Polycystic ovary syndrome
August 2016
in “Nature Reviews Disease Primers”
TLDR Polycystic Ovary Syndrome (PCOS) is a common condition in women that can cause metabolic, reproductive, and psychological issues, and requires lifestyle changes and medication for management.
The document from 2016 provides a comprehensive overview of Polycystic Ovary Syndrome (PCOS), a condition affecting 5-20% of women of reproductive age, characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology. It discusses the associated metabolic dysfunctions such as insulin resistance, the increased risk of type 2 diabetes, gestational diabetes, and cardiovascular events, as well as the psychological impact, including depression and anxiety. The document also explores the genetic factors, with nearly 100 susceptibility genes identified, and the pathophysiological mechanisms, such as increased Anti-Müllerian Hormone (AMH) levels and Luteinizing Hormone (LH) hypersecretion. It emphasizes the importance of screening for metabolic and psychological morbidities, lifestyle interventions as the first-line treatment, and various pharmacological treatments for managing metabolic dysfunction and hyperandrogenism. The document also highlights the need for future research to understand the genotype-phenotype associations, underlying mechanisms, and the development of novel treatments for hirsutism and androgenic alopecia.
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Cited in this study
research Androgen excess: Investigations and management
The conclusion is that managing androgen excess requires long-term treatment, including hormonal contraceptives and androgen blockers, with follow-up after six months.
research Of PCOS Symptoms, Hirsutism Has the Most Significant Impact on the Quality of Life of Iranian Women
Excessive hair growth affects the quality of life of Iranian women with PCOS the most.
research The polycystic ovary syndrome: a position statement from the European Society of Endocrinology
The European Society of Endocrinology advises individualized long-term management for PCOS, focusing on lifestyle changes, accurate diagnosis, and treatments for associated health risks and symptoms.
research The prevalence of metabolic disorders in various phenotypes of polycystic ovary syndrome: a community based study in Southwest of Iran
Different types of PCOS have different levels of metabolic problems, with the most severe type showing the highest disturbances.
research Diagnosis and Treatment of Polycystic Ovary Syndrome: An Endocrine Society Clinical Practice Guideline
The guideline suggests using specific criteria to diagnose PCOS, recommends various treatments for its symptoms, and advises screening for related health issues.
research Androgen Profiling by Liquid Chromatography–Tandem Mass Spectrometry (LC-MS/MS) in Healthy Normal-Weight Ovulatory and Anovulatory Late Adolescent and Young Women
The research found that anovulatory young women have higher androgen and hormone levels than those who ovulate, suggesting immature hormonal regulation rather than a specific condition.
research Diabetes and cardiovascular events in women with polycystic ovary syndrome: a 20-year retrospective cohort study
Women with PCOS have a higher risk of diabetes and heart problems, especially when they get older.
research Consensus on women’s health aspects of polycystic ovary syndrome (PCOS): the Amsterdam ESHRE/ASRM-Sponsored 3rd PCOS Consensus Workshop Group
research Epidemiology, diagnosis and management of hirsutism: a consensus statement by the Androgen Excess and Polycystic Ovary Syndrome Society
Experts recommend using evidence-based methods to diagnose and treat hirsutism, focusing on symptoms and underlying causes.
research The Androgen Excess and PCOS Society criteria for the polycystic ovary syndrome: the complete task force report
The report concludes that PCOS is mainly a condition of excess male hormones and its definition may change as new information is discovered.
research Antiandrogens for the Treatment of Hirsutism: A Systematic Review and Metaanalyses of Randomized Controlled Trials
research Use of ethinylestradiol/drospirenone combination in patients with the polycystic ovary syndrome
research Assessment, diagnosis and treatment of a patient with hirsutism
research A systematic review of commonly used medical treatments for hirsutism in women
Certain medications including flutamide, spironolactone, and others effectively reduce excessive hair growth in women, especially when combined with lifestyle changes.
research Criteria for Defining Polycystic Ovary Syndrome as a Predominantly Hyperandrogenic Syndrome: An Androgen Excess Society Guideline
Polycystic Ovary Syndrome should be seen mainly as a condition of excess male hormones, with a focus on this in its definition.
research Metformin treatment of polycystic ovary syndrome improves health-related quality-of-life, emotional distress and sexuality
research Health Care-Related Economic Burden of the Polycystic Ovary Syndrome during the Reproductive Life Span
Polycystic ovary syndrome costs the U.S. over $4 billion a year, mainly from treating related health issues.
research Relative Safety and Efficacy of Finasteride for Treatment of Hirsutism
Finasteride reduces hirsutism effectively with fewer side effects but is a second-choice treatment due to safety concerns.
research Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS)
The 2003 consensus updated PCOS diagnosis criteria and linked PCOS to higher risks of diabetes and heart problems, recommending lifestyle changes to lower these risks.
research Topical Eflornithine
research A Prospective Randomized Trial Comparing Low Dose Flutamide, Finasteride, Ketoconazole, and Cyproterone Acetate-Estrogen Regimens in the Treatment of Hirsutism
Cyproterone acetate-estrogen most effective for hirsutism, but consider side effects and patient needs.