Polycystic Ovary Syndrome: A Contemporary Clinical Approach

Author(s): Jelica Bjekić-Macut*, Tamara Vukašin, Zelija Velija-Ašimi, Azra Bureković, Marija Zdravković, Zoran Andrić, Marija Branković, Slobodanka Crevar-Marinović, Tatjana Madić, Olivera Stanojlović, Danijela V. Milutinović, Sarantis Livadas, George Mastorakos

Journal Name: Current Pharmaceutical Design

Volume 27 , Issue 36 , 2021


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Abstract:

Polycystic ovary syndrome (PCOS) is a frequent endocrine disease in women during the reproductive period. It is considered a complex metabolic disorder with long-term metabolic, as well as reproductive consequences. Main pathophysiological pathways are related to the increased androgen levels and insulin resistance. Nowadays, genetic origins of PCOS are acknowledged, with numerous genes involved in the pathogenesis of hyperandrogenemia, insulin resistance, inflammation, and disturbed folliculogenesis. Rotterdam diagnostic criteria are most widely accepted and four PCOS phenotypes have been recognized. Metabolic abnormalities are more common in phenotypes 1 and 2. Women with classic PCOS are more obese and typically have the central type of obesity, more prevalently displaying dyslipidemia, insulin resistance, and metabolic syndrome that could be associated with an increased risk of cardiovascular complications during life. Heterogeneity of phenotypes demands an individualized approach in the treatment of women with PCOS. Metabolic therapies involve a lifestyle intervention followed by the introduction of insulin sensitizers including metformin and inositols, glucagon-like peptide 1 receptor agonists (GLP-1 RA), as recently sodium-glucose cotransporter-2 (SGLT2) inhibitors. The addition of an insulin sensitizer to the standard infertility therapy such as clomiphene citrate improves ovulation and pregnancy rates. Our current review analyzes the contemporary knowledge of PCOS etiology and etiopathogenesis, its cardiometabolic risks and their outcomes, as well as therapeutic advances for women with PCOS.

Keywords: Polycystic ovary syndrome, hyperandrogenism, insulin resistance, genetic abnormalities, metformin, GLP-1 RA, SGLT2 inhibitors.

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Article Details

VOLUME: 27
ISSUE: 36
Year: 2021
Published on: 18 January, 2021
Page: [3812 - 3820]
Pages: 9
DOI: 10.2174/1381612827666210119104721
Price: $95

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