Polycystic Ovary Syndrome: Etiology, Current Management, and Future Therapeutics

February 2023 in “ Journal of Clinical Medicine ”

Samradhi Singh, Namrata Pal, Swasti Shubham, Devojit Kumar Sarma, Vinod Verma, Francesco Marotta, Manoj Kumar

polycystic ovary syndrome PCOS hyperinsulinemia hyperandrogenism gut microbiota dysbiosis probiotics prebiotics fecal microbiota transplant FMT miRNA therapy gut eubiosis gut bacteria imbalance gut health microRNA therapy

Studysummary This review discusses various potential risk factors and possible therapeutic interventions for polycystic ovary syndrome, including the modulation of gut microbiota, but reports no new findings.

Our plain-language summary. Not medical advice or a treatment recommendation. Consult a qualified healthcare professional before changing treatment. Full disclaimer

Polycystic Ovary Syndrome (PCOS) was a complex disorder influenced by genetic, environmental, and lifestyle factors, with gut dysbiosis playing a significant role in its pathophysiology. Key features included hyperandrogenism and hyperinsulinemia, contributing to symptoms like anovulation and infertility. Management strategies focused on lifestyle changes, such as low-glycemic-index diets and exercise, alongside pharmacological treatments like metformin and hormonal contraceptives. Emerging therapies included probiotics, prebiotics, fecal microbiota transplants, and miRNA therapy, which aimed to improve metabolic and reproductive outcomes. The document emphasized the importance of personalized treatment approaches and further research to enhance PCOS management.

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Research cited in this study

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research The Effects of Statins on Hyperandrogenism in Women with Polycystic Ovary Syndrome: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

17 citations , December 2021 in “Reproductive Biology and Endocrinology”

This study found that statin treatment significantly reduced androgen levels and improved symptoms of hyperandrogenism, such as hirsutism and acne, in women with polycystic ovary syndrome.

research Insulin Resistance and Elevated Androgen Levels: A Major Cause of Polycystic Ovary Syndrome

36 citations , October 2021 in “Frontiers in Endocrinology”

This study highlights the importance of understanding the roles of hyperandrogenemia and insulin resistance in the development and progression of PCOS, emphasizing further research to clarify their mutual influence.

research Nutrition Strategy and Lifestyle in Polycystic Ovary Syndrome: Narrative Review

49 citations , July 2021 in “Nutrients”

This review explores lifestyle modifications for women with polycystic ovary syndrome, discussing dietary, physical, and supplementation strategies, but reports no new clinical results.

research Risk of Polycystic Ovary Syndrome in Women Exposed to Fine Air Pollutants and Acidic Gases: A Nationwide Cohort Analysis

20 citations , November 2019 in “International Journal of Environmental Research and Public Health”

This study found that high exposure to air pollutants like SO2, NO, NO2, NOx, and PM2.5 was linked to a significantly increased risk of developing PCOS in women.

research Hyperandrogenism in Polycystic Ovarian Syndrome and Role of CYP Gene Variants: A Review

49 citations , November 2019 in “Egyptian Journal of Medical Human Genetics”

This review discusses the role of CYP gene polymorphisms in exacerbating hyperandrogenism in women with PCOS and reports no clinical results; further validation of this hypothesis is needed.

research The Mechanism of Androgen Actions in PCOS Etiology

30 citations , August 2019 in “Medical Sciences”

This review summarizes evidence suggesting that excess androgens play a key role in the origins of polycystic ovary syndrome, highlighting opportunities for developing targeted treatments.

research Obesity and Polycystic Ovary Syndrome: Implications for Pathogenesis and Novel Management Strategies

129 citations , January 2019 in “Clinical medicine insights”

This review discusses the mechanisms linking obesity and polycystic ovary syndrome and explores potential management options, but it presents no original research findings.

