September is  Polycystic Ovary Syndrome Awareness Month and is an excellent time to focus on the latest Cochrane evidence.

Polycystic ovary syndrome (PCOS) is a very common condition affecting 8% to 13% of women. Being overweight worsens all clinical features of PCOS. These clinical features include reproductive issues such as reduced frequency of ovulation and irregular menstrual cycles, reduced fertility, polycystic ovaries on ultrasound and high levels of male hormones such as testosterone, which can cause unwanted facial or body hair growth and acne. PCOS is also associated with metabolic features, with risk factors for diabetes and cardiovascular disease including high levels of insulin or insulin resistance and abnormal cholesterol levels. PCOS affects quality of life and can worsen anxiety and depression either due to its symptoms or due to the diagnosis of a chronic disease.

The Cochrane Gynaecology and Fertility Group (CGF)  is concerned with the systematic evaluation of the management and treatment of menstrual disorders and subfertility. The CGF carries out extensive searches for all relevant randomised controlled trials (RCTs) both published and unpublished; scrutinises each trial for its relevance and quality; critically appraises trials; draws conclusions based on pooling data about how their net result should be applied in healthcare; and produces structured reports (systematic reviews) for widespread dissemination to health care providers and planners, and to consumers.

Here is a curated list of some PCOS related Cochrane systematic reviews:

• Insulin‐sensitising drugs (metformin, rosiglitazone, pioglitazone, D‐chiro‐inositol) for women with polycystic ovary syndrome, oligo amenorrhoea and subfertility
• Lifestyle changes in women with polycystic ovary syndrome
• Ultrasound-guided transvaginal ovarian needle drilling for clomiphene-resistant polycystic ovarian syndrome in subfertile women
• Acupuncture for polycystic ovarian syndrome
• Gonadotrophins for ovulation induction in women with polycystic ovarian syndrome
• Inositol for subfertile women with polycystic ovary syndrome
• In vitro maturation in subfertile women with polycystic ovarian syndrome undergoing assisted reproduction
• Aromatase inhibitors for subfertile women with polycystic ovary syndrome
• Metformin during ovulation induction with gonadotrophins followed by timed intercourse or intrauterine insemination for subfertility associated with polycystic ovary syndrome
• Ovarian surgery for symptom relief in women with polycystic ovary syndrome
• Chinese herbal medicine for subfertile women with polycystic ovarian syndrome
• Metformin treatment before and during IVF or ICSI in women with polycystic ovary syndrome
• Laparoscopic drilling by diathermy or laser for ovulation induction in anovulatory polycystic ovary syndrome
• Statins for women with polycystic ovary syndrome not actively trying to conceive
• Insulin-sensitising drugs versus the combined oral contraceptive pill for hirsutism, acne and risk of diabetes, cardiovascular disease, and endometrial cancer in polycystic ovary syndrome
• Clomiphene and other antioestrogens for ovulation induction in polycystic ovarian syndrome
• Antidepressants for polycystic ovary syndrome
• Long versus short course treatment with metformin and clomiphene citrate for ovulation induction in women with PCOS
• Pulsatile gonadotrophin releasing hormone for ovulation induction in subfertility associated with polycystic ovary syndrome