Treatment strategies for women with polycystic ovary syndrome

Abstract

Polycystic ovary syndrome (PCOS) is a common endocrine disorder in women, and it is the main cause of infertility in women of reproductive age due to anovulation. PCOS also increases the risk of diseases such as cardiovascular disease and type 2 diabetes in women with this disorder. The mechanism of pathogenesis is not clear, as it may be related to heredity, the environment and internal embryonic factors; thus, the treatment strategies remain unclear. This review summarizes current treatments for PCOS worldwide. Lifestyle modification (LSM) is considered the first-line treatment, regardless of fertility status, without the addition of metformin. Oral contraceptive (OC) pills should be used as a first-line treatment for long-term management for patients with no reproductive requirements. For patients with fertility requirements, ovulation therapy is an effective treatment. For refractory ovulation disorders, patients can choose from among the latest treatments, including ovarian hippocampal signal path block theory, the theory of leptin, inositol treatment, bilateral ovarian drilling to stimulate ovulation and assisted reproductive technology. Because current treatments cannot cure PCOS, lifelong administration is still the mainstream method of management; however, the optimal treatment plan needs further research and exploration.

Inositols’ Importance in the Improvement of the Endocrine–Metabolic Profile in PCOS

“…In fact, 74% of patients with PCOS have cycles without ovulation. Moreover, approximately 30% of all infertility patients are non-ovulatory, and 90% of these conditions are caused by PCOS [2,70].…”

“…It has been demonstrated that PCOS is the most common cause of infertility in women during reproductive age [1]. Among the current treatments for PCOS, first-line therapies can be distinguished, such as lifestyle modification or oral contraceptive pills, as well as treatments for patients with ovulation disorders, including ovarian hippocampal signal path block theory, the theory of leptin, or inositol treatment [2]. The mechanisms of action for most of these methods are directional—with more of an impact on some PCOS symptoms and less on others.…”

Association between VEGF gene polymorphisms (11 sites) and polycystic ovary syndrome risk

“…If one woman exists one or more significant following five SNPs (rs699947, rs833061, rs1570360, rs3025020, rs3025039) for VEGF from peripheral blood test, which may indicate that it is possible to increase the occurrence of PCOS for her in present time or at some point in the future. Therefore, it can be offer us some targets to intervene, such as lifestyle modification (reducing the BMI, obesity, high blood pressure, high blood fat and cardiovascular disease) for prevention status, regular gynecological examination (vaginal ultrasound or CT scans or endocrinology) to identify or rule out this disease and carry out treatments as soon as possible (oral contraceptive therapy, ovulation induction, high testosterone therapy, insulin sensitizer, GLP-I receptor agonist therapy, surgical treatment) [42]. To sum up, we wish to use this method to reduce the incidence of PCOS and improve the cure rate of early treatment.…”

THADA_rs13429458 Minor Allele Increases the Risk of Polycystic Ovary Syndrome in Asian, but Not in Caucasian Women: A Systematic Review and Meta-Analysis

“…Women with PCOS have increased insulin resistance, and obesity aggravates insulin resistance and PCOS symptoms [4]. All treatments that reduce serum insulin levels and induce weight loss by lifestyle changes, bariatric surgery, metformin or thiazolidinedione, significantly diminish anovulation and hyperandrogenemia in PCOS patients [37,38]. However, it remains controversial [12].…”