Current and future aspects of several adjunctive treatment strategies in polycystic ovary syndrome |
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| Affiliation: | 1. Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University and Monash Health, Locked Bag 29, Clayton, VIC 3168, Australia;2. Faculté de Médecine, Université de Lille, Lille, France;3. Department of Obstetrics and Gynaecology, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong Special Administrative Region, China;4. Department of Health Policy, Management, and Behavior, School of Public Health, University at Albany, SUNY, Albany, NY 12144, USA;5. Robinson Research Institute, University of Adelaide and Fertility SA, Adelaide, SA, Australia;6. Department of Endocrinology, Odense University Hospital, Clinical Institute, University of Southern Denmark, 5000 Odense C, Denmark;7. Imperial College London, Institute of Reproductive and Developmental Biology, Hammersmith Hospital, London W12 0NN, UK;8. Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, University of Rochester, Rochester, NY 14642, USA;9. Diabetes and Endocrine Units, Monash Health, Clayton, VIC 3168, Australia;10. Department of Pediatrics, Division of Endocrinology, Diabetes, and Metabolism, Columbia University Medical Center, New York, NY 10032, USA;11. Gynaecworld, Center for Women’s Health and Fertility, Maharashtra 400036, India;12. Huisartsenpraktijk Hohmann & De Vet, Rotterdam 3061, The Netherlands;13. PCOS Challenge, Inc., 931 Monroe Drive, NE Suite A-470 Atlanta, GA 30308, USA;14. Department of Endocrinology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Raebareli Road, Lucknow 226014, India;15. Division of Reproductive Medicine, Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, The Netherlands |
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| Abstract: | Polycystic ovary syndrome (PCOS) is a common endocrinopathy in women of reproductive age. PCOS is characterized by hyperandrogenism, menstrual disorders, and polycystic ovarian morphology. PCOS patients have an increased risk of type 2 diabetes, cardiovascular disease, and infertility. The mechanism of PCOS is not yet fully understood, but insulin resistance and genetic factors may play distinct roles in the pathomechanism.There is ongoing research on new therapeutic modalities for women with PCOS. In this minireview, we assessed the evidence for the effectiveness and safety of selected adjunctive agents (metformin, statins, resveratrol, melatonin, and inositols) for the treatment of women with PCOS. Metformin is a safe medication used in PCOS for 25 years that is currently recommended in select PCOS subpopulations, such as adolescents, women with metabolic disorders, and infertility infertile women undergoing ovarian hyperstimulation. Statins are also suggested in PCOS therapy, as these compounds decrease testosterone concentrations, improve lipid profiles, and ameliorate inflammatory reactions. Despite promising results, the role of statins in PCOS management needs to be further validated. Dietary supplements have also been tested in PCOS patients. Resveratrol was shown to decrease total testosterone production and improve fasting insulin but, until recently, only in one randomized study. Data on the therapeutic efficacy of melatonin and inositols on endocrine and metabolic abnormalities are limited and inconclusive. The multifactorial etiology of PCOS makes tailoring of its treatment more demanding, and there is a constant need for causative and effective modes of PCOS therapy. |
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| Keywords: | Polycystic ovary syndrome Metformin Statin Resveratrol Inositol |
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