelines from 2018, anti-Müllerian hormone (AMH, not in adolescents!) was included as a diagnostic criterion and can replace the sonographic morphological imaging of polycystic ovaries. A particular focus in the update is the long-term cardiovascular and metabolic consequences. Also new is the revaluation of inositol and the inclusion of anti-obesity pharmacological agents in the treatment recommendations. For cycle regulation and antiandrogenic treatment hormonal contraceptives are recommended after weighing up the risks. The position of letrozole as a first-line drug treatment for ovulation induction was strengthened; however, despite the high effectiveness and safety, letrozole can still only be prescribed off-label.