Polycystic ovarian syndrome
ICD-10 E28.2 · ICD-11 5A80.1

Treatment of PCOS with Clinical or Biochemical Hyperandrogenism and/or Irregular Menstrual Cycles

This protocol applies to adult women with polycystic ovarian syndrome who present with clinical or biochemical hyperandrogenism and/or irregular menstrual cycles, and who have no contraindication to combined oral contraceptive pills (COCP).

Clinical scenario Combined oral contraceptive pills are the recommended approach for managing hyperandrogenism and irregular menstrual cycles in this population of women with PCOS.

In certain circumstances, antiandrogen therapy may be considered alongside COCP management for specific androgenic manifestations — the full clinical criteria, sequencing, and contraceptive requirements are in the structured protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1016/j.fertnstert.2023.07.025

The COCP alone should be recommended in adult women with PCOS for management of hyperandrogenism and/or irregular menstrual cycles.

In combination with the COCP, antiandrogens should only be considered in PCOS to treat hirsutism, after six months or more of COCP and cosmetic therapy have failed to adequately improve symptoms.

In combination with the COCP, antiandrogens could be considered for the treatment of androgen-related alopecia in PCOS.

In PCOS, antiandrogens must be used with effective contraception, to avoid male foetal undervirilisation.

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