Recent Advances in the Management of Polycystic Ovary Syndrome: A Review Article

Abstract

Polycystic ovarian syndrome (PCOS) is an endocrine disorder. This condition is characterized by chronic anovulation and ovarian dysfunction, unlike other ovulation disorders when the ovaries are non-functional or abnormal. Currently, most therapy is centred on the patient's primary complaint. Treatment focuses on reducing hyperandrogenism symptoms, restoring menstrual regularity, and achieving conception. In treating infertility caused by polycystic ovarian syndrome, letrozole (an aromatase inhibitor) appears to be more successful than clomiphene citrate (an anti-estrogen and a reference infertility drug). When provided by a multidisciplinary team, it can help patients maintain appropriate lifestyle changes, such as reducing body fat, increasing metabolism, and enhancing reproductive health. Compound oral contraceptives are the most common kind of androgen inhibitor and are the preferred therapy for menstrual disruption in PCOS patients who do not want to get pregnant. Weight loss should be prioritized for women with PCOS since a healthy, balanced diet combined with regular exercise can boost metabolism, increase insulin sensitivity, and aid weight loss safely. This will improve their physical health. Other than reproductive symptoms, PCOS symptoms include insulin resistance (IR), metabolic syndrome (MS), and chronic low-grade inflammation. Our understanding of the pathophysiological process, diagnosis, and therapy of PCOS has advanced recently.

The interplay between androgens and the immune response in polycystic ovary syndrome

“…In a study by Baptiste et al, both drugs were used in non-obese women with PCOS, demonstrating that even in PCOS women who are not obese and have normal levels of insulin, hyperandrogenemia is connected with insulin resistance [ 6 ]. Metformin reduced insulin levels below normal by decreasing liver glucose production and reducing high androgen levels, thereby decreasing the incidence of T2DM in PCOS patients [ 20 ]. It is prescribed with a starting dose of 500-850 mg per day that can be increased to 2000 mg as needed [ 20 ].…”

“…Metformin reduced insulin levels below normal by decreasing liver glucose production and reducing high androgen levels, thereby decreasing the incidence of T2DM in PCOS patients [ 20 ]. It is prescribed with a starting dose of 500-850 mg per day that can be increased to 2000 mg as needed [ 20 ]. Rosiglitazone, a PPARγ agonist, also reduced the androgen levels without changing insulin levels, which suggests that PPARγ agonists may dampen the hyper-responsiveness of androgens to insulin [ 6 ].…”

Omega‐3 fatty acid supplements and recurrent miscarriage: A perspective on potential mechanisms and clinical evidence

“…However, the dose of these agents should be carefully adjusted. In terms of polycystic ovary syndrome, the currently recommended management includes improvement of dietary intake, more physical activities, and weight control (Akre et al, 2022). In addition, metformin is also recommended to assist in weight management and insulin resistance (Zhao & He, 2022).…”

The efficacy of Linum usitatissimum seeds to inhibit estrogen receptor as a natural therapy for PCOS: An in silico and in vitro analysis

“…Clomiphene citrate and tamoxifen both have previously been used as ESR inhibitors during the first half of the cycle as they regulate the level of estrogen and promote ovulation 28 . Clomid citrate (CC) has also been used as an antiestrogen, it increases the serum levels of gonadotropin releasing hormone (GnRH), which increases the level of follicle‐stimulating hormone (FSH) and lowers the estrogen 8,29 …”

“…For this purpose, estrogen receptor (ESR) inhibitors were analyzed, and they were proven to show the required results for the management of PCOS, which have been explained in this manuscript. 8 PCOS being an endocrine disorder, is largely influenced by estrogen and ESRs hence, the main aim of this study is to acknowledge the anti-estrogenic activity of the compounds from the natural origin, which can lead to ovulation and prevention of cyst formation in the same manner as clomiphene citrate and tamoxifen. 24 ESR also called transcription factor, belongs to a super family of receptors present in the nucleus.…”