Differential Expression of miR-93 and miR-21 in Granulosa Cells and Follicular Fluid of Polycystic Ovary Syndrome Associating with Different Phenotypes

research Differential Expression of miR-93 and miR-21 in Granulosa Cells and Follicular Fluid of Polycystic Ovary Syndrome Associating with Different Phenotypes

54 citations , November 2017 in “Scientific Reports”

In this study, researchers observed that hyperandrogenic PCOS patients exhibited distinct miRNA and TGFβ signaling gene expression patterns in granulosa cells, suggesting these factors may play a role in PCOS pathogenesis.

research Intermittent Low-Dose Finasteride Administration Is Effective for Treatment of Hirsutism in Adolescent Girls: A Pilot Study

23 citations , February 2014 in “Journal of Pediatric and Adolescent Gynecology”

This study found that a low-dose intermittent finasteride regimen significantly reduced hirsutism scores in adolescent girls with PCOS or idiopathic hirsutism, with similar efficacy but potentially safer and less expensive than continuous administration.

research Polycystic Ovarian Syndrome: A Comprehensive Review of Symptoms, Diagnosis, and Management

27 citations , January 2013 in “Indian Journal of Dermatology, Venereology and Leprology”

This article explores the endocrine functions involved in the pathogenesis of polycystic ovarian syndrome and discusses approaches for diagnosing and managing the condition, with no new clinical results reported.

research Treatment Options for Polycystic Ovary Syndrome

514 citations , February 2011 in “International journal of women's health”

This review discusses treatments for various symptoms of polycystic ovary syndrome, including lifestyle changes, medical, and surgical interventions, but does not present new clinical results.

research Evaluation and Treatment of Hirsutism in Premenopausal Women: An Endocrine Society Clinical Practice Guideline

502 citations , February 2008 in “The Journal of Clinical Endocrinology & Metabolism”

This review discusses hirsutism management guidelines, recommending androgen testing only for women with abnormal hirsutism scores and advocating for combined therapy approaches depending on severity and underlying conditions, but it reports no new clinical results.

research Health Care-Related Economic Burden of Polycystic Ovary Syndrome During the Reproductive Life Span

414 citations , August 2005 in “The Journal of Clinical Endocrinology and Metabolism”

This study estimates the total cost of evaluating and treating polycystic ovary syndrome in reproductive-aged women in the United States to be $4.36 billion, suggesting more liberal screening could be beneficial.

research Revised 2003 Consensus on Diagnostic Criteria and Long-Term Health Risks Related to Polycystic Ovary Syndrome

4809 citations , January 2004 in “Fertility and Sterility”

This review discusses polycystic ovary syndrome, emphasizing its broad range of manifestations and associations with risks like type 2 diabetes and cardiovascular events, but reports no new clinical results.

research The Benefits of Finasteride for Hirsute Women with Polycystic Ovary Syndrome or Idiopathic Hirsutism

40 citations , January 2003 in “Gynecological Endocrinology”

This study found that finasteride significantly reduced hirsutism in women with idiopathic hirsutism or polycystic ovary syndrome over six months, suggesting its potential effectiveness for this condition.

Comparison of Spironolactone, Flutamide, and Finasteride Efficacy in the Treatment of Hirsutism: A Randomized, Double-Blind, Placebo-Controlled Trial

research Comparison of Spironolactone, Flutamide, and Finasteride Efficacy in the Treatment of Hirsutism: A Randomized, Double-Blind, Placebo-Controlled Trial

94 citations , January 2000 in “The Journal of Clinical Endocrinology and Metabolism”

This study found that spironolactone, flutamide, and finasteride are similarly effective in reducing hair diameter and Ferriman-Gallwey scores in women with hirsutism over a 6-month treatment period.

research Comparison of Spironolactone, Flutamide, and Finasteride Efficacy in the Treatment of Hirsutism: A Randomized, Double-Blind, Placebo-Controlled Trial

46 citations , January 2000 in “The Journal of Clinical Endocrinology and Metabolism”

A Prospective Randomized Trial Comparing Low Dose Flutamide, Finasteride, Ketoconazole, and Cyproterone Acetate-Estrogen Regimens in the Treatment of Hirsutism

research A Prospective Randomized Trial Comparing Low Dose Flutamide, Finasteride, Ketoconazole, and Cyproterone Acetate-Estrogen Regimens in the Treatment of Hirsutism

113 citations , April 1999 in “The Journal of Clinical Endocrinology and Metabolism”

This study found that all four treatments—flutamide, finasteride, ketoconazole, and EE-CPA—significantly reduced hirsutism, but EE-CPA and flutamide appeared most effective, with varying effects on androgen levels and side-effect profiles.