Current Aspects of Polycystic Ovary Syndrome II: Treatment of Hyperandrogenism, Insulin Resistance, and Infertility

This document reviewed treatments for polycystic ovary syndrome (PCOS), focusing on hyperandrogenism, insulin resistance, and infertility. It emphasized that current treatments are not causal but aim to manage symptoms and prevent complications. Lifestyle changes, such as a 5-10% weight reduction, were noted to significantly improve outcomes. For hyperandrogenism, oral contraceptives with antiandrogenic properties and antiandrogens like cyproterone acetate and spironolactone were recommended, though combined contraceptives could increase venous thromboembolism risk. Metformin was highlighted as a primary therapy for insulin resistance due to its additional cardiovascular and anti-cancer benefits. Other insulin resistance treatments included thiazolidinediones, acarbose, GLP-1 agonists, and inositols. For infertility, clomiphene citrate, gonadotropins, IVF, and ovarian drilling were discussed, with a focus on preventing ovarian hyperstimulation syndrome and multiple pregnancies.