Reconsidering PCOS Etiology, Diagnosis, Clinical Subgroups, and Subgroup-Specific Treatments

    January 2024 in “ Endocrine and metabolic science ”
    Vittorio Unfer, Eleni Kandaraki, Lali Pkhaladze, Scott Roseff, Mónica H. Vazquez‐Levin, Antonio Simone Laganà, C. Shiao-Yng, Maria Isidora Margarita Yap‐Garcia, Nicholas D. E. Greene, Christophe O. Soulage, Arturo Bevilacqua, Salvatore Benvenga, Lorenzo Di Bari, Basilio Pintaudi, Artur Wdowiak, Cesare Aragona, Zdravko Kamenov, Marialuisa Appetecchia, Giuseppina Porcaro, Imelda Hernández Marín, Fabio Facchinetti, Tony Tak Yu Chiu, O.A. Pustotina Pustotina, Olga Papalou, Maurizio Nordio, Tonino Cantelmi, Pietro Cavalli, Ivana Vučenik, Rosario D’Anna, Vittorio Unfer, Simona Dinicola, Saghar Salehpour, Annarita Stringaro, M Oliva, М. Т. Тугушев, Nikos Prapas, Mariano Bizzarri, Maria Salomè Bezerra Espinola, Cherubino Di Lorenzo, Ali Cenk Özay, John E. Nestler
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    TLDR Different types of PCOS need specific diagnosis methods and treatments.
    Polycystic Ovary Syndrome (PCOS) is a complex endocrine disorder affecting 10-13% of women of reproductive age, with four clinical subgroups (A, B, C, and D) identified. Subgroups A, B, and C are characterized by hyperandrogenism and metabolic irregularities such as insulin resistance, which affects around 75% of PCOS patients. Subgroup D lacks hyperandrogenic features and has a lower incidence of metabolic and endocrine issues, suggesting a solely ovarian pathogenesis. The document suggests that the current diagnostic criteria for PCOS should consider additional parameters such as insulin resistance and endometrial thickness. It also highlights the need for a more tailored therapeutic approach, especially for subgroup D, and calls for further research to refine diagnostic criteria and develop targeted treatments.
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