Diagnosis and Management of Polycystic Ovary Syndrome by Physicians from the Middle East and Africa

Polycystic ovary syndrome (PCOS) is the most common endocrine disease in women of reproductive age that may present to endocrinologists, gynecologists, dermatologists, or even the psychiatric services. 1 The economic healthcare burden is considerable and estimated at $4.6 billion in the United States alone; however, the associated disorders of menstrual irregularity, infertility, hirsutism, obesity, and impaired quality of life have a major impact on those with PCOS, and havethe potential for the developmentofdiabetes, endometrial cancer, and cardiovascular disease. 1,2 PCOS is a diagnosis of exclusion of other conditions such as hyper-prolactinemia, congenital adrenal hyperplasia, and thyroid dysfunction before the application of the diagnostic criteria reported for the Rotterdam criteria, androgen excess society guidelines, or the National Institute of Health consensus. 3 There have been several articles that have given recommendations from international evidence-based guidelines for the assessment and management of PCOS. 4 A survey of man-agementofPCOSbyphysiciansfromtheMiddleEastandAfrica is published in the current issue of Journal of Diabetes and Endocrine Practice (JDEP). 5 The question is how does physicians within the Middle East and Africa re fl ect published guidelines? From the report, the overall response rate was unclear, but 190 responders in total were available for analy-sis. 5 Therewasabiasforendocrinologists torespond,thatmay have affected the overall practice, that was reported. In addi-tion, the availability of resources may have had a major effect onthepracticeineachofthecentersthatresponded.Overall,it