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Polycystic ovary syndrome (PCOS) is a common hormonal condition with reproductive, metabolic, and psychological sequelae that affects 8 to 13% of reproductive-aged women and 3 to 11% of adolescent girls. Sleep is often compromised in women with PCOS due to increased rates of sleep problems, with the most established problem being obstructive sleep apnea (OSA). OSA is highly prevalent in reproductive-aged adult women with PCOS, but not so in adolescence. The international evidence-based PCOS guideline to improve health outcomes in women with PCOS indicated routine screening to identify and alleviate symptoms of OSA. The guidelines, however, did not weigh other multidimensional constructs of sleep health such as sleep disturbances (e.g., sleep quality and quantity), beyond OSA. This is perhaps due to the lack of research and existing mixed findings in the area of PCOS and sleep health. This narrative review summarizes the current knowledge about OSA and expands further to include the limited knowledge about other sleep problems in PCOS among reproductive-aged women and adolescent girls. We broadly cover the prevalence, risk factors, and mechanisms of sleep problems in PCOS and their relationship with cardiometabolic and psychological health. A brief summary on treatment and intervention strategies for sleep problems in PCOS and future recommendations will be deliberated. [ABSTRACT FROM AUTHOR]

Lifestyle (diet, physical activity [PA], and/or behavioral) interventions are recommended for all women with polycystic ovary syndrome (PCOS) in international guidelines. The internet is a widely used health information resource. However, the accuracy of lifestyle information on PCOS websites is unknown and is reviewed here to inform translation of the international guideline on PCOS. An internet search was conducted with three search engines across different web browsers and countries. Accuracy was assessed through a checklist of 29 questions based on international guidelines for diet, PA, or weight management for the general population and for PCOS with higher scores indicating greater accuracy. Fifteen websites were eligible out of 72 (20%). The total accuracy score was 56 ± 13 (mean ± standard deviation; potential range: -29 to 87) comprising 23 ± 6 for diet (-11 to 33), 15 ± 5 for PA (-9 to 27), and 14 ± 3 for weight management (-8 to 24). A moderate proportion of websites provided general information on appropriate diet (40-80%) or weight management strategies (47-60%), but only 10 to 40% of websites provided information on core foods, discretionary foods, exercise quantity/intensity, energy deficits, or behavioral strategies. Limited websites on PCOS contain information on lifestyle management. The majority provided information on general diet, PA, and weight recommendations but less information on practical implementation of lifestyle change as an identified translation gap for the international guideline on PCOS., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

Polycystic ovary syndrome (PCOS) affects approximately one in seven women worldwide from early adulthood with heterogeneity in their healthcare needs through the life cycle. PCOS is challenging to diagnose and manage, with one-third of women reporting at least a 2-year delay in diagnosis. Current clinical services do not satisfactorily educate and support women with their diverse reproductive, metabolic, and psychological care needs with fragmentation of services across health providers. Women are dissatisfied with the care they received, while the first contact general practitioners often feel ill-equipped to diagnose and manage PCOS. Despite national evidence-based guidelines recommending integrated multidisciplinary services, guideline translation has been limited, with wide practice variation and no optimal models of care. Lifestyle management and psychological support are the cornerstones of care and health providers who most commonly manage PCOS (general practitioners, dermatologists, endocrinologists, and gynecologists) require appropriate resources and multidisciplinary support. An evidence-based patient-centered clinical model of care, codeveloped by consumers and health professionals that provides education and resources and offers multidisciplinary holistic care, is vital to support women with PCOS., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

The evidence-based guideline for the assessment and management of polycystic ovary syndrome (PCOS) integrates the best available evidence with international, multidisciplinary clinical expertise and consumer preferences to provide health professionals, consumers, and policy makers with high-quality, comprehensive guidance about diagnosing and managing PCOS. Here, we outline the rigorous and systematic process, defined a priori and documented to be reproducible, to minimize bias and maintain transparency, in alignment with the Appraisal of Guidelines for Research and Evaluation (AGREE II) criteria and incorporating the Grading of Recommendations Assessment, Development and Evaluation (GRADE) framework that render this PCOS evidence-based guideline credible, trustworthy, reliable, and useable., Competing Interests: Disclosure The authors report no conflicts of interest in this work., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)

The rise in obesity and associated morbidity is currently one of our greatest public health challenges. Women represent a high risk group for weight gain with associated metabolic, cardiovascular, reproductive and psychological health impacts. Regular physical activity is fundamental for health and well-being with protective benefits across the spectrum of women's health. Preconception, pregnancy and the early postpartum period represent opportune windows to engage women in regular physical activity to optimize health and prevent weight gain with added potential to transfer behavior change more broadly to children and families. This review summarizes the current evidence for the role of physical activity for women in relation to preconception (infertility, assisted reproductive therapy, polycystic ovary syndrome, weight gain prevention and psychological well-being) pregnancy (prevention of excess gestational weight gain, gestational diabetes and preeclampsia as well as labor and neonatal outcomes) and postpartum (lactation and breastfeeding, postpartum weight retention and depression) health. Beneficial outcomes validate the importance of regular physical activity, yet key methodological gaps highlight the need for large, high-quality studies to clarify the optimal type, frequency, duration and intensity of physical activity required for beneficial health outcomes during preconception, pregnancy and postpartum., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)