Beyond Fertility: Clinical Bias and Access to GLP-1 Receptor Agonists in PCOS Care

Abstract

Polycystic Ovarian Syndrome, otherwise known as PCOS, affects 6-20% of reproductive-aged women and people with uteruses, but up to 70% of those affected go undiagnosed. The treatment for this endocrine disorder of the female reproductive system is still progressing, and the research for this disorder is still mainly focused on fertility and not the other painful and physical symptoms of PCOS. PCOS symptoms can include irregular and anovulatory menstrual cycles, elevated levels of androgens like testosterone, and having one or more cysts within the ovaries. PCOS is the leading cause of infertility, and it is usually linked to obesity. One of the emerging treatments for this disorder is GLP-1 receptor agonists (GLP-1 RAs), like the popular medication Ozempic. GLP-1 RAs can lower testosterone levels, increase the menstrual frequency rate, and increase weight loss better than the previous treatments of Metformin and oral contraceptives (birth control pill). GLP-1 RAs are a new treatment that many PCOS patients have yet to be prescribed. Weight bias, clinical bias, and insurance issues are common within the journey to treatment for affected individuals. The objective of this research project is to investigate the published clinical biases that may influence the adoption, prescribing patterns, and evaluation of GLP-1 RAs as a treatment for PCOS. Clinical bias affects who is offered GLP-1 RAs for PCOS, and improving care requires clear prescribing guidelines and better clinician training.