A new evidence‐based guideline for assessment and management of polycystic ovary syndrome

To the Editor: Norman and Teede outline the new international guidelines on polycystic ovary syndrome (PCOS), led by Australia and involving 37 societies and patient support groups and 71 countries.1 These guidelines highlight gaps in evidence and emphasise the critical need for more research into PCOS.2 In the United States, a recent analysis of National Institutes of Health (NIH) research funding from 2006 to 2015 for PCOS concluded that PCOS research may be underfunded by the NIH.3 In Australia, the National Health and Medical Research Council (NHMRC) is the premier funder of medical research and its main funding mechanism is by way of project grants, with over 500 granted annually. Using NHMRC online data (https://www.nhmrc.gov.au/grants-funding/outcomes-funding-rounds/previous-outcomes-project-grants-funding-rounds) and searching for “polycystic” or “PCOS” in the titles of funded project grants, we found only nine grants associated with PCOS from 2003 to 2018. Additionally, while there are many not‐for‐profit organisations raising funds for medical conditions, there are none for PCOS.

We have considered the issues that may affect funding for PCOS. It could be that the name PCOS does not accurately describe the condition because having polycystic ovaries is neither needed nor sufficient in order to diagnose PCOS, and the name does not indicate any of the condition's important metabolic symptoms.4 This could potentially lead to grants being assigned to panels without the full expertise required to handle such grants. Barriers to funding in Australia could also potentially include a lack of internationally competitive researchers in PCOS in Australia, but this is not the case. Australia has established an international network in PCOS and led the world by producing the first evidence‐based guidelines.2 Three individual Australian researchers are listed in the top ten in the world in PCOS research (http://expertscape.com/ex/polycystic+ovary+syndrome). This attests to the calibre of Australian researchers in PCOS.

We acknowledge that the international guidelines were funded in part by the NHMRC via a Centre for Research Excellence in PCOS. The Centre's efforts have positioned Australia at the forefront of international PCOS activities and have highlighted the vital need for specific dedicated research funding. However, given Australia's leading global role in the development of PCOS guidelines and identification of knowledge gaps, we, along with patient support groups, believe that greater efforts are required to recognise the prevalence, diverse clinical impact and health and economic burdens of PCOS, and to prioritise funding for research into PCOS.