Abstract
Polycystic ovary syndrome (PCOS) is a multifaceted condition characterized by chronic anovulation and excess ovarian activity, in contrast to other causes of anovulation that involve ovarian dormancy or primary insufficiency. Recent studies indicated that PCOS is associated with low-grade chronic inflammation and that women with PCOS are at increased risk of non-alcoholic fatty liver disease. The inflammatory and metabolic derangements associated with PCOS are explained in part by the coexistence of insulin resistance and obesity but are further fueled by the androgen excess. New insights into the regulation of hormones and cytokines in muscle and fat tissue support the concept that PCOS is a systemic syndrome. The therapeutic plan should be tailored to the patient phenotype, complaints, and reproductive desire. Of note, the aromatase inhibitor letrozole seems to be more effective than the reference drug clomiphene citrate to treat infertility due to PCOS. Integral management by a multidisciplinary team may help the patients to adhere to lifestyle interventions and thereby reduce body adiposity and recover their metabolic and reproductive health.
Highlights
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women, presenting with several possible combinations of signs and symptoms and a range of phenotypes, which may include reproductive, endocrine, and metabolic alterations
Summary and conclusions New insights into the cross-talk between muscle, fat, brain, and ovary tissue support the concept that PCOS is a systemic syndrome
The inflammatory and metabolic derangements associated with PCOS are explained in part by the coexistence of insulin resistance (IR) and obesity but are further fueled by the androgen excess
Summary
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women, presenting with several possible combinations of signs and symptoms and a range of phenotypes, which may include reproductive, endocrine, and metabolic alterations. The overall goals of therapy of women with PCOS include the mitigation of hyperandrogenic symptoms, management of metabolic abnormalities and reduction of risk factors for type 2 diabetes and cardiovascular disease, prevention of endometrial hyperplasia, planning and obtaining a safe pregnancy if desired, and improving general well-being and quality of life. These goals are ideally achieved by a multidisciplinary team providing patient-centered care (Figure 2). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript
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