The modern pathogenetic challenges of polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is one of the neuroendocrine syndromes in women of reproductive age. In the pathogenesis of its development a great importance is paid to the hormonal disbalance, metabolic changes, overweight and obesity, diabetes mellitus, insulin resistance, genetic factors, etc. Very often, PCOS is accompanied by infertility, cardiovascular risks, diabetes mellitus.The article is devoted to a review of modern scientific literature about the last researches devoted to the mechanisms of metabolic disorders which are connected with insulin resistance, overweight and obesity, also, with psychological disturbance and stress. The article describes the specific of psychological conditions in PCOS patients. On the basis of the analyzed scientific publications the connection between hormonal disbalance, psychological disorders, overweight, obesity and lipidogram parameters is presented.Also, the researches about gut and vaginal microbiota are described in this paper. The last studies demonstrate the significant changes of human microbiome in the development and course of polycystic ovary syndrome. The article presents the concepts of the difference in the composition of the gut and vagina microbiota in women with this neuroendocrine syndrome.The pathogenetic mechanisms of the role of the microbiota in the processes of PCOS pathogenesis, namely, the regulation of the immune response and inflammation processes in this pathology, are described. It has been shown that in women with PCOS there are differences in the microflora composition of the intestines, manifested by a decreased concentration of Lactobacillus and the presence of a variety of other microorganisms compared to the healthy women.Thus, the main pathogenetic links of PCOS development are closely connected with each other. That is why multimodal approaches for study of PCOS and for management of the patients with PCOS are extremely important.