Management of Polycystic Ovarian Syndrome: Looking Beyond the Ovaries

Polycystic Ovarian Syndrome (PCOS) is a complex metabolic and reproductive disorder, not just an ovarian issue. Insulin resistance, exacerbated by poor lifestyle choices, plays a key role in its pathogenesis. Diagnosis often uses the Rotterdam criteria, and management includes lifestyle interventions, hormonal contraceptives, anti-androgens, and insulin sensitizers like metformin and pioglitazone. Screening for cardiovascular disease, endometrial pathology, sleep apnea, and mental health disorders is crucial. For pregnancy, letrozole is preferred for ovulation induction. Inositols, especially Myo-inositol and D-chiro-inositol, show promise in improving ovulation, reducing hirsutism, aiding weight loss, and enhancing embryo quality in IVF. Treatment focuses on lifestyle changes and tailored pharmacologic therapies to address various symptoms and complications.