Background: Polycystic ovary syndrome (PCOS) is a frequent female reproductive endocrine disease.
It has been associated with a number of severe reproductive and metabolic abnormalities. However, there are still
open questions especially regarding the best long-term management.
Methods: We summarized the literature focused on the symptoms and negative long-term consequences of untreated
PCOS and the existing options for the treatment. We reviewed the Pubmed and China National Knowledge
Infrastructure databases and the relevant literature for the last 20 years. Included in this review also are new
results of own (published) research and own experience from treating daily more than 100 PCOS patients.
Results: Obesity is one of the most common findings. It can cause abnormal ovulations which can lead to infertility.
Important long-term consequences can be adverse pregnancy outcomes. There is an agreement that the risk of
endometrial cancer can be increased. Insulin resistance, important within the pathophysiology of PCOS, predisposes
patients to metabolic dysfunction and increased risk of type 2 diabetes mellitus. Lifestyle modifications
including dietary changes, exercise and weight loss are first-line interventions for many patients. Well known
drug treatments such as metformin, oral contraceptives, etc. should be selected according to the individual situation
and patients' needs. Regarding newer methods in the long-term management of PCOS, we found that orlistat
may help to achieve weight loss and to improve lipid and glucose metabolism.
Conclusion: In addition to pharmacological interventions, long-term standardized individualized management of
PCOS patients is needed to achieve fertility and to reduce the risk of metabolic related diseases.