Polycystic Ovary Syndrome: Challenges And Opportunities

This document described the pathophysiological characteristics and treatment options for polycystic ovary syndrome (PCOS), the most common endocrine and metabolic disorder in women of reproductive age. PCOS was considered a multigenetic disorder influenced by environmental factors, with key features including hyperandrogenism, (oligo)anovulation, and polycystic ovarian morphology. Women with PCOS faced increased risks of glucose intolerance, type 2 diabetes, dyslipidemia, hypertension, and cardiovascular diseases, leading to reduced health-related quality of life and higher prevalence of depression, anxiety, psychosexual dysfunction, and eating disorders. Optimal treatment aimed to combine non-pharmacological measures, such as a hypocaloric diet and physical activity, with pharmacological treatments. First-line treatment for hyperandrogenism included combined oral contraceptives, with antiandrogens as a second line. Medroxyprogesterone acetate, levonorgestrel-releasing intrauterine systems, and combined oral contraceptives helped regulate menstrual cycles and protect against endometrial hyperplasia and cancer. Metformin was used for metabolic irregularities, while clomiphene citrate was the first line for inducing ovulation in anovulatory PCOS patients.