Polycystic Ovary Syndrome: Pragmatic Management Across Levels of Care

The review outlines pragmatic management strategies for Polycystic Ovary Syndrome (PCOS) across various care levels, emphasizing coordinated management of reproductive, metabolic, and psychological aspects. It suggests managing menstrual irregularities with oral contraceptives or progestins in primary care, while dermatological symptoms may require topical or hormonal therapy. Cardiometabolic risks should be screened routinely, with specialist referrals for complex cases. Emotional wellbeing should be assessed with validated questionnaires. The review stresses the importance of clear roles between primary and specialist care, integration of digital tools, and patient-centered education. It also addresses challenges like workforce shortages and local service variations, adapting international recommendations to the UK context. The document highlights weight management, insulin-sensitizing agents, and cognitive behavioral therapy for psychological impacts, advocating for a collaborative approach to improve treatment and patient satisfaction.