Journal of endocrinological investigation · 2026
Diagnosis and management of polycystic ovary syndrome/polyendocrine metabolic ovarian syndrome: unmet needs and areas of clinical confidence among European endocrinologists.
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Livadas Sarantis, Yildiz Bulent O, Obermayer-Pietsch Barbara, Gambineri Alessandra, Pignatelli Duarte, Beuschlein Felix, Fanelli Flaminia, Escobar-Morreale Héctor F, Mastorakos George, Andersen Marianne Skovsager, Giorgino Francesco, Reisch Nicole, Reincke Martin, Macut Djuro
Аннотация
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.
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.