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This chapter describes the diagnosis, pathophysiology, treatments, and current management of polycystic ovary syndrome (PCOS). A definitive diagnosis of PCOS can be difficult to achieve in adolescence and an early diagnosis should be re-evaluated in adulthood. The management of PCOS (including its long-term health risks) is best delivered by a multidisciplinary approach, including dietary and educational counselling, exercise training, stress management and psychosocial support. All women with PCOS should be assessed for the risk of developing impaired glucose tolerance and type 2 diabetes. Metformin is overused in the treatment of PCOS and is ineffective as a solo agent or in combination to treat infertility and to achieve live births. Large cross-sectional studies are required of different ethnic communities to assess the prevalence of PCOS and longitudinal studies are required of its evolution over time, from puberty and throughout life.
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