Polycystic Ovary Syndrome: Pragmatic Management Across Levels of Care

This narrative review addresses the management of polycystic ovary syndrome (PCOS) by proposing pragmatic strategies across different levels of care. It emphasizes the importance of managing menstrual irregularities in primary care using oral contraceptives or progestins, with referrals for fertility or complex cases. Dermatological symptoms like hirsutism and acne may need topical or hormonal treatments, escalating to anti-androgens or dermatology specialists if necessary. Routine screening for cardiometabolic and glycaemic risks should occur in general practice, with specialist referrals for complex profiles. Emotional wellbeing, including anxiety, depression, and body image issues, can be initially screened in primary care with validated questionnaires, followed by referrals as needed. The review concludes that effective PCOS management requires clear role delineation between primary and specialist care, integration of digital tools, and patient-centered education to enhance efficiency and outcomes.