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Publications

Journal Article Ahead of print

PubMed: 42905305 DOI: 10.1007/s40618-026-03050-8

Diagnosis and management of polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome: unmet needs and areas of clinical confidence among European endocrinologists.

J Endocrinol Invest

Authors: Sarantis Livadas, Bulent O Yildiz, Barbara Obermayer-Pietsch, Alessandra Gambineri, Duarte Pignatelli, Felix Beuschlein, Flaminia Fanelli, Héctor F Escobar-Morreale, George Mastorakos, Marianne Skovsager Andersen, Francesco Giorgino, Nicole Reisch, Martin Reincke, Djuro Macut

Affiliations

  • Endocrine Unit, Athens Medical Centre, Athens, Greece.
  • Division of Endocrinology and Metabolism, Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
  • Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria.
  • Division of Endocrinology and Diabetes Prevention and Care, IRCCS Azienda Ospedaliero-Universitaria di Bologna and Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
  • Department of Endocrinology, Centro Hospitalar e Universitário de São João, Faculty of Medicine, University of Porto, Porto, Portugal.
  • Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
  • Diabetes, Obesity, and Human Reproduction Research Group, Instituto Ramón y Cajal de Investigación Sanitaria, Centro de Investigación Biomédica en Red Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM) and Universidad de Alcalá, Madrid, Spain.
  • Department of Endocrinology and Nutrition, Hospital Universitario Ramón y Cajal, Madrid, Spain.
  • Unit of Endocrinology, Diabetes Mellitus and Metabolism, Aretaieion Hospital, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece.
  • Department of Endocrinology, Odense University Hospital, Odense, Denmark.
  • Department of Regenerative and Precision Medicine and Ionian Area, Section of Internal Medicine, Endocrinology, Andrology, and Metabolic Diseases, University of Bari Aldo Moro, Bari, Italy.
  • Department of Medicine IV, LMU University Hospital, Ludwig Maximilian University Munich, Munich, Germany.
  • Clinic for Endocrinology, Diabetes and Metabolic Diseases, Faculty of Medicine, University of Belgrade, Dr Subotića 13, Belgrade, 11000, Serbia.

Abstract

BACKGROUND

Polycystic ovary syndrome (PCOS) or polyendocrine metabolic ovarian syndrome (PMOS) is a common, heterogeneous endocrine disorder whose diagnosis and management remain variable across clinical settings. Despite contemporary international guidance, several diagnostic definitions and therapeutic decisions are not consistently applied.

OBJECTIVE

To identify persistent unmet needs and areas of clinical confidence in PCOS/PMOS care, using the 2023 survey of the European Society of Endocrinology PCOS Special Interest Group as the principal data source.

METHODS

This manuscript presents a secondary, survey-informed analysis of aggregate data from an electronic cross-sectional survey distributed to members of the European Society of Endocrinology. A total of 505 respondents participated. Survey findings were interpreted in the context of current guidelines, contemporary evidence, the previous 2014 European survey, and patient-reported priorities.

RESULTS

Considerable variation was observed in the operational definition of chronic ovulatory dysfunction, the assessment of hirsutism, the biochemical evaluation of androgen excess, and the interpretation of ovarian morphology. Only one quarter of respondents reported access to liquid chromatography-tandem mass spectrometry for steroid measurement. Uncertainty also persisted regarding the choice and duration of combined oral contraceptive therapy and the optimal pharmacological approach to chronic anovulation. Conversely, several areas of clinical confidence were evident. Respondents commonly assessed metabolic risk and lifestyle behaviours, recognized the psychological burden of PCOS/PMOS, emphasized lifestyle intervention, and supported multidisciplinary care. Physician priorities also showed increasing concordance with the concerns reported by women with PCOS/PMOS.

CONCLUSIONS

PCOS/PMOS care in Europe combines important progress in patient-centered, metabolic, and multidisciplinary management with persistent diagnostic and therapeutic variability. Greater standardization of operational diagnostic definitions, wider access to accurate steroid assays, and adequately powered comparative trials of commonly used treatments are required. These initiatives should be developed alongside, rather than at the expense of, the patient-centered practices that are already well established.

STUDY DESIGN

Secondary analysis and expert interpretation of cross-sectional survey data.

MeSH

Endocrinology, Cross-Sectional Studies, Life Style, Ovary, Endocrinologists, Diagnosis, Polycystic Ovary Syndrome, Therapeutics, Steroids