What Is the Treatment of Polycystic Ovarian Syndrome? First-Line Lifestyle Protocol
Polycystic ovarian syndrome (PCOS) requires a structured, evidence-based approach from the outset. The first-line protocol is built around lifestyle intervention and applies universally, with additional components tailored to those with excess weight.
Approach overview
The recommended strategy is a multicomponent lifestyle intervention — combining dietary modification, structured physical activity, and behavioural strategies — with the specific components, targets, and framework set out in full within the complete protocol.
Clinical goal
For those with excess weight, a 5–10% reduction in body weight within six months is defined as a successful treatment outcome and is associated with significant clinical improvement.
References
DOI: 10.1016/j.fertnstert.2023.07.025
- Healthy lifestyle behaviours encompassing healthy eating and regular physical activity should be recommended in all those with PCOS to achieve and/or maintain healthy weight and to optimise hormonal outcomes, general health, and QoL across the life course.
- Lifestyle intervention (preferably multicomponent including diet, exercise and behavioural strategies) should be recommended in all those with PCOS and excess weight, for reductions in weight, central obesity and insulin resistance.
- To achieve weight loss in those with excess weight, an energy deficit of 30% or 500 - 750 kcal/day (1,200 to 1,500 kcal/day) could be prescribed for women, also considering individual energy requirements, body weight and physical activity levels.
- In adults from 18 – 64 years, a minimum of 150 min/week of moderate intensity physical activity or 75 min/week of vigorous intensities or an equivalent combination of both, including muscle strengthening activities on 2 non-consecutive days/week.
- Lifestyle interventions could include behavioural strategies such as goal-setting, self-monitoring, stimulus control, problem solving, assertiveness training, slower eating, reinforcing changes and relapse prevention, to optimise weight management, healthy lifestyle and emotional wellbeing in women with PCOS.
- Achievable goals such as 5% to 10% weight loss in those with excess weight yields significant clinical improvements and is considered successful weight reduction within six months.
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