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Find out which patients can be followed with watchful waiting, when to choose medical therapy over surgery, and which drugs and procedures have the best evidence.
Compared with placebo, thiazolidinediones (TZDs) decrease systolic blood pressure and fasting blood glucose and insulin levels while improving menstrual irregularities in women with PCOS. Metformin and TZDs have similar effects on pregnancy rates, ovulation, and menstrual frequency, but TZDs can cau...
Polycystic ovary syndrome is a common and complex endocrinopathy. Evidence for the pathology involves identifying at least two of three key criteria. Treatment should be guided by patient preference and presentation of the disease, because some therapies may conflict with a woman’s desire to have children.
The levonorgestrel-releasing intrauterine system achieves significantly higher resolution rates of endometrial hyperplasia without atypia compared with cyclic oral progestins (68% to 100% vs. 48% to 69%, respectively).
Find out which tests should be ordered initially, what red flag signs to look for, which pharmacologic and nonpharmacologic treatments are supported by the evidence, and when to refer patients for laparoscopy or long-term opioid therapy.
Sep 1, 2015 Issue
Insulin Sensitizers for Treatment of Menstrual Irregularities Associated with PCOS [FPIN's Help Desk Answers]
Metformin, pioglitazone (Actos), and rosiglitazone (Avandia) can be used to improve menstrual cycling in women with PCOS.
May 15, 2015 Issue
ACP Provides Guidance on Screening Pelvic Examination in Women [Practice Guidelines]
This guideline from the American College of Physicians (ACP) provides evidence on the use of pelvic examination to screen for pathology in average-risk, non-pregnant women. This guideline concentrates on screening in women without symptoms; a pelvic examination with bimanual examination may be used in some non-screening circumstances.
Nov 1, 2014 Issue
Oral Contraceptives Are Not an Effective Treatment for Ovarian Cysts [Cochrane for Clinicians]
Oral contraceptives are not an effective treatment for ovarian cysts, whether the cysts are spontaneous or associated with medically induced ovulation. Most cysts resolve without intervention within two to three months. Those that do not resolve in this time frame are more likely to be pathologic in...
Given the lack of evidence to support annual pelvic examinations, it would be better for patients if we spend that time addressing screening, counseling, and other preventive services for which strong evidence exists.
Initial evaluation of an ovarian cyst is largely determined by its characteristics on ultrasonography, in addition to the presence of symptoms, laboratory evaluation, and patient history. Women with an ovarian cyst, but with no symptoms, family or personal history of cancer (e.g., ovarian, breast, c